Evidence map›Paper›PMID 33737418›Full record

SynthesisBMJ open2021

Risk of dispersion or aerosol generation and infection transmission with nasopharyngeal and oropharyngeal swabs for detection of COVID-19: a systematic review.

Arnav Agarwal, Shannon M Fernando, Kimia Honarmand, Layla Bakaa, Sonia Brar, David Granton, Dipayan Chaudhuri, Devin Chetan, Malini Hu, John Basmaji and 12 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Arnav AgarwalDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-0931-7851
Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0003-4549-4289
Kimia HonarmandDivision of Critical Care, Department of Medicine, Western University, London, Ontario, Canada.ORCID http://orcid.org/0000-0002-7583-1445
Layla BakaaFaculty of Science, McMaster University, Hamilton, Ontario, Canada.
Sonia BrarSchool of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York, USA.
David GrantonMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Dipayan ChaudhuriDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Devin ChetanDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Malini HuMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
John BasmajiDivision of Critical Care, Department of Medicine, Western University, London, Ontario, Canada.
Fiona MuttalibCenter for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
Bram RochwergDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Neill K J AdhikariDepartment of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Francois LamontagneCentre de recherche due CHU de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Srinivas MurthyFaculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
David S HuiDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong.ORCID http://orcid.org/0000-0003-4382-2445
Charles D GomersallDepartment of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Shatin, Hong Kong.
Samira MubarekaDivision of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada.
Janet DiazPacific Medical Center, San Francisco, California, USA.
Karen Ea BurnsInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Rachel CoubanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Per O VandvikMAGIC Evidence Ecosystem Foundation, Oslo, Norway per.vandvik@gmail.com.

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectivesSARS-CoV-2-related disease, referred to as COVID-19, has emerged as a global pandemic since December 2019. While there is growing recognition regarding possible airborne transmission, particularly in the setting of aerosol-generating procedures and treatments, whether nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 generate aerosols remains unclear.

designSystematic review. DATA SOURCES: We searched Ovid MEDLINE and EMBASE up to 3 November 2020. We also searched the China National Knowledge Infrastructure, Chinese Medical Journal Network, medRxiv and ClinicalTrials.gov up to 29 March 2020. ELIGIBILITY CRITERIA: All comparative and non-comparative studies that evaluated dispersion or aerosolisation of viable airborne organisms, or transmission of infection associated with nasopharyngeal or oropharyngeal swab testing.

resultsOf 7702 citations, only one study was deemed eligible. Using a dedicated sampling room with negative pressure isolation room, personal protective equipment including N95 or higher masks, strict sterilisation protocols, structured training with standardised collection methods and a structured collection and delivery system, a tertiary care hospital proved a 0% healthcare worker infection rate among eight nurses conducting over 11 000 nasopharyngeal swabs. No studies examining transmissibility with other safety protocols, nor any studies quantifying the risk of aerosol generation with nasopharyngeal or oropharyngeal swabs for detection of SARS-CoV-2, were identified.

conclusionsThere is limited to no published data regarding aerosol generation and risk of transmission with nasopharyngeal and oropharyngeal swabs for the detection of SARS-CoV-2. Field experiments to quantify this risk are warranted. Vigilance in adhering to current standards for infection control is suggested.

Indexed as

AerosolsCOVID-19COVID-19 TestingHumansInfection ControlNasopharynxOropharynxPandemicsAerosolsDiagnostic microbiologyInfection controlPublic health

Identifiers

PMID33737418
PMCPMC7977073

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.