scholarly journals Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ruyi Cai ◽  
Jinshi Zhang ◽  
Yifan Zhu ◽  
Lin Liu ◽  
Yueming Liu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Exclusion Criteria ◽  
Infected People ◽  
Newcastle Ottawa Scale ◽  
Careful Screening ◽  
Ottawa Scale

AbstractAt the beginning of 2020, the outbreak of coronavirus disease 2019 (COVID-19) led to a worldwide pandemic and mass panic. The number of infected people has been increasing exponentially since, and the mortality rate has also been concomitantly increasing. At present, no study has summarized the mortality risk of COVID-19 in patients with chronic kidney disease (CKD). Therefore, the aim of the present study was to conduct a literature review and meta-analysis to understand the frequency of mortality among CKD patients infected with COVID-19. A comprehensive systematic search was conducted on the PubMed, Embase, and Cochrane databases to find articles published until May 15, 2020. Study quality was assessed using a modified version of the Newcastle–Ottawa Scale. After careful screening based on the inclusion and exclusion criteria, 3,867,367 patients from 12 studies were included. The mortality rate was significantly higher among CKD patients with COVID-19 infection than among CKD patients without COVID-19 infection, as indicated by a pooled OR of 5.81 (95% CI 3.78–8.94, P < 0.00001, I2 = 30%). The patients were then stratified into ≥ 70 and < 70 years, and subgroup analysis revealed that among CKD patients with COVID-19 infection, the mortality rate was higher in the < 70 years group (OR 8.69, 95% CI 7.56–9.97, P < 0.0001) than in the ≥ 70 years group (OR 2.44, 95% CI 0.75–6.63, P = 0.15). Thus, COVID-19 patients with CKD have a high mortality risk and require a comprehensive multidisciplinary management strategy.

Exposure to cadmium and head and neck cancers: a meta-analysis of observational studies

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maysam Rezapour ◽  
Habib Allah Rezapour ◽  
Maryam Chegeni ◽  
Narges Khanjani
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Environmental Pollutant ◽  
Pharyngeal Cancer ◽  
Epidemiologic Evidence ◽  
Standard Mean Difference ◽  
Newcastle Ottawa Scale ◽  
Careful Screening ◽  
Ottawa Scale

Abstract Cadmium (Cd) is a widespread environmental pollutant. A number of observational studies have reported that Cd might be a cause of nasopharyngeal (NPC), pharyngeal (PC), or laryngeal cancers (LC). In this study evidence about the relation of Cd and NPC, PC, and LC has been summarized. A literature review was conducted until 20 June 2020 in PubMed, Ovid, Scopus, Web of Science and Google scholar databases to investigate the epidemiologic evidence for the relation between cadmium exposure and cancers of the nasopharynx, pharynx, and larynx. Ten articles were selected after careful screening of retrieved studies. All of these studies obtained a Newcastle-Ottawa Scale (NOS) quality score from 6 to 8. Due to high heterogeneity, in all analyses, random effect was used. The pooled results showed that cadmium levels in NPC (standard mean difference (SMD=0.55; 95% CI=0.20, 0.89; p=0.002) and PC (SMD=9.79; 95% CI=0.62, 18.96; p=0.036) patients/tissues were significantly higher than their controls. But cadmium levels were not significantly different between LC cases/tissues and their controls. (SMD=−0.05; 95% CI=−0.99, 0.89; p=0.921). Exposure to cadmium is likely to cause nasopharyngeal and pharyngeal cancer.

scholarly journals Extracorporeal membrane oxygenation (ECMO) in patients with severe COVID-19 adult respiratory distress syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Hany Hasan Elsayed ◽  
Aly Sherif Hassaballa ◽  
Taha Aly Ahmed ◽  
Mohammed Gumaa ◽  
Hazem Youssef Sharkawy
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Mortality Risk ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Random Effect ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Venovenous Ecmo ◽  
Ottawa Scale

Abstract Background COVID 19 is the most recent cause of adult respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients failing conventional mechanical ventilation, but its role is still controversial. We conducted a systematic review and meta-analysis on ECMO for COVID-associated ARDS to study its outcome. Main body CENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched from inception to May 28, 2020. Studies reporting five or more patients with COVID-19 infection treated venovenous with ECMO were included. The main outcome assessed was mortality and ICU/hospital discharge. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. The validity of all the included observational studies was appraised with the Newcastle Ottawa scale. Meta-regression and publication bias were tested. This trial was registered with PROSPERO under registration number CRD42020183861. From 1647 initial citations, 34 full-text articles were analyzed and 12 studies were selected, including 194 patients with confirmed COVID-19 infection requiring ICU admission and venovenous ECMO treatment. Median Newcastle-Ottawa scale was 6 indicating acceptable study validity. One hundred thirty-six patients reached an endpoint of weaning from ECMO with ICU/hospital discharge or death while the rest were still on ECMO or in the ICU. The median Berlin score for ARDS prior to starting ECMO was III. Patients received mechanical ventilation before ECMO implementation for a median of 4 days and ECMO was maintained for a median of 13 days. In hospital and short-term mortality were highly variable among the included studies ranging between 0 and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.49 (95% confidence interval 0.259 to 0.721; I2 = 94%). Subgroup analysis according to country of origin showed persistent heterogeneity only in the 7 Chinese studies with pooled estimate mortality risk ratio of 0.66 (I2 = 87%) (95% CI = 0.39-0.93), while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.41 (95% CI 0.28-0.53) with homogeneity (p=0.67) similar to France with a pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p=0.86). Meta-regression showed only younger age as a predictor of mortality (p=0.02). Publication bias was excluded by visualizing the funnel plot of standard error, Egger’s test with p=0.566, and Begg and Mazumdar test with p=0.373. Conclusion The study included the largest number of patients with outcome findings of ECMO in this current pandemic. Our findings showed that the use of venovenous ECMO at high-volume ECMO centers may be beneficial for selected COVID 19 patients with severe ARDS. However, none of the included studies involve prospective randomized analyses; and therefore, all the included studies were of low or moderate quality according to the Newcastle-Ottawa scale. In the current era and environment of the pandemic, it will likely be very challenging to conduct a prospective randomized trial of ECMO versus no-ECMO for COVID-19. Therefore, the information contained in this systematic review of the literature is valuable and provides important guidance. Trial registration The study protocol link is at www.crd.yorl.ac.uk/PROSPERO under registration number CRD42020183861.

scholarly journals Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254554
Author(s):  
Sultana Shajahan ◽  
Janaki Amin ◽  
Jacqueline K. Phillips ◽  
Cara M. Hildreth
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Increased Risk ◽  
The Usa ◽  
The Impact ◽  
Cardiovascular Mortality Risk

Chronic kidney disease (CKD) is a significant health challenge associated with high cardiovascular mortality risk. Historically, cardiovascular mortality risk has been found to higher in men than women in the general population. However, recent research has highlighted that this risk may be similar or even higher in women than men in the CKD population. To address the inconclusive and inconsistent evidence regarding this relationship between sex and cardiovascular mortality within CKD patients, a systematic review and meta-analysis of articles published between January 2004 and October 2020 using PubMed/Medline, EMBASE, Scopus and Cochrane databases was performed. Forty-eight studies were included that reported cardiovascular mortality among adult men relative to women with 95% confidence intervals (CI) or provided sufficient data to calculate risk estimates (RE). Random effects meta-analysis of reported and calculated estimates revealed that male sex was associated with elevated cardiovascular mortality in CKD patients (RE 1.13, CI 1.03–1.25). Subsequent subgroup analyses indicated higher risk in men in studies based in the USA and in men receiving haemodialysis or with non-dialysis-dependent CKD. Though men showed overall higher cardiovascular mortality risk than women, the increased risk was marginal, and appropriate risk awareness is necessary for both sexes with CKD. Further research is needed to understand the impact of treatment modality and geographical distribution on sex differences in cardiovascular mortality in CKD.

scholarly journals Oxytocin levels in individuals with schizophrenia are high in cerebrospinal fluid but low in serum: A systematic review and meta-analysis.

2021 ◽  
Author(s):  
Yazmin Hernández-Díaz ◽  
Thelma Beatriz González-Castro ◽  
Carlos Tovilla-Zarate ◽  
María Lilia López-Narváez ◽  
Alma Delia Genis-Mendoza ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Comparison Group ◽  
Meta Analysis ◽  
Analysis Software ◽  
Exclusion Criteria ◽  
Prisma Statement ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

Abstract Schizophrenia is a mental and disabling disease. Levels of oxytocin have been proposed as a biomarker of schizophrenia; however, the observed levels of oxytocin in individuals with schizophrenia have been inconsistent across studies. We performed a meta-analysis to evaluate oxytocin levels in plasma, serum and cerebrospinal fluid to see if there are statistically different concentrations between individuals with schizophrenia and the comparison group.The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to guarantee a high quality and reproducibility.Following the inclusion and exclusion criteria, 14 studies were included in the meta-analysis. The quality of the study was evaluated by the Newcastle-Ottawa Scale (NOS). A random-effects model was performed using the Comprehensive Meta-analysis software with the standardized mean difference (SMD) and 95% confidence intervals (CIs).Serum oxytocin levels in individuals with schizophrenia were significantly lower than that in comparison group (SMD = − 1.74, 95% CI = − 3.22 to − 0.26, p = 0.02) but cerebrospinal fluid oxytocin levels in individuals with schizophrenia were significantly higher than those in the comparison group (SMD = 0.55, 95% CI = 0.05 to 1.04, p = 0.03).Our results suggest that oxytocin levels in cerebrospinal fluid are increased in individuals with schizophrenia but decreased in serum. Therefore, the oxytocin system dysregulation may play a role in the pathophysiology of schizophrenia and it should be measured in more populations for a possible implementation as a biomarker of schizophrenia.

scholarly journals Lopinavir/Ritonavir in the Treatment of COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (5) ◽  
pp. 19-25
Author(s):  
Yan Du ◽  
Tongtong Wang ◽  
Bo Li ◽  
Fang Pang ◽  
Xuanguo Zhang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Treatment Group ◽  
Conversion Rate ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Control Group ◽  
Exclusion Criteria ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale ◽  
Negative Conversion

Objective: To systematically evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) in the treatment of COVID-19. Methods: PubMed, Embase, Ovid, CNKI, CBM, Wanfang, and VIP databases were searched to obtain the clinical studies of LPV/r in the treatment of COVID-19 from December 2019 to July 2020. The literatures were screened according to the inclusion and exclusion criteria. Their qualities were evaluated according to the Newcastle-Ottawa Scale (NOS) and RevMan 5.3 software was used for meta-analysis. Results: A total of 688 patients were included in five studies, involving China and France. Compared with patients in the control group, who was only treated with routine treatment, there were no significant differences of the 7-day nucleic acid negative conversion rate and 14-day nucleic acid negative conversion rate in the treatment group. However, the use of LPV/r increased the incidence of adverse reactions in the treatment group compared to the control group. Conclusion: There is no available evidence to support the use of Lopinavir/ritonavir in the treatment of COVID-19.

scholarly journals Extracorporeal membrane oxygenation (ECMO) in patients with severe COVID-19 adult respiratory distress syndrome: a systematic review and meta-analysis 

2020 ◽  
Author(s):  
Hany Hasan Elsayed ◽  
Aly Sherif Hassaballa ◽  
Taha Aly Ahmed ◽  
Mohammed Gumaa ◽  
Hazem Youssef Sharkawy
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Mortality Risk ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Random Effect ◽  
Newcastle Ottawa Scale ◽  
Meta Regression ◽  
Venovenous Ecmo ◽  
Ottawa Scale

Abstract Background: COVID 19 is the most recent cause of Adult respiratory distress syndrome ARDS. Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients failing conventional mechanical ventilation, but its role is still controversial. We conducted a systematic review and meta-analysis on ECMO for COVID-associated ARDS to study its outcome.Materials and Methods: CENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched from inception to May 28, 2020. Studies reporting five or more patients with COVID 19 infection treated venovenous with ECMO were included. The main outcome assessed was mortality. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. The validity of all the included observational studies was appraised with the Newcastle Ottawa scale. Meta-regression and publication bias were tested. This trial was registered with PROSPERO under registration number CRD42020183861Results: From 1647 initial citations, 34 full text articles were analysed and 12 studies were selected, including 194 patients with confirmed COVID 19 infection requiring ICU admission and venovenous ECMO treatment. Median New Castle Ottawa scale was 6 indicating acceptable study validity. 136 patients reached an endpoint of weaning from ECMO or death while the rest were still on ECMO. The median Berlin score for ARDS prior to starting ECMO was III. Patients received mechanical ventilation before ECMO implementation for a median of four days and ECMO was maintained for a median of 13 days. In hospital and short-term mortality were highly variable among the included studies ranging between 0% and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.49 (95% confidence interval 0.259 to 0.721; I2 = 94%). Subgroup analysis according to country of origin showed persistent heterogeneity only in the 7 Chinese studies with pooled estimate mortality risk ratio of 0.66 (I2 = 87%) (95% CI = 0.39-0.93), while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.41 (95% CI 0.28-0.53) with homogeneity (p=0.67) similar to France with a pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p=0.86). Meta-regression showed only younger age as a predictor of mortality (p=0.02). Publication bias was excluded by visualizing the funnel plot of standard error, Egger's test with p=0.566 and Begg&Mazumdar test with p=0.373Conclusion: The study included the largest number of patients with outcome findings of ECMO in this current pandemic. Our findings showed that the use of venovenous ECMO at high-volume ECMO centres may be beneficial for selected COVID 19 patients with severe ARDS. However, none of the included studies involve prospective randomized analyses; and therefore, all the included studies were of low or moderate quality according to the Newcastle-Ottawa scale. In the current era and environment of the pandemic, it will likely be very challenging to conduct a prospective randomized trial of ECMO versus no-ECMO for COVID-19. Therefore, the information contained in this systematic review of the literature is valuable and provides important guidance.

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