BACKGROUND: Restricting infectious healthcare workers (HCWs) from the workplace is an important infection prevention strategy. The duration of viral shedding or symptoms are often used as proxies for the infectious period in adults but may not accurately estimate it. OBJECTIVE: To determine the risk period for transmission among previously healthy adults infected with SARS-CoV-2 omicron variant (omicron) or influenza A (influenza) by examining the duration of shedding and symptoms, and day of symptom onset in secondary cases of transmission pairs. DESIGN: Rapid review. METHODS: This rapid review adhered to PRISMA-ScR; five databases were searched. The cumulative daily proportion of participants with an outcome of interest was calculated for each study and summarized. RESULTS: Forty-three studies were included. Shedding resolved among ≥ 70% of participants by the end of day nine post symptom onset for omicron, and day seven for influenza; and for ≥ 90% of participants, by the end of day 10 for omicron and day nine for influenza. Two studies suggested shedding continues > 24 hours post-fever resolution for both viruses. Symptom onset occurred in ≥ 80% of secondary cases by the end of day seven post-primary case symptom onset for omicron and day six for influenza. CONCLUSIONS: Omicron shedding is consistent with previous recommendations to exclude infected HCWs from work for 10 days; and influenza follows a similar trend. Earlier symptom onset in most secondary cases for both pathogens indicates that, despite persistent viral shedding, most transmission occurs earlier; and the cumulative serial interval might better approximate the duration of infectiousness.

INTRODUCTION: While various demographic factors and underlying medical conditions are associated with the development of post-COVID conditions within a month after SARS-CoV-2 infection, less is known about factors associated with post-COVID symptoms that persist for 6 months or more. The aim of this review was to determine the association between underlying conditions, other risk factors, health behaviors, and the presence of symptoms ≥6 months after COVID-19. METHODS: Studies reporting on post-COVID symptoms were searched in databases, including Medline, EMBASE, Global Health, PsycInfo, Scopus, CINAHL, Proquest, and WHO COVID-19 literature, from the beginning of the pandemic until November 2022. Studies were included if they reported on symptoms ≥6 months after COVID-19 and a relevant measure of association (adjusted or unadjusted odds or risk ratio). RESULTS: A total of 17 studies with 109,293 participants met the inclusion criteria; they were conducted in China (3), Italy (3), Spain (3), Russia (2), France (1), Germany (1), Sweden (1), Scotland (1), United Kingdom (1), and the United States (1). When compared to males, female participants were at an increased risk of post-COVID-19 symptoms (risk ratio (RR): 1.24; adjusted odds ratio (aOR): 3.08). Underlying conditions, including COPD/lung disease, overweight status or obesity, hypertension, cardiovascular disease, and asthma, were identified as possibly being associated with an increased risk of post-COVID symptoms. CONCLUSION: Female gender and certain underlying medical conditions were associated with an increased risk of post-COVID symptoms ≥6 months after COVID-19. Further research is needed to better understand some of these associations and identify groups that are at increased risk for persistent post-COVID conditions.

Importance: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective: To provide new and updated evidence-based recommendations for the prevention of SSI. Evidence Review: A targeted systematic review of the literature was conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library from 1998 through April 2014. A modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence and the strength of the resulting recommendation and to provide explicit links between them. Of 5759 titles and abstracts screened, 896 underwent full-text review by 2 independent reviewers. After exclusions, 170 studies were extracted into evidence tables, appraised, and synthesized. Findings: Before surgery, patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the operative day. Antimicrobial prophylaxis should be administered only when indicated based on published clinical practice guidelines and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made. In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision. Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated. For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain. Topical antimicrobial agents should not be applied to the surgical incision. During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL, and normothermia should be maintained in all patients. Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI. Conclusions and Relevance: This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety.