Issues for conducting meta-analyses in COVID-19. Commentary on “Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis’’

AbstractImportanceWith the increasing number of infections for COVID-19, the global health resources are deficient. At present, we don’t have specific medicines or vaccines against novel coronavirus pneumonia (NCP) and our assessment of risk factors for patients with severe pneumonia was limited. In order to maximize the use of limited medical resources, we should distinguish between mild and severe patients as early as possible.ObjectiveTo systematically review the evidence of risk factors for severe corona virus disease 2019 (COVID-19) patients.Evidence ReviewWe conducted a comprehensive search for primary literature in both Chinese and English electronic bibliographic data bases including China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese Biomedicine Literature Database (CBM-SinoMed), MEDLINE (via PubMed), EMBASE, Cochrane Central Register, and Web of science. The American agency for health research and quality (AHRQ) tool were used for assessing risk of bias. Mata-analysis was undertaken using STATA version 15.0.Results20 articles (N=4062 participants) were eligible for this systematic review and meta-analysis. First in this review and meta-analysis, we found that elderly male patients with a high body mass index, high breathing rate and a combination of underlying diseases (such as hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease) were more likely to develop into critically ill patients. second, compared with ordinary patients, severe patients had more significant symptom such as fever and dyspnea. Besides, the laboratory test results of severe patients had more abnormal than non-severe patients, such as the elevated levels of white-cell counts, liver enzymes, lactate dehydrogenase, creatine kinase, c-reactive protein and procalcitonin, etc, while the decreased levels of lymphocytes and albumin, etc.InterpretationThis is the first systematic review investigating the risk factors for severe corona virus disease 2019 (COVID-19) patients. The findings are presented and discussed by different clinical characteristics. Therefore, our review may provide guidance for clinical decision-making and optimizes resource allocation.Key PointsQuestionWhat are the risk factors for severe patients with corona virus disease 2019 (COVID-19)?FindingsFirst in this review and meta-analysis, we found that elderly male patients with a high body mass index, high breathing rate and a combination of underlying diseases were more likely to develop into critically ill patients. second, compared with ordinary patients, severe patients had more significant symptom such as fever and dyspnea. Last, we also found that the laboratory test results of severe patients had more abnormal than non-severe patients.MeaningThis review summaried the risk factors of severe COVID-19 patients and aim to provide a basis for early identification of severe patients by clinicians.

Download Full-text

Efficacy and Safety of Integrated Traditional Chinese and Western Medicine for Corona Virus Disease 2019 (COVID-19): a systematic review and meta-analysis

Pharmacological Research ◽

10.1016/j.phrs.2020.104896 ◽

2020 ◽

Vol 158 ◽

pp. 104896 ◽

Cited By ~ 24

Author(s):

Ming Liu ◽

Ya Gao ◽

Yuan Yuan ◽

Kelu Yang ◽

Shuzhen Shi ◽

...

Keyword(s):

Systematic Review ◽

Western Medicine ◽

Virus Disease ◽

Meta Analysis ◽

Efficacy And Safety ◽

Corona Virus

Download Full-text

Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis

Journal of Clinical Virology ◽

10.1016/j.jcv.2020.104371 ◽

2020 ◽

Vol 127 ◽

pp. 104371 ◽

Cited By ~ 143

Author(s):

Yong Hu ◽

Jiazhong Sun ◽

Zhe Dai ◽

Haohua Deng ◽

Xin Li ◽

...

Keyword(s):

Systematic Review ◽

Virus Disease ◽

Meta Analysis ◽

Corona Virus

Download Full-text

Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review

F1000Research ◽

10.12688/f1000research.11078.2 ◽

2017 ◽

Vol 6 ◽

pp. 390 ◽

Cited By ~ 7

Author(s):

María Fernanda Alvarez ◽

Adrián Bolívar-Mejía ◽

Alfonso J. Rodriguez-Morales ◽

Eduardo Ramirez-Vallejo

Keyword(s):

Systematic Review ◽

Virus Infection ◽

Chikungunya Virus ◽

Virus Disease ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Clinical Findings ◽

Cardiovascular Involvement ◽

Meta Analyses

Background: In the last three years, chikungunya virus disease has been spreading, affecting particularly the Americas, producing more than two million cases. In this setting, not only new disease-related epidemiological patterns have been found, but also new clinical findings have been reported by different research groups. These include findings on the cardiovascular system, including clinical, electrocardiographic and echocardiographic alterations. No previous systemic reviews have been found in major databases about it. Methods: We performed a systematic review looking for reports about cardiovascular compromise during chikungunya disease. Cardiac compromise is not so common in isolated episodes; but countries where chikungunya virus is an epidemic should be well informed about this condition. We used 6 bibliographical databases as resources: Medline/Pubmed, Embase, ScienceDirect, ClinicalKey, Ovid and SciELO. Dengue reports on cardiovascular compromise were included as well, to compare both arbovirus’ organic compromises. Articles that delved mainly into the rheumatic articular and cutaneous complications were not considered, as they were not in line with the purpose of this study. The type of articles included were reviews, meta-analyses, case-controls, cohort studies, case reports and case series. This systematic review does not reach or performed a meta-analysis. Results: Originally based on 737 articles, our reviewed selected 40 articles with 54.2% at least mentioning CHIKV cardiovascular compromise within the systemic compromise. Cardiovascular manifestations can be considered common and have been reported in France, India, Sri Lanka, Malaysia, Colombia, Venezuela and USA, including mainly, but no limited to: hypotension, shock and circulatory collapse, Raynaud phenomenon, arrhythmias, murmurs, myocarditis, dilated cardiomyopathy, congestive insufficiency, heart failure and altered function profile (Troponins, CPK). Conclusions: Physicians should be encouraged to keep divulgating reports on the cardiovascular involvement of chikungunya virus disease, to raise awareness and ultimately encourage suitable diagnosis and intervention worldwide. More research about cardiovascular involvement and manifestations of systemic Chikungunya virus infection is urgently needed.

Download Full-text

Gastrointestinal and hepatic manifestations of Corona Virus Disease-19 and their relationship to severe clinical course: A systematic review and meta-analysis

Indian Journal of Gastroenterology ◽

10.1007/s12664-020-01058-3 ◽

2020 ◽

Vol 39 (3) ◽

pp. 268-284 ◽

Cited By ~ 4

Author(s):

Ashish Kumar ◽

Anil Arora ◽

Praveen Sharma ◽

Shrihari Anil Anikhindi ◽

Naresh Bansal ◽

...

Keyword(s):

Systematic Review ◽

Clinical Course ◽

Virus Disease ◽

Meta Analysis ◽

Corona Virus

Download Full-text

Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis

Cancers ◽

10.3390/cancers12071899 ◽

2020 ◽

Vol 12 (7) ◽

pp. 1899

Author(s):

Alessandro Rizzo ◽

Margherita Nannini ◽

Annalisa Astolfi ◽

Valentina Indio ◽

Pierandrea De Iaco ◽

...

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Locoregional Recurrence ◽

Early Stage ◽

Meta Analysis ◽

Distant Recurrence ◽

Uterine Leiomyosarcoma ◽

Primary Surgery ◽

Locoregional Recurrence Rate ◽

Meta Analyses

Background: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Materials and Methods: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. Results: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.

Download Full-text

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

International Journal of Molecular Sciences ◽

10.3390/ijms21144982 ◽

2020 ◽

Vol 21 (14) ◽

pp. 4982 ◽

Cited By ~ 1

Author(s):

Pietro Gentile ◽

Aris Sterodimas ◽

Jacopo Pizzicannella ◽

Laura Dionisi ◽

Domenico De Fazio ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Stromal Vascular Fraction ◽

Lateral Epicondylitis ◽

Medicinal Products ◽

Advanced Therapy Medicinal Products ◽

Advanced Therapy ◽

Meta Analyses ◽

Clinical Experiments

Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor then re-cellularized by ASCs of the recipient, in order to develop the advanced therapy medicinal products (ATMP) in fully personalized clinical approaches. A systematic review of this field has been realized in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, Embase, MEDLINE, Pre-MEDLINE, PsycINFO, CINAHL, Clinicaltrials.gov, Scopus database, and Cochrane databases has been conducted to identify articles and investigations on human allogenic ASCs transplant for clinical use. Of the 341 articles identified, 313 were initially assessed for eligibility on the basis of the abstract. Of these, only 29 met all the predetermined criteria for inclusion according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach, and 19 have been included in quantitative synthesis (meta-analysis). Ninety-one percent of the studies previously screened (284 papers) were focused on the in vitro results and pre-clinical experiments. The allogenic use regarded the treatment of perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome, refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects. The information analyzed suggested the safety and efficacy of allogenic ASCs and ECM transplants without major side effects.

Download Full-text

Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-95329-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chandan Mishra ◽

Suneeta Meena ◽

Jitendra Kumar Meena ◽

Suman Tiwari ◽

Purva Mathur

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Total Sample ◽

Urine Samples ◽

Pathogenic Potential ◽

Clinical Specimens ◽

Qrt Pcr ◽

Corona Virus ◽

Positive Rate

AbstractSARS-CoV-2 has posed an unprecedented challenge to the world. Pandemics have been caused previously by viruses of this family like Middle East Respiratory Corona Virus (MERS CoV), Severe Acute Respiratory Syndrome Corona Virus (SARS CoV). Although these viruses are primarily respiratory viruses, but they have been isolated from non-respiratory samples as well. Presently, the detection rate of SARS‐CoV‐2 RNA from different clinical specimens using Real Time Reverse Transcriptase Polymerized Chain Reaction (qRT‐PCR) after onset of symptoms is not yet well established. Therefore, the aim of this systematic review was to establish the profile of detecting SARS‐CoV‐2, MERS CoV, SARS CoV from different types of clinical specimens other than the respiratory using a standard diagnostic test (qRT‐PCR). A total of 3429 non-respiratory specimens were recorded: SARS CoV (total sample—802), MERS CoV (total sample—155), SARS CoV-2 (total sample—2347). Out of all the samples studied high positive rate was seen for saliva with 96.7% (14/14; 95% CI 87.6–100.0%) for SARS CoV and 57.5% (58/250; 95% CI − 1.2 to 116.2%) for SARS CoV-2, while low detection rate in urine samples for SARS CoV-2 with 2.2% (8/318; 95% CI 0.6–3.7%) and 9.6% (12/61; 95% CI − 0.9 to 20.1%) for SARS CoV but there was relatively higher positivity in urine samples for MERS CoV with detection rate of 32.4% (2/38; 95% CI − 37.3 to 102.1%). In Stool sample positivity was 54.9% (396/779; 95% CI 41.0–68.8%), 45.2% (180/430; 95% CI 28.1–62.3%) and 34.7% (4/38; 95% CI − 29.5 to 98.9%) for SARS CoV-2, MERS CoV, and SARS CoV, respectively. In blood sample the positivity was 33.3% (7/21; 95% CI 13.2–53.5%), 23.7% (42/277; 95% CI 10.5–36.9%) and 2.5% (2/81; 95% CI 0.00–5.8%) for MERS CoV, SARS CoV-2 and SARS CoV respectively. SARS‐CoV‐2 along with previous two pandemic causing viruses from this family, were highly detected stool and saliva. A low positive rate was recorded in blood samples. Viruses were also detected in fluids along with unusual samples like semen and vaginal secretions thus highlighting unique pathogenic potential of SARS‐CoV‐2.

Download Full-text

Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽

10.1186/s12893-021-01272-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stefano Granieri ◽

Francesco Sessa ◽

Alessandro Bonomi ◽

Sissi Paleino ◽

Federica Bruno ◽

...

Keyword(s):

Systematic Review ◽

Clinical Symptoms ◽

Rare Complication ◽

Meta Analysis ◽

Treatment Options ◽

Palliative Surgery ◽

Review Of The Literature ◽

Colovesical Fistula ◽

Level Of Evidence ◽

Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

Download Full-text

Pre-Procedural Lumbar Neuraxial Ultrasound—A Systematic Review of Randomized Controlled Trials and Meta-Analysis

Healthcare ◽

10.3390/healthcare9040479 ◽

2021 ◽

Vol 9 (4) ◽

pp. 479

Author(s):

Tatiana Sidiropoulou ◽

Kalliopi Christodoulaki ◽

Charalampos Siristatidis

Keyword(s):

Systematic Review ◽

Lumbar Spine ◽

Randomized Controlled Trials ◽

Success Rate ◽

Meta Analysis ◽

Controlled Trials ◽

Technical Failure ◽

Obese Patients ◽

Randomized Controlled ◽

Meta Analyses

A pre-procedural ultrasound of the lumbar spine is frequently used to facilitate neuraxial procedures. The aim of this review is to examine the evidence sustaining the utilization of pre-procedural neuraxial ultrasound compared to conventional methods. We perform a systematic review of randomized controlled trials with meta-analyses. We search the electronic databases Medline, Cochrane Central, Science Direct and Scopus up to 1 June 2019. We include trials comparing a pre-procedural lumbar spine ultrasound to a non-ultrasound-assisted method. The primary endpoints are technical failure rate, first-attempt success rate, number of needle redirections and procedure time. We retrieve 32 trials (3439 patients) comparing pre-procedural lumbar ultrasounds to palpations for neuraxial procedures in various clinical settings. Pre-procedural ultrasounds decrease the overall risk of technical failure (Risk Ratio (RR) 0.69 (99% CI, 0.43 to 1.10), p = 0.04) but not in obese and difficult spinal patients (RR 0.53, p = 0.06) and increase the first-attempt success rate (RR 1.5 (99% CI, 1.22 to 1.86), p < 0.0001, NNT = 5). In difficult spines and obese patients, the RR is 1.84 (99% CI, 1.44 to 2.3; p < 0.0001, NNT = 3). The number of needle redirections is lower with pre-procedural ultrasounds (SMD = −0.55 (99% CI, −0.81 to −0.29), p < 0.0001), as is the case in difficult spines and obese patients (SMD = −0.85 (99% CI, −1.08 to −0.61), p < 0.0001). No differences are observed in procedural times. Ιn conclusion, a pre-procedural ultrasound provides significant benefit in terms of technical failure, number of needle redirections and first attempt-success rate. Τhe effect of pre-procedural ultrasound scanning of the lumbar spine is more significant in a subgroup analysis of difficult spines and obese patients.

Download Full-text