Advances in COVID-19 research until November 2020: Update from the UNCOVER registry

www.jogh.org • doi: 10.7189/jogh.11.03022 1 2021 • Vol. 11 • 03022 Since the declaration of Coronavirus Disease 2019 (COVID-19) pandemic on 11 March 2020 by the WHO, an accumulated number of at least 70 461 926 confirmed cases and 1 599 704 deaths in 216 countries/ territories has been recorded by 14/12/2020 [1]. In line with the established WHO global research roadmap for COVID-19 [2], the UNCOVER (Usher Network for COVID-19 Evidence Reviews) group committed to summarise COVID-19 evidence-based reviews for policymakers, clinicians and researchers to respond quickly to the outbreak of COVID-19. To assist in policy and clinical decision making and to avoid duplicate efforts, we created the UNCOVER registry of reviews, an online collection of published and ongoing reviews. Details of the UNCOVER registry have been previously reported [3] and here we present an update in relation to the main characteristics of the current collection.

(n = 342, 14.7%); 3) Health-system arrangements (n = 85, 3.6%); 4) Economic and social responses (n = 59, 2.5%); 5) Other reviews (n = 93, 4.0%) (Figure 2, Panel A) [7]. We further categorised each review into 22 subgroups under the five COVIDEND groups ( Table 1 Panel B. Review sources. medRxiv preprints were replaced with the peer-reviewed publications once they have been published in peer-reviewed journals; the review types displayed directly in the searching results of the website and the review sources can be accessed through the filter.
Health-system arrangements, a total of 85 reviews were divided into two subgroups: Health care resource arrangement (n = 38); Clinical department arrangement (n = 42).  Authorship contributions: XZ, WX wrote the manuscript with input from all co-authors. All authors have read and approved the final manuscript as submitted.
Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest Economic and social responses, a total of 59 reviews were divided into four subgroups: Education (n = 11); Social consequences (n = 29); Economy (n = 7); Governance (n = 6).
On average, we include 292 reviews per month. There has been an increasing trend in the number of published or ongoing COVID-19 reviews and the composition of research topics has changed over time. Figure 2, Panel B, shows that the proportion of reviews on clinical management of COVID-19 and pandemic-related health issues increased from April to September (from 60.3% to 82.3%) but the proportion has been steadily declining since September to 74.4% and 72.4% for October and November respectively. In contrast, the proportion of reviews on public health measures decreased from May to September except for August (from 21.4% to 10.5%) and the proportion was higher in October and November (16.8% and 13.9% respectively). For the other three topics, the trend is fluctuating. We further categorized the pandemic into three time periods: 1) before June 2020, where the main contributors were Western Pacific, Americas and Europe but the case incidence was kept in relatively low levels; 2) June-September 2020, where the number of new cases continued to increase and the main contributors were Americas and South-East Asia; and 3) October 2020 to now, where the number of cases increased significantly driven by the second outbreak in Americas and Europe. From Figure 2, Panel C, the highest proportion of reviews on clinical management of COVID-19 and pandemic-related health issues was in June to September while the proportion of reviews on public health measures was relatively high in periods before June and after September. The proportion of reviews on economic and social responses has been increasing, but they still account for a small proportion.
In summary, a total of 2334 COVID-19 evidence-based reviews have been indexed in UNCOVER registry, more than half of the reviews included were from PubMed, and over two-thirds of the included reviews were systematic reviews and meta-analyses. The research topics concentrated on clinical features, tests, treatment and outcomes, COVID-19 comorbidities, and the transmission, prevention and control of COVID-19. Although we have seen an increasing trend for reviews on economic and social responses across the three time periods, the total number remains very low and not in line with its importance.
The registry offers the opportunity to explore the aforementioned topics using state of the art methodologies in evidence-based research (such as umbrella reviews with evidence synthesis and assessment of the risk of bias) [8][9][10][11][12]. This will provide policymakers, clinicians and researchers a clear understanding of broad topic areas in relation to COVID-19.
Photo: Register of reviews from UNCOVER team, the University of Edinburgh (from the author's own collection, used with permission).
The research topics of COVID-19 related reviews concentrated on clinical features, tests, treatment and outcomes, COVID-19 comorbidities, and the transmission, prevention and control of COVID-19.