Sexual transmission of SARS-CoV-2 virus and its role in the spread of COVID-19: A living systematic review protocol.

Abstract

To provide a review of the literature on the presence of SARS-CoV-2 in the sexual fluids of patients with COVID-19 and to observe its possible sexual transmission in a timely, rigorous, and continuously updated manner. We will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature, and a centralized repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from the Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal. We adapted an already published standard protocol for multiple parallel systematic reviews to the specificities of this question. We will include randomized trials evaluating the sexual transmission of the SARS-CoV-2 virus. Randomized trials evaluating the sexual transmission of other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomized studies in COVID-19 will be searched if no direct evidence from randomized trials is found or if the direct evidence provides a low to a very low level of certainty for critical outcomes. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use GRADE to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit the review if the conclusions change or if there are substantial updates. (CRD42020189368).