American University of Beirut

New COVID-19 studies co-led by AUB researchers and commissioned by WHO impact policy and receive global attention

​​​​​​​​​​​Sally Abou Melhem, Office of Communications​​

The “COVID-19 Systematic Urgent Reviews Group Effort (SURGE) group, " co-lead by researchers at AUB's Clinical Research Institute (CRI)​ along with researchers from McMaster University in Canada, undertook three rapid systematic reviews commissioned by the World Health Organization (WHO), on the following topics: Ventilation techniques; physical distancing, face masks, and eye ​protection; and safe management of bodies of deceased persons with COVID-19.

The first study found indirect and low-certainty evidence suggesting that noninvasive ventilation, similar to invasive mechanical ventilation (IM), probably reduces mortality in patients with COVID-19 but may increase the risk for transmission of to health care workers.

The second study found a reduced risk of infection with physical distancing of 1 meter or more (and a larger risk reduction with 2 m or more); the use of face masks (with a larger reduction with N95 compared to surgical masks), and eye protection (e.g., goggles or face shields).

The study on safe management of bodies of deceased persons with suspected or confirmed COVID-19, synthesized data from 23 guidance documents providing practical advice on the steps of handling the bodies: preparation, packing, transport to storage site, storage, viewing, embalming, burial, cremation and other measures. The advice related to both the handling of the dead bodies and the use of personal protective equipment by individuals handling them.

The three studies were published in top ranked medical journals including The Lancet and the Annals of Internal Medicine, and attracted the attention of international media outlets such as CNN, ABC News, The Guardian, and NBC News. While the WHO used all studies to guide its recommendations, the study on use of face masks has received intense media coverage and has led the World Health Organization to broaden its indications for use of masks among healthcare workers and the public.

“This is yet another proof that AUB is an institution of international caliber and its researchers were able to promptly rise to the occasion and impact the management at a global level of once in a lifetime crisis," stated Dr. Elie Akl, the director of the CRI.

The team
The SURGE group is composed of 40 clinicians and experts in systematic review methods. Group members from AUB include Dr. Fatimah Chamseddine, Amena El-Harakeh, , Rayane El Khoury, Dr. Tamara Lotfi, Dr. Assem M Khamis, and Zahra Saad (CRI team members); Layal Hneiny (information specialist); Dr. Imad Bou Akl and Dr. Nesrine Rizk (content experts); Joanne Khabsa and Sally Yaacoub (team coordinators); and Dr. Elie Akl (team leader).

“We were able to finish in six weeks what typically requires one or two full years of work", stated Dr. Akl. He added that “having a large number of collaborators from different time zones allowed for working around the clock in order to urgently achieve these reviews, with an average of 10 days per review. The CRI team was simply exceptional in terms of skills, dedication, hard work and professionalism.". 

More on CRI and AUB COVID-19 research
The Clinical Research Instit​ute (CRI) was stablished in 2010 to provide the required infrastructure to support and promote innovative clinical research and collaborative activities at AUB's Faculty of Medicine and its medical center, thus leading to discoveries, advancement of clinical practice, and improvement in patient care outcomes. ​

“At the Faculty of Medicine level, the CRI has supported and encouraged COVID-19 research through regularly sharing grant opportunities with faculty members, running a series of five free CRI E-workshops, and working very closely with faculty members on their COVID-19 research," Dr. Akl said.

“At the AUB level, the CRI contributed to the launching of two university wide initiatives: the AUB COVID-19 Research Response Portal and the AUB COVID-19 Research Brown Bag Series. The purpose of these two initiatives is to stimulate collaborative research on COVID-19 across AUB campus," Akl added.

In addition, members of the CRI team acted as methodologists for a WHO rapid guidance on the use of chest imaging in the diagnosis and management of COVID-19. In addition, Dr. Akl, as a member of the American College of Physicians (ACP)'s Scientific Medical Policy Committee (SMPC), contributed to two practice guidelines on the use of hydroxychloroquine and on the use of N95 respirators, surgical masks, and cloth masks in community and healthcare settings. The guidelines are being published in the Annals of Internal Medicine.​

AUB, and through the CRI, is a partner institution in the ​ ​COVID-19 Evidence ​Network to support Decision-making (COVID-END)​. This network aims to reduce duplication in and better coordinate the evidence syntheses efforts related to COVID-19.​

Dr. Elie Akl
He is a tenured professor of medicine   at the American University of Beirut (AUB). Dr. Akl leads the division of General Internal Medicine and Geriatrics (GIMG) at AUBMC and directs the CRI and its AUB GRADE Center. He has a part time appointment in the Department of Health Research Methods, Evidence, and Impact (HE&I) at McMaster University. His research expertise is in systematic reviews, practice guidelines, and conflicts of interest. He serves as a guideline methodologist for a number of North American professional organizations and the World Health Organization. He published close to 400 peer-reviewed papers and was listed by Thomson Reuters as one of the 2015 "world's most influential scientific minds" and as one of the “Highly Cited Researchers" yearly since 2015.

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