Results
A total of 194 Covid-19 related guidance relevant to the
Otolaryngologist was identified during the 20 weeks between the 1st of
January and 31st May 2020. 19 of these 194 duplicates
published by multiple organisations as collaborative work. Therefore 175
original articles were published by international organisations 52/175
(29.70%), national organisations 57/175 (32%) and by ENT specific
organisations 66/175 (38.20%). Figure 1.
All of the 175 guidance’s covered multiple topics, separating these into
the 10 main topics PPE was the subject in 31%, Service prioritisation
(13%). General advice relating to treating elective otolaryngological
conditions either surgically or conservatively (20%). Screening (4%),
Cancer care (8%), tracheostomy (7%) and specific areas of Otology
(4.1%), Rhinology (4%), Paediatrics ENT (3%) and Service recovery
(5%). In total 313 topic areas were covered in the 175 guidance’s.
(Table 1)
The WHO declared the pandemic on the 11th March 202018. Before this date only 8/175 guidance had been
published. Following this there was a rapid escalation in guidance being
issued. The peak guidance production took place in the third and fourth
week of March (16/03/2020- 29/03/2020) with 33/175 publications in the
third week of March and 37/175 in the fourth week. (See Figure 2)
Of these 70 publications, 27 came from the international category, 17
from national bodies and 26 from ENT-specific organisations. During this
peak period the majority of the advice was related to PPE (48/70,
68.5%). (Table 2)
Service recovery related publications commenced a fortnight post-peak
guidance period. Between the 9th of April and the
20th of May, 16 guidances on service recovery were
identified. During this period, the number of publications increased by
an average of 2.2 per week with a peak of 5 publications during the
second week of May.
12 came from national and ENT-specific bodies: 5 from ENT-UK, 2 from the
Royal College of Surgeons, 3 from Public Health England, 1 from the
Royal College of Radiologists and 1 from the NHS website. 4 came from
International bodies included the American Academy of Otolaryngology and
Head and Neck, Centres for Medicare and Medicaid.
Most guidance relevant to otology, rhinology and paediatric ENT was
produced during the peak period and constitutes 10%, 7.1% and 7.1%
respectively. During the subsequent four weeks 1-2 pieces of advice were
produced per week before the number of publications tailed off.
A total of 13,863 peer-reviewed publications relating to COVID-19 were
identified using PubMed and Cochrane searches. At the time of the
pandemic being announced there had been 966 COVID-19 related
publications of which 610 related to Otolaryngology. The volume
increased over time, with a sharp increase occurring at the end of March
2020. Figure 3. A similar pattern was followed by the volume of
publications relevant to ENT, where 10,567 total publications were
identified.