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Table 4 Summary of findings from the studies that included statistical comparisons with respect to transmission of COVID-19 during specific AGMPs*

From: Risk of transmission of respiratory viruses during aerosol-generating medical procedures (AGMPs) revisited in the COVID-19 pandemic: a systematic review

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)
  1. 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
  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
  3. aUnadjusted Odds Ratio and 95% confidence interval unless otherwise specified