Table 4.
Summary of findings from the studies that included statistical comparisons with respect to transmission of COVID-19 during specific AGMPs*
| AGMP | HCW role during AGMP | Author | Study design | Sample size | Odds ratioa (95%CI) |
|---|---|---|---|---|---|
| Airway Suctioning | Participated in | Nakagama [45] | Prospective cohort |
AGMP: n = 202 Control: n = 202 |
RR: 1.67(NR); p = 0.04 |
| NR; sputum suction | Ran [42] | Retrospective cohort |
AGMP: n = 11 Control: n = 61 |
RR: 0.43 (0.12 to 1.55) | |
| Performed or assisted, or present in room | Heinzerling [48] | Cohort |
AGMP: n = 7 Control: n = NR |
AGMP cases: 0 Control cases: NR p = 1.00 |
|
| NR | Chatterjee [28] | Case–control |
AGMP: n = 35 Control: n = 716 |
0.73 (0.37 to 1.45) | |
| Performed open suctioning | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.55 (0.3 to 1.01) | |
| Performed closed suctioning | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.89 (0.57 to 1.39) | |
| Broncho-Alveolar Lavage | Performed (> 5 times) | Lormans [36] | Cohort |
AGMP: n = NR Control: n = NR |
0.42 (0.05 to 3.53) |
| Bronchoscopy | NR | Ran [42] | Retrospective cohort |
AGMP: n = 1 Control: n = 71 |
RR: 0.63 (0.06 to 7.08) |
| Performed or assisted | Heinzerling [48] | Cohort |
AGMP: n = 3 Control: n = NR |
AGMP cases: 0 Control cases: NR p = 1.00 |
|
| Present in room | Heinzerling [48] | Cohort |
AGMP: n = 3 Control: n = NR |
AGMP cases: 0 Control cases: NR p = 1.00 |
|
| Performed rigid bronchoscopy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.256 (0.03 to 2.0) | |
| Witnessed/assisted rigid bronchoscopy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.09 (0.3 to 4.0) | |
| Performed | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.55 (0.3 to 1.03) | |
| Witnessed/assisted | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.7 (0.32 to 1.51) | |
| Performed | Caglayan [34] | Cross-sectional |
AGMP: n = 31 Control: n = 122 |
AGMP cases:3 Control cases:5 p = 0.21 |
|
| CPR | Participated in | Nakagama [45] | Prospective cohort |
AGMP: n = 13 Control: n = 202 |
RR: 1.94 (NR); p = 0.214 |
| NR | Ran [42] | Retrospective cohort |
AGMP: n = 1 Control: n = 71 |
RR: 0.63 (0.06 to 7.08) | |
| Performed | Celebi [29] | Case–control |
AGMP: n = 20 Control: n = 161 |
AGMP cases:6 Control cases:41 p = 0.629 |
|
| Advanced airway throughout | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.06 (0.5 to 2.25) | |
| No advanced airway at some point | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.32 (0.61 to 2.86) | |
| Extubation | NR | Ran [42] | Retrospective cohort |
AGMP: n = 1 Control: n = 71 |
0.63 (0.06 to 7.08) |
| Performed | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.55 (0.25 to 1.24) | |
| Witnessed or assisted | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.29 (0.68 to 2.47) | |
| Intubation/Extubation | Participated in | Nakagama [45] | Prospective cohort |
AGMP: n = 21 Control: n = 202 |
RR: 0.8 (NR); p = 1 |
| Intubation | Performed or assisted | Heinzerling [48] | Cohort |
AGMP: n = 2 Control: n = NR |
AGMP cases: 1 Control cases: NR p = 0.16 |
| Present in room | Heinzerling [48] | Cohort |
AGMP: n = 1 Control: n = NR |
AGMP cases: 0 Control cases: NR p = 1.00 |
|
| Performed (> 1 time) | Lormans [36] | Cohort |
AGMP: n = NR Control: n = NR |
0.23 (0.03 to 1.98) | |
| Performed or present in room | Celebi [29] | Case–control |
AGMP: n = 27 Control: n = 154 |
AGMP cases:6 Control cases:41 p = 0.705 |
|
| NR | Chatterjee [28] | Case–control |
AGMP: n = 31 Control: n = 720 |
2.5 (1.13 to 5.5) | |
| Performed | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.73 (0.38 to 1.37) | |
| Witnessed or assisted | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.74 (0.44 to 1.26) | |
| Manual Ventilation | Participated in | Nakagama [45] | Prospective cohort |
AGMP: n = 19 Control: n = 202 |
RR: 3.1(NR); p = 0.008 |
| Performed or assisted, or present in room (BiPAP, CPAP) | Heinzerling [48] | Cohort |
AGMP: n = 6 Control: n = NR |
AGMP cases: 2 Control cases: NR p = 0.06 |
|
| Performed or assisted, or present in room | Heinzerling [48] | Cohort |
AGMP: n = 3 Control: n = NR |
AGMP cases: 1 Control cases: NR p = 0.23 |
|
| Adjusted NIPPV mask | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.6 (0.38 to 0.95) | |
| Present during use of NIPPV | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.71 (0.49 to 1.04) | |
| Mechanical Ventilation | Present in room | Celebi [29] | Case–control |
AGMP: n = 42 Control: n = 139 |
AGMP cases:9 Control cases:38 p = 0.484 |
| Nebulizer | Administration | Nakagama [45] | Prospective cohort |
AGMP: n = 8 Control: n = 202 |
RR: 1.05(NR); p = 1 |
| Sputum induction | Nakagama [45] | Prospective cohort |
AGMP: n = 12 Control: n = 202 |
RR: 2.8(NR); p = 0.055 | |
| Performed or assisted, or present in room | Heinzerling [48] | Cohort |
AGMP: n = 5 Control: n = NR |
AGMP cases: 2 Control cases: NR p = 0.04 |
|
| Present during delivery | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.11 (0.69 to 1.8) | |
| Oxygen administration | Applied or adjusted patient's HFNC | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.98 (0.65 to 1.47) |
| Present during use | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.05 (0.74 to 1.47) | |
| Tracheostomy | Oxygen supplementation via tracheostomy | Nakagama [45] | Prospective cohort |
AGMP: n = 63 Control: n = 202 |
RR: 1.07 (NR); p = 0.83 |
| Exposed to with any role (first operator, fiberoscopist, instrumental nurse, or anesthesia nurse) | Rosano [38] | Cohort |
AGMP: n = 91 Control: n = 52 |
AGMP cases:7 Control cases:6 p = 0.55 |
|
| Performed open tracheostomy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
1.04 (0.21 to 5.03) | |
| Witnessed or assisted open tracheostomy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.99 (0.27 to 3.58) | |
| Performed percutaneous tracheostomy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.45 (0.06 to 3.63) | |
| Witnessed or assisted percutaneous tracheostomy | Lentz [32] | Case–control |
AGMP: n = NR Control: n = NR |
0.78 (0.22 to 2.72) |
Bolded estimates represent statistically significant results (p < 0.05). Details pertaining to patients and settings and studies that only reported count data but no statistical comparisons can be found in Table 2
AGMP aerosol-generating medical procedure; CI confidence interval; HCW healthcare worker; HFNC high flow nasal cannula; NIPPV noninvasive positive-pressure ventilation; NR not reported; RR risk ratio
aUnadjusted Odds Ratio and 95% confidence interval unless otherwise specified