The impact of prenatal exposure to PM2.5 on childhood asthma and wheezing: a meta-analysis of observational studies

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) share a target receptor with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The use of ACEIs/ARBs may cause angiotensin-converting enzyme 2 receptor upregulation, facilitating the entry of SARS-CoV-2 into host cells. There is concern that the use of ACEIs/ARBs could increase the risks of severe COVID-19 and mortality. The impact of discontinuing these drugs in patients with COVID-19 remains uncertain. We aimed to assess the association between the use of ACEIs/ARBs and the risks of mortality and severe disease in patients with COVID-19. A systematic search was performed in PubMed, EMBASE, Cochrane Library, and MedRxiv.org from December 1, 2019, to June 20, 2020. We also identified additional citations by manually searching the reference lists of eligible articles. Forty-two observational studies including 63,893 participants were included. We found that the use of ACEIs/ARBs was not significantly associated with a reduction in the relative risk of all-cause mortality [odds ratio (OR) = 0.87, 95% confidence interval (95% CI) = 0.75–1.00; I2 = 57%, p = 0.05]. We found no significant reduction in the risk of severe disease in the ACEI subgroup (OR = 0.95, 95% CI = 0.88–1.02, I2 = 50%, p = 0.18), the ARB subgroup (OR = 1.03, 95% CI = 0.94–1.13, I2 = 62%, p = 0.48), or the ACEI/ARB subgroup (OR = 0.83, 95% CI = 0.65–1.08, I2 = 67%, p = 0.16). Moreover, seven studies showed no significant difference in the duration of hospitalization between the two groups (mean difference = 0.33, 95% CI = −1.75 to 2.40, p = 0.76). In conclusion, the use of ACEIs/ARBs appears to not have a significant effect on mortality, disease severity, or duration of hospitalization in COVID-19 patients. On the basis of the findings of this meta-analysis, there is no support for the cessation of treatment with ACEIs or ARBs in patients with COVID-19.

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Prognostic Impact of Metabolic Syndrome in Patients With Heart Failure: A Meta-Analysis of Observational Studies

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.704446 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zhuo-Ming Huang ◽

Wen-Rong Chen ◽

Qi-Wen Su ◽

Zhuo-Wen Huang

Keyword(s):

Heart Failure ◽

Metabolic Syndrome ◽

Cardiovascular Mortality ◽

Cardiovascular Events ◽

Observational Studies ◽

Meta Analysis ◽

Prognostic Impact ◽

The Metabolic Syndrome ◽

All Cause Mortality ◽

The Impact

Background: The metabolic syndrome (MS) is significantly associated with the risk of incident heart failure (HF). However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. This meta-analysis aimed to ascertain the effect of MS on the prognosis in patients with HF.Methods: We searched multiple electronic databases, including PubMed, Opengrey, EMBASE, and Cochran Library, for potential studies up to February 15, 2021. Observational studies that reported the impact of MS on the prognosis in patients with established HF were included for meta-analysis.Results: Ten studies comprising 18,590 patients with HF were included for meta-analysis. The median follow-up duration of the included studies was 2.4 years. Compared with HF patients without MS, the risk of all-cause mortality and cardiovascular mortality was not increased in HF with MS (HR = 1.04, 95% CI = 0.88–1.23 for all-cause mortality; HR = 1.66, 95% CI = 0.56–4.88 for cardiovascular mortality, respectively). However, there was a significant increase in composited cardiovascular events in the HF patients with MS compared with those without MS (HR = 1.73, 95% CI = 1.23–2.45).Conclusions: In patients with established HF, the presence of MS did not show an association on the risk of all-cause mortality or cardiovascular mortality, while it may increase the risk of composite cardiovascular events.

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The impact of booster seat use on child injury and mortality: Systematic review and meta-analysis of observational studies of booster seat effectiveness

Accident Analysis & Prevention ◽

10.1016/j.aap.2018.07.004 ◽

2018 ◽

Vol 119 ◽

pp. 50-57

Author(s):

Mark Asbridge ◽

Rachel Ogilvie ◽

Maria Wilson ◽

Jill Hayden

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Child Injury ◽

Booster Seat ◽

The Impact

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Impact of Thrombophilia On Arterial Ischemic Stroke or Cerebral Venous Sinus Thromboses in Children: A Systematic Review & Meta-Analysis of Observational Studies.

Blood ◽

10.1182/blood.v114.22.3993.3993 ◽

2009 ◽

Vol 114 (22) ◽

pp. 3993-3993

Author(s):

Lisa K Lütkhoff ◽

Manuela Albisetti ◽

Timothy J. Bernard ◽

Mariana Bonduel ◽

Leonardo R. Brandao ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Random Effects ◽

Antiphospholipid Antibodies ◽

Observational Studies ◽

Meta Analysis ◽

Inclusion Criteria ◽

Arterial Ischemic Stroke ◽

Off Label ◽

The Impact

Abstract Abstract 3993 Poster Board III-929 Background The incidence of stroke in children is estimated at about 2.6 per 100,000 per year. Risk factors include congenital heart malformations, trauma, hemolytic anemias, collagen tissue diseases, inborn metabolic disorders, and infectious diseases. Apart from acquired thrombophilic risk factors, such as the presence of antiphospholipid antibodies, inherited thrombophilias (IT) have been found to be associated with stroke in infants and children. However, results of single studies on the risk of stroke onset associated with IT have been contradictory or inconclusive, mainly due to lack of statistical power. The aim of this study was to estimate the impact of thrombophilia (IT) on risk of childhood stroke via meta-analysis of published observational studies. Methods and Results A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1970 to 2009 was conducted using key words in combination both as MeSH terms and text words. Citations were independently screened by two authors and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, stroke type (arterial ischemic stroke [AIS]; cerebral venous sinus thrombosis [CSVT]) were abstracted. Publication bias indicator and heterogeneity across studies were evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using both fixed-effects and random-effects models. Twenty-one of 185 references found met inclusion criteria. 1698 patients (AIS: 1291; CSVT: 407) and 2913 controls aged neonate to 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. A statistically significant association with stroke onset was demonstrated for each IT trait evaluated, with no difference found between AIS (table) and CSVT. Summary ORs/CIs (random-effects model) for AIS & CSVT cohorts were as follows: Protein C-deficiency (8.76/4.53-16.96), FV G1691A (3.34/2.66-4.26), FII G20210A (2.50/1.67-3.74), MTHFR T677T (1.61/1.21-2.14), antiphospholipid antibodies (5.84/3.06-11.18), elevated lipoprotein (a) (6.24/4.51-8.64), and combined ITs (8.85/3.32-23.57). Carrier rates reported for antithrombin- or protein S deficiency among patients were 1.5% and 1.6% as compared with 0.06% (p<0.001) and 0.4% (p=0.003) in healthy controls. Conclusions The present meta-analysis indicates that IT serve as risk factors for incident stroke. However, the impact of IT upon outcome and recurrence risk needs to be further investigated. Disclosures: Manco-Johnson: Baxter BioScience: Honoraria; Bayer HealthCare: Honoraria; CSL Behring: Honoraria; NovoNordisk: Honoraria; Octapharma: Honoraria. Off Label Use: Enoxaparin (LMWH) is used off-label in children to prevent symptomatic thromboembolism.

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Red Meat Intake and Risk of Rheumatoid Arthritis: A Categorical and Dose-Response Meta-Analysis

10.21203/rs.3.rs-871604/v1 ◽

2021 ◽

Author(s):

WeiWei Chen ◽

Ke Liu ◽

Qing Su ◽

Xinxian Sang ◽

Yihan Hu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Dose Response ◽

Observational Studies ◽

Meta Analysis ◽

Red Meat ◽

High Dose ◽

Case Control Studies ◽

Meat Intake ◽

Red Meat Intake ◽

The Impact

Abstract Objective: Findings from previous observational studies on the association between red meat intake and risk of rheumatoid arthritis (RA) are inconsistent. Therefore, we aimed to evaluate the impact of red meat intake on the incidence of RA by meta-analysis.Methods: PubMed and Web of Science were searched for eligible observational studies regarding the association between red meat intake and the risk of RA until June 30, 2021. Risk estimates with corresponding 95% confidence interval (95% CI) were pooled. Subgroup analysis and meta-regression analysis were performed to explore the potential sources of heterogeneity. Sensitivity analysis and publication bias test were also carried out.Results: A total of eleven studies were selected, involving 4 cohort studies with 5 203 identified cases from 349 776 individuals and 7 case-control studies with 3 762 cases and 6 856 controls. The pooled risk estimate of RA risk was 0.94 (95% CI: 0.77 to 1.15) for ever versus non/occasional red meat intake, while high dose of red meat intake increased the risk of RA (OR: 1.26, 95% CI: 1.07 to 1.50) in the categorical meta-analysis. Dose-response meta-analysis suggested a non-linear dose-response relationship between red meat intake and RA (P=0.028). Red meat intake was found to be a risk factor of RA when the dose ranged from 96 to 166 g/day.Conclusion: High dose of red meat intake could increase the risk of RA. Mechanistic studies are warranted to clarify the aetiologic pathways through which high dose of red meat intake may promote RA.

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The impact of selective serotonin reuptake inhibitors on the risk of intracranial haemorrhage: A systematic review and meta-analysis

European Stroke Journal ◽

10.1177/2396987319827211 ◽

2019 ◽

Vol 4 (2) ◽

pp. 144-152 ◽

Cited By ~ 2

Author(s):

Melanie P Jensen ◽

Oliver J Ziff ◽

Gargi Banerjee ◽

Gareth Ambler ◽

David J Werring

Keyword(s):

Serotonin Reuptake ◽

Observational Studies ◽

Intracranial Haemorrhage ◽

Selective Serotonin Reuptake Inhibitors ◽

Meta Analysis ◽

Serotonin Reuptake Inhibitors ◽

Quality Data ◽

Selective Serotonin ◽

Increased Risk ◽

The Impact

Introduction Observational studies have suggested increased risk of intracranial haemorrhage (ICrH) in patients receiving selective serotonin reuptake inhibitors (SSRIs). We sought to clarify the impact of SSRIs on ICrH, accounting for study methodology. Patients and methods A comprehensive search of Medline, Embase and the Cochrane Library from 1960 to December 2017 identified studies comparing SSRIs with control. The outcomes (first-ever and recurrent ICrH) were meta-analysed using a random effects model. Results Twenty-four observational studies and three randomised trials were available for meta-analysis, totalling 4,844,090 patient-years of follow-up. Those receiving SSRIs were more likely to be female ( p = 0.01) and have depression ( p < 0.001). Compared to controls, SSRI users had a significantly increased risk of ICrH (relative risk (RR) 1.26, 95%CI 1.11–1.42). Although SSRI use was associated with increased ICrH risk in those without previous ICrH (RR 1.31, 95%CI 1.15–1.48), this was not the case in those with previous ICrH (RR 0.95, 95%CI 0.83–1.09). Sensitivity analysis according to the bleeding definition reported demonstrated that although ‘haemorrhagic stroke’ was associated with SSRIs (RR 1.40, 95%CI 1.13–1.72), intracerebral haemorrhage was not (RR 1.11, 95%CI 0.86–1.42). Additional sensitivity analyses demonstrated a stronger association between SSRIs and ICrH in studies with a high ( p < 0.001) compared to low risk of bias ( p = 0.09) and with retrospective ( p < 0.001) compared to prospective (p=0.31) study designs. Discussion Although SSRIs are associated with an increased risk of ICrH, the association is partly accounted for by important biases and other methodological limitations in the available observational data. Conclusion Our findings suggest there is insufficient high-quality data to advise restriction of SSRIs because of concern regarding ICrH risk.

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A Meta-analysis of Real-World Observational Studies on the Impact of Flash Glucose Monitoring on Glycemic Control as Measured by HbA1c

Diabetes ◽

10.2337/db18-72-lb ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 72-LB ◽

Cited By ~ 2

Author(s):

ALEXANDER SEIBOLD ◽

ZOE K. WELSH ◽

SARA ELLS ◽

CHRISTOF SCHLAEGER

Keyword(s):

Glycemic Control ◽

Real World ◽

Observational Studies ◽

Meta Analysis ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

The Impact

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Endotoxin exposure and childhood asthma: a meta-analysis of observational studies

Paediatric Respiratory Reviews ◽

10.1016/s1526-0542(11)70055-0 ◽

2011 ◽

Vol 12 ◽

pp. S64

Author(s):

E. Forno ◽

A. Mendy ◽

J. Gasana ◽

E. Ramos-Vieira ◽

J. Patel ◽

...

Keyword(s):

Childhood Asthma ◽

Observational Studies ◽

Meta Analysis ◽

Endotoxin Exposure

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The Effects of Influenza Vaccination during Pregnancy on Birth Outcomes: A Systematic Review and Meta-Analysis

American Journal of Perinatology ◽

10.1055/s-0036-1586101 ◽

2016 ◽

Vol 33 (11) ◽

pp. 1104-1114 ◽

Cited By ~ 50

Author(s):

Marta Nunes ◽

Anushka Aqil ◽

Saad Omer ◽

Shabir Madhi

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Birth Outcomes ◽

Observational Studies ◽

English Language ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Pregnancy And Birth Outcomes ◽

The Impact ◽

The Relationship

Objective Numerous observational studies have evaluated the relationship between influenza vaccination during pregnancy and birth outcomes. The number of studies on this subject has increased, especially after the 2009 A/H1N1 pandemic (A/H1N1pdm09). This meta-analysis aims to determine the impact of maternal vaccination with either seasonal trivalent inactivated influenza vaccines (IIV) or A/H1N1pdm09 monovalent vaccines on the rates of preterm (PTB), small for gestational age (SGA), and low birth weight (LBW) births. Methods English language randomized controlled trials and observational studies assessing the proposed outcomes after administration of influenza vaccine during pregnancy were screened. Observational studies were included if they presented adjusted measures and if the total number of women evaluated reached predefined thresholds. Sensitivity analyses were performed, including all published observational studies irrespectively of the sample size. Results A total of 5 and 13 publications that assessed the impact of IIV and monovalent A/H1N1pdm09 vaccines, respectively, fulfilled the inclusion criteria for the main analyses. The rate of PTB and LBW was lower in women who received IIV during pregnancy compared with nonvaccinated women (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.77, 0.98 for PTB and OR: 0.74; 95% CI: 0.61, 0.88 for LBW); and in women vaccinated with monovalent A/H1N1pdm09 versus nonvaccinated women (OR: 0.92; 95% CI: 0.85, 0.99 for PTB and OR: 0.88; 95% CI: 0.79, 0.98 for LBW). No significant impact of vaccination on SGA birth rates was detected in the main analyses independently of the vaccine group. Conclusion Receipt of influenza vaccine during pregnancy was associated with a decreased risk of PTB and LBW.

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