Table A3.

Studies on the safety-related aspects of the COVID-19 pandemic.

No.	Reference	Safety dimension*	Method of study	Key message/finding	Key recommendations
1	Devaux et al. (2020)	Medical	Preliminary trials	-Encouraging evidence for the effectiveness of chloroquine as COVID-19 treatment	-N.A.
2	Liu et al. (2020a)	Medicine	Limited clinical trials	-Evidence that Hydroxychloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro	-N.A.
3	Chen et al. (2020d)	Medicine	Vaccine strategies related to SARS-CoV	-Reviewing the previous SARS-CoV vaccine developments efforts	-Multiple vaccine strategies need to be advanced quickly and then evaluated for safety and efficacy -Safety studies to mitigate undesired risks will be the biggest time hindrance
4	Cortegiani et al. (2020)	Medicine	Existing medical evidence and ongoing clinical trials	-Reviewing efficacy and safety of chloroquine for COVID-19 treatment	-There is enough evidence to justify clinical trials for chloroquine in patients with COVID-19 -Urgent need for safety data and data from clinical trials
5	Chang et al. (2020)	Blood	Relevant publications on previous coronaviruses	-There is a theoretical risk of transmission of coronaviruses through the transfusion of labile blood products	-Discussing pathogen inactivation methods in Coronaviruses
6	Dodd and Stramer (2020)	Blood	Relevant publications on previous coronaviruses	-Public health messages are generally complied with even by those who do not trust the government -Evaluating the possibilities of transfusion transmission in relation to COVID-19	-Outlining key questions in order to determine whether blood safety intervention is needed
7	Schwartz and Graham (2020)	Pregnancy	Evidence from SARS and other Coronavirus Infections	-Limited experience with Coronavirus infections during pregnancy -Assessing the potential of the 2019-nCoV to cause maternal, fetal and neonatal morbidity	-Recommendations for consideration of pregnant women in the design of clinical trials
8	Chen et al. (2020a)	Pregnancy	Retrospective review of medical records	-Limited data are available for pregnant women with COVID-19 pneumonia -Evaluating clinical characteristics of COVID-19 in pregnancy and the potential for vertical transmission -No neonatal asphyxia observed in newborn babies	-Public health messages are generally complied with even by those who do not trust the government -The similarity between clinical characteristics of COVID-19 pneumonia in pregnant women and those for non-pregnant adults -No evidence of vertical transmission for women in late pregnancy
9	Rasmussen et al. (2020)	Pregnancy	Evidence from similar pathogenic coronaviruses	-Limited data available about coronavirus disease 2019 during pregnancy -No evidence of in utero transmission observed in severe acute respiratory syndrome or Middle East respiratory syndrome	-Coronavirus disease 2019 might increase the risk for pregnancy complications -Outlining principles of management of COVID-19 in pregnancy
10	Topalidou et al. (2020)	Pregnancy	Synthesising the scientific literature	-Reviewing clinical and psychological impacts of COVID-19 on perinatal women and their infants	-Lack of enough scientific evidence on issues surrounding pregnancy and labouring
11	Chen et al. (2020b)	Pregnancy, Surgery	Retrospective review of patients’ records	-Excessive incidences of hypotension during epidural anesthesia for COVID-19 patients undergoing Caesarean	-Evaluating safety and efficacy of different anesthetic regimens for COVID-19 patient during Cesarean delivery
12	Givi et al. (2020)	Surgery	Review of the literature and communication with physicians with firsthand experience of treating COVID-19 patients	-Head and neck surgeons who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures are at high risk of contracting the disease	-Safety recommendations for evaluation and surgery of head and neck for COVID-19 patients
13	Kang et al. (2020b)	Pregnancy, Surgery	Medical practice experience in China	-Anesthesia management in cesarean section for patients with coronavirus disease 2019	-Discussing protection of medical staff and psychological intervention for the patients during the operation
14	Fadel et al. (2020)	Occupational	N.A.	-Highlighting the role of companies and businesses in crisis management	-A list of recommendations for companies to decrease the biological and psychological risk to their employees during the epidemic
15	Chen et al. (2020e)	Occupational	Clinical practice in West China Hospital	-Discussing clinical safety measures including patient screening, respiratory precautions and telemedicine consultations	-The importance of having in place policies for infection control in every dermatology clinic
16	Cheung et al. (2020)	Occupational	Clinal practice in Hong Kong	-Aerosol generating procedures is a high-risk activity for healthcare professionals exposing them to contracting the infection	-Outlining an approach for managing staff health risks during aerosol generating procedures
17	Ambigapathy et al. (2020)	Occupational	N.A.	-The importance of the correct user of PPE by the GP’s	-The correct use of PPE will help GPs balance between personal safety and appropriate levels of public concern
18	Greenhalgh et al. (2020)	Transport & visit	Evidence from randomised trials	-Evaluating suitability of video consultation and the challenges involved -Overall high patient satisfaction, no difference in disease progression and lower costs associated with video consultations	-The need for revisiting these evaluations for patients with acute symptoms
19	Liew et al. (2020)	Transport & visit	Evidence from influenza pandemic	-Highlighting potential breaches of infection control during episodes of patient transport outside isolation occur -Outlining patient transport issues for COVID-19	-The importance of planning safe patient transport for suspected or confirmed cases -Recommendations for inter-hospital and intra-hospital transfer of patients or suspected cases
20	Kooraki et al. (2020)	Laboratory, Occupational	N.A.	-Reviewing precautionary and safety measures for radiology department personnel to manage patients with known or suspected COVID-19 infections	-The need for implementation of robust plans by the radiology departments to prevent further transmission
21	Nie et al. (2020)	Laboratory	Laboratory tests	-High infectivity and pathogenicity of SARS-CoV-2 pseudo-virus requires that it be handled in biosafety level 3 facilities, and this has hindered the development of anti-viral measures	-Developing a series of pseudo-virus-based neutralisation assays and protocols for SARS-COV-2 which are safer and can be handled in biosafety level 2 facilities
22	Shariatifar and Molaee-aghaee (2019)	Food	N.A.	-Highlighting the possibility of mass transmission during food packaging and preparedness	-Recommendations for both producers and consumers on how to mitigate the risk infection through food
23	Yuan et al. (2020)	Food	Epidemiological evidence related to SARS and COVID-19 outbreaks	-Analysing the association of the SARS and COVID-19 outbreaks with wildlife diet in China	-Suggestions for regulating wildlife conservation and food safety to prevent human exposure to novel viruses
24	Bachireddy et al. (2020)	Social	N.A.	-The importance of the Medicaid programs as a public social safety net in the US during the epidemic	-A list of measures by which Medicaid programs can help reduce the spread of the virus and aid the healthcare system in the US
25	Jun et al. (2020)	Occupational, Mental	Evidence from previous epidemics	-The importance of taking suicide prevention measures among healthcare professionals during the epidemic	-Provision of adequate PPE, prior training, adequate sleep and nutrition could help mitigate the rate of suicide among doctors and nurses -The benefits of maintaining healthcare reserve corps, or utilising the expertise of the military staff to mitigate the workload of clinicians -The importance of maintaining shared social identity among healthcare professionals
26	Wang et al. (2020a)	Mental	Survey the general public in China	-More than half of respondents rated psychological impact of the outbreak as moderate to severe -Female gender, student status and poor self-rated health associated with higher anxiety, depression and stress levels	-N.A.
27	Shigemura et al. (2020)	Mental	Evidence from previous pandemics and public emergencies	-Overwhelming and sensational news headlines and images add to public anxiety and fear -Fear of the unknown elevates anxiety in healthy individuals and those with pre-existing mental conditions	-The importance of providing mental support particularly for those who are most exposed to prevent adverse consequences such as suicide
28	Li et al. (2020)	Mental	Analysis of social media feed (A Chinese microblogging website)	-An increase in negative emotions and sensitivity to social risks and a decrease in scores of positive emotions and life satisfaction after the outbreak	-The need for governments to plan to fight against the negative mental consequences of the outbreak
29	Alves et al. (2020)	Mental	N.A.	-During self-isolation women living in rural areas are at a heightened risk of domestic violence -Pandemic restrictions tend to aggravate family tensions	-The need to promote strategies to protect women particularly in households with the history of family violence
30	Van Bavel et al. (2020)	Mental	Evidence from a selection of research topics relevant to pandemics	-Distancing could aggravate feelings of loneliness and cause long-term health consequences -Stress caused by self-isolation could impact on the immune system -Older adults who are at greater risk are also more susceptible to these effects	-The importance of differentiating between loneliness and isolation -The use of a better term such as “physical distancing” rather than “social distancing” -The importance of maintaining social connectivity while keeping physically apart -Cautioning against the passive use of social media
31	Greenberg et al. (2020)	Mental, Occupational	N.A.	-The possible mental impact of moral injury on healthcare professionals -Moral injury can potentially lead to depression, PTSD or even suicide	-Listing several potential mechanisms that can help mitigate the negative impact of moral injury
32	Wang et al. (2020b)	Mental	Evidence from previous outbreaks	-Post-traumatic stress score could be significantly higher in children who were quarantined than children who were not	-Considering the potential impact of prolonged school closure on children mental health -Recommendations to mitigate mental health impact on children at the level of government, parents, schools and communities
33	Ornell et al. (2020)	Mental	Survey of recommendations from WHO and the US Centre for Disease Control and Prevention	-During the pandemic, fear increases anxiety level of healthy individuals and intensifies the symptoms of those with pre-existing psychiatric disorders	-The need to implement public mental health policies along with clinical response strategies, during and after the crisis -A list of mental health recommendations at the level of governments, individuals, social groups and medical facilities
34	Barari et al. (2020)	Mental	Public survey of Italian population sample	-Public health messages are generally complied with even by those who do not trust the government -Compliance slightly lower among young adults -The quarantine restrictions have had serious mental impact	-Public communication should focus on how people can cope better with home quarantine -The need for behavioural interventions to help people cope better with the crisis

*Medicine = “medicine, treatment and vaccine safety”, Blood = “blood safety”, Pregnancy = “pregnancy safety”, Surgery = “surgery and anesthetic safety”, Occupational = “occupational safety of healthcare workers”, Transport & visit = “patient transport and visit safety”, Laboratory = “biosafety of laboratories and facilities”, Food = “food safety”, Social = “Social public safety”, Mental = “mental/psychological health and domestic safety”.