COVID-19: contributions from KCE

KCE made its expertise available to colleagues from other government agencies involved in tackling the COVID-19 crisis.

Literature reviews:

Rapid literature review to list the medical procedures that disperse aerosols (contaminating droplets). Identification of the procedures with the highest risk of transmission of a respiratory pathogen. This document helps determine which healthcare providers should as a priority wear masks.

  • Tromboprophylaxis 
    (at the request of the Superior Health Council and the Federal Agency for Medicines and Health products– April-May 2020)

COVID-19 increases the risk of thromboembolic problems, both in the venous and arterial circulations, which increases the risk of death significantly.

On April 7, Sciensano recommended replacing treatment with oral anticoagulants in hospitalised patients (before admission) with curative low molecular weight heparin. The reason for this was the possible drug interactions and difficulties in adjusting the dose of oral anticoagulants. In addition, the Belgian Society on Thrombosis and haemostasis (BSTH) had published algorithms for COVID-19 positive patients in hospital (in intensive care or otherwise) and for ambulatory patients. 

As the scientific evidence evolves constantly, we performed a rapid literature review to complement the literature review already conducted. The conclusion was that the algorithms from the BSTH were in line with international recommendations but that guidance was lacking for pregnant women or women in the post-partum phase. As a result, the BSTH started an urgent consensus process to update the algorithms supplementing them with background information and recommendations for pregnant and post-partum women. 

By means of a quick literature review, KCE investigated the susceptibility of children to the coronavirus and the role they play in its transmission. It appears that there are still many uncertainties about this issue. This makes it difficult to estimate the public health risks when schools are reopened. Contact investigations are currently being carried out across the country to identify cases of (potential) contamination as soon as possible. However, when a large number of corona cases occur in schools, "outbreak teams" should also investigate the role of schoolchildren in corona infection. Thanks to such a population study scientific information on the risk of infection from school-aged children could be obtained, and this is urgently needed.
In addition, epidemiological studies are recommended to describe the course of a corona infection in children. And to monitor immunity in children, more children should have regular blood tests.

Clinical trials:

The KCE Trials program is a program of publicly funded, non-commercial, practice-oriented clinical studies. These studies address issues that are usually neglected by industry, despite their high societal importance. 

In the context of the COVID-19 crisis, KCE Trials coordinates and funds clinical trials of hospital researchers to urgently test new treatments.

  • The COV-AID study is about the use of different drug combinations - often used in rheumatoid arthritis - which block interleukin 1 and 6. The aim is to prevent cytokine shock in patients with respiratory problems. This study, which was started by UZ Gent, includes 342 patients in 16 Belgian hospitals.
  • De DAWN-plasma study testing the efficacy and safety of administering plasma from patients cured of COVID-19 to sick patients. This study is a collaboration between university and non-university hospitals in the country, coordinated by UZ Leuven.

International cooperation

The KCE is the Belgian representative at the European Observatory on Health Systems and Policies, an institution of the World Health Organization (WHO). In this context, in April 2020, KCE was asked to post information for Belgium on the international platform, which provides an overview of the corona-measures of each country:

Each country answers a number of questions, in this way an overview of the measures within the different health systems is provided.

Gudrun BRIAT (NL)
Communication Manager for the KCE
+32 (0)2 287 33 54 (FR: 33 48)
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