Table 1.
Study characteristics and COVID-19 IPC measures implemented in hospital and other healthcare settings.
| Scheme | Design | Country | Setting | Population | Quality Score/4 a | Infection Prevention and Control Measures |
|---|---|---|---|---|---|---|
| [32] | Prospective Cohort Study | India | Hospital | Residents (n = 5), lab technicians (n = 10), nursing orderlies (n = 3) | 2 | In-house, homemade tools for standard operating procedures: face masks, OT gowns |
| [29] | Prospective Cohort Study | Canada | Hospital and nursing home residences | HCWs+ (n = 30) | 3 | Home-based 7-day control strategy for exposed HCWs, asymptomatic RT-PCR testing |
| [57] | Retrospective Cohort Study | Italy | Teaching hospital | Patients and HCWs (n = 103) | 2 | Nasal swab qPCR and IgG/IgM antibodies testing |
| [62] | Prospective Observational Study | Italy | Hospital | HCWs (n = 7595) | 3 | Separated and dedicated COVID areas, multiple hand hygiene installations, PPE, training protocols, implementation of surveillance system |
| [30] | Prospective Cohort Study | Korea | Hospital | HCWs and patients (n = 142) | 3 | Universal screening programme |
| [80] | Modelling Study | USA | Healthcare facilities | Residents and HCWs (n = 100) | LRB b | Routine asymptomatic PCR testing |
| [31] | Prospective Cohort Study | Korea | Hospital setting | HCWs (n = 317) | 2 | Contact tracing |
| [63] | Prospective Observational study | Canada | Tertiary care centre | HCWs (cohort 1: n = 1669, cohort 2: 4107, cohort 3: n = 1597) | 3 | Symptomatic/asymptomatic nasopharyngeal swab PCR testing |
| [65] | Prospective Observational Study | UK | Hospital setting | Staff (n = 10,034) | 3 | Naso-/oropharyngeal swab and/or immunoassay IgG testing; contact tracing |
| [75] | Mathematical Modelling | UK | n/A | Not reported | LRB b | Estimate of PCR test sensitivity, sensitivity and specificity of IgG antibody test, positive predictive value of a positive antibody test |
| [73] | Surveillance Study | Taiwan | Hospital | HCWs (n = 374) | 3 | Online body temperature surveillance, outbreak investigation and management, advising HCWs not to travel |
| [34] | Prospective Descriptive Study | Vietnam | Hospital laboratory Setting | Staff members (n = 32) | 2 | Risk assessment and management, laboratory training program, self-reporting and electronic reporting of COVID-19 symptoms, PPE stock monitoring system |
| [33] | Prospective Seroprevalence Study | Germany | Hospital setting | Clinical and non-clinical MRI staffs (n = 6305), and medical students (n = 1699) | 3 | PPE; PCR testing for SARS-CoV-2, anti-SARS-CoV-2 IgG and IgM testing |
| [79] | Modelling | USA | Hospital | HCW’s (n = 1350) | LRB b | Nasopharyngeal samples |
| [35] | Prospective Cohort Study | UK | Teaching hospital | HCWs (n = 360) | 3 | Symptomatic/asymptomatic HCW screening |
| [67] | Outbreak Investigation Report | Germany | Maternity and Perinatal centre | Not reported | 2 | Extensive testing; universal face masks; central monitoring of sick leaves; measures to ensure social distancing; continuous on-site visits by hygiene experts and staff training |
| [36] | Prospective Cohort Study | California, USA | Skilled nursing facility | Hospital staff and residents (n = 725) | 2 | Targeted testing: point prevalence surveys. |
| [56] | Retrospective Cohort Study | Korea | Hospital setting | Patients and HCWs (n = 2924) | 2 | Nasopharyngeal and oropharyngeal swabs, surveillance of people with contact history with confirmed COVID-19 patients. |
| [68] | Outbreak Investigation Report | Germany | Tertiary university hospital | HCWs (n = 432) | 3 | Quarantine of positive HCWs, containment measures including surgical masks; physical distancing, and systematic testing. |
| [48] | Cohort Study | China | Tertiary hospital | Patients (n = 1860) | 2 | Hospital layout adjustments, specialized training, pre-testing and triage, environmental cleansing, PPE |
| [23] | Cross-Sectional | France | Hospital | HCW’s (n = 314) | 1 | Nasal swab testing, self-isolation, and masks |
| [39] | Prospective Cohort Study | Belgium | Hospital | HCWs (n = 699) | 2 | SARS-CoV-2 RNA and anti-SARS-CoV-2 IgG antibodies testing |
| [27] | Case-Control study | International | n/A (online survey) | HCWs (n = 1130) | 1 | Use of respirators for aerosol generating procedures (AGP); PPE use and training |
| [25] | Cross-Sectional | Finland | Tertiary hospitals | HCWs (n = 1072) | 1 | Social distance of 1 m |
| [44] | Prospective Cohort Study | Italy | Hospital | HCWs (n = 5750) | 2 | Contact tracing, reinforced hygiene practices, PPE, education, and signage |
| [70] | Post hoc Analysis of a Randomized Controlled Trial | Vietnam | Hospital | HCWs (n = 607) | 3 | Washing method for cloth masks |
| [37] | Prospective Cohort Study | Germany | Hospital | Hospital staff (n = 1185) | 3 | Low-threshold SARS-CoV-2 testing facility |
| [26] | Cross-Sectional Study | Spain | Hospital setting | Hospital Workers (n = 2963) | 2 | Use of PPE |
| [74] | Surveillance Study | Italy | Hospital setting | Staff and residents under contract working (n = 5942) | 3 | Mass screening (oropharyngeal and nasopharyngeal swabs) with/without contact tracing |
| [77] | Mathematical Modelling Studies | International | Healthcare setting | HCWs (n = 224) | LRB b | Surveillance |
| [78] | Modelling Study | USA | Hospital setting | Hospital Workers (n = 53,000, number of hospital workers in the US) | LRB b | Use of PPE in all healthcare workers. Use of PPE only in high-risk workers. Restricting age of workers < 60 y; restricting age of workers < 50 y |
| [40] | Prospective Cohort Study | UK | Teaching hospital | HCWs (n = 1032), symptomatic HCW’s (n = 169), symptomatic household contacts (n = 52) | 3 | Asymptomatic screening using real-time RT-PCR Symptomatic screening using real-time RT-PCR Symptomatic screening of household contacts |
| [38] | Prospective Cohort Study | USA | Electrophysiology unit | Staff (n = 912) and patients (n = 758) | 2 | Universal asymptomatic testing for patients, caregivers, staff, and emergency medical service staff |
| [41] | Prospective Cohort Study | USA | 2 Community hospitals | HCWs (n = 21,014) | 1 | Universal masking |
| [42] | Prospective Cohort Study | Italy | Hospital | HCWs (n-2611) | 1 | PPE and sanitation guidelines implemented, epidemiological investigation and contact tracing of high-risk HCWs, symptomatic swab testing |
| [60] | Prospective Observational Study | Italy | 2 Large hospitals | HCWs (6800) | 3 | Contact tracing and testing of close contacts; random testing |
| [43] | Prospective Cohort Study | Japan | Hospital setting | HCWs (n = 49) | 1 | PPE (90% compliance) |
| [71] | Short-Term Prospective Study | Germany | Tertiary care centre | Staff (n = 1253) | 3 | Multimodal infection control: strict barrier nursing of known COVID-19 patients, including full PPE, visitor restrictions, universal face masks, universal RT-PCR admission screening of patients |
| [54] | Retrospective Cohort Study | Korea | Healthcare setting | Hospital staff (n = 87) and patients (n = 224) | 3 | Outbreak investigation surveillance |
| [55] | Retrospective Cohort Study | USA | Hospitals | HCWs (n = 9850) | 3 | Universal masking for HCWs |
| [45] | Prospective Cohort Study | USA | Hospital | HCWs (n = 832) | 3 | Universal face mask policy |
| [47] | Prospective Cohort Study | Singapore | Hospital | HCWs (n = 1642) | 3 | Enforcing reporting of HCWs with acute respiratory illness (ARI) to staff clinic for monitoring; ongoing syndromic surveillance; outbreak investigation and management |
| [61] | Prospective Observational Study | Singapore | Hospital | HCWs (n = 13,066) | 3 | Multi-tiered infection control strategy: improved patient segregation and distancing, heightened infection prevention and control measures including universal masking, testing of all symptomatic patients |
| [64] | Prospective Observational Study | Singapore | Hospital | Staff (n = 253) | 3 | Contact tracing; 14-day phone surveillance and 28-day follow-up of close contacts; testing of symptomatic contacts |
| [46] | Prospective Cohort Study | Malaysia | Hospital | HCWs (n = 400) | 2 | Full PPE, which includes an N95 mask, an isolation gown, gloves, eye protection and a head cover when providing care to patients under investigation or confirmed COVID-19 patients, and anti-SARS-CoV-2 antibodies serological tests |
a Studies scored from 1 to 4 according to experimental design, total study population reported, PCR testing used, and follow-up time reported. Cross-sectional studies automatically scored 1 due to their high risk of bias. b LRB = Low risk of bias according to Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) + HCW = Healthcare worker.