Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis

AbstractSusceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune system from their history of chronic HIV infection and their use of antiretroviral therapy, some of which have been used experimentally to treat coronavirus disease 2019 (COVID-19). Therefore, we conducted a systematic review and meta-analysis to assess the epidemiology of SARS-COV-2/HIV coinfection and estimate associated mortality from COVID-19 (Prospero Registration ID: CRD42020187980). PubMed, SCOPUS, OVID and Cochrane Library databases, and medRxiv preprint repositories were searched from January 1, 2020, to December 12, 2020. Data were extracted from studies reporting COVID-19 attack and mortality rates in PLWHA compared to their HIV-negative counterparts. Pooled attack and mortality risks were quantified using random-effects models. We identified 22 studies that included 20,982,498 participants across North America, Africa, Europe, and Asia. The median age was 56 years, and 50% were male. HIV-positive persons had a significantly higher risk of SARS-CoV-2 infection [risk ratio (RR) 1.24, 95% CI 1.05–1.46)] and mortality from COVID-19 (RR 1.78, 95% CI 1.21–2.60) than HIV-negative individuals. The beneficial effects of tenofovir and protease-inhibitors in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in PLWHA remain inconclusive. HIV remains a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality from COVID-19. In support of the current Centers for Disease Control and Prevention (CDC) guidelines, persons with HIV need priority consideration for the SARS-CoV-2 vaccine.

Download Full-text

Renin–angiotensin–aldosterone system inhibitors and the risk of mortality in patients with hypertension hospitalised for COVID-19: systematic review and meta-analysis

Open Heart ◽

10.1136/openhrt-2020-001353 ◽

2020 ◽

Vol 7 (2) ◽

pp. e001353 ◽

Cited By ~ 2

Author(s):

Anna E Ssentongo ◽

Paddy Ssentongo ◽

Emily S Heilbrunn ◽

Alain Lekoubou ◽

Ping Du ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Angiotensin Ii Receptor ◽

Random Effects Models ◽

Renin Angiotensin ◽

Assessment Development ◽

Risk Of Mortality ◽

Prior Use ◽

Raas Inhibitors

ObjectiveThe association between the use of renin–angiotensin–aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear. We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality risk in patients with hypertension.MethodsPubMed (MEDLINE) SCOPUS, OVID, Cochrane Library databases and medrxiv.org were searched from 1 January 2020 to 1 September 2020. Studies reporting the association of RAAS inhibitors (ACEi or ARBs) and mortality in patients with hypertension, hospitalised for COVID-19 were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed risk ratio (RR) estimates, and heterogeneity was quantified.ResultsFourteen studies were included in the systematic review (n=73,073 patients with COVID-19; mean age 61 years; 53% male). Overall, the between-study heterogeneity was high (I2=80%, p<0.01). Patients with hypertension with prior use of RAAS inhibitors were 35% less likely to die from COVID-19 compared with patients with hypertension not taking RAAS inhibitors (pooled RR 0.65, 95% CI 0.45 to 0.94). The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations was graded as ‘moderate’ quality.ConclusionsIn this meta-analysis, with prior use of RAAS inhibitors was associated with lower risk mortality from COVID-19 in patients with hypertension. Our findings suggest a potential protective effect of RAAS-inhibitors in COVID-19 patients with hypertension.PROSPERO registration numberThe present study has been registered with PROSPERO (registration ID: CRD 42020187963).

Download Full-text

Effect of somatometric parameters on the prevalence and severity of varicocele: a systematic review and meta-analysis

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00695-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Runqing Li ◽

Junjie Liu ◽

Yushan Li ◽

Quanxian Wang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Random Effects Models ◽

Knowledge Infrastructure ◽

Regression Test ◽

Mean Differences ◽

Q Statistic ◽

The Relationship

Abstract Background Published studies have shown contradictory results regarding the relationship between somatometric parameters and varicoceles. We performed a systematic review and meta-analysis to investigate the possible effects of age, height, weight, and body mass index (BMI) on the presence and severity of varicoceles. Methods Databases including EMBASE, MEDLINE, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, and Google Scholar were systematically searched to identify relevant articles published up to March 2020. Two researchers independently identified eligible articles and extracted data. Cochran’s Q statistic and I2 statistics were used to assess heterogeneity. Meta-analysis was performed using StataSE 12.0 software (StataCorp LP, USA). Random-effects models were used to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Results The search strategy produced 272 articles, of which 18 articles were eligible according to the inclusion/exclusion criteria. A total of 56,325 patients with varicocele and 1,334,694 patients without varicocele were included in the meta-analysis to evaluate the effect of somatometric parameters on the presence and severity of varicocele. The overall results demonstrated that the presence of varicoceles was significantly associated with height (WMD = 1.41, 95% CI = 1.07 to 1.74, P < 0.001) and inversely correlated with BMI (WMD = − 1.35, 95% CI = -1.67 to − 1.03, P < 0.001) but not with age (WMD = -0.93, 95% CI = -2.19 to 0.33, P = 0.149) or weight (WMD = 0.24, 95% CI = -2.24 to 2.72, P = 0.850). The severity of varicocele was inversely correlated with increased BMI but not with age. Conclusion The presence of varicoceles was significantly associated with height and inversely correlated with BMI.

Download Full-text

Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies

Public Health Nutrition ◽

10.1017/s1368980014000949 ◽

2014 ◽

Vol 18 (4) ◽

pp. 695-704 ◽

Cited By ~ 37

Author(s):

Rosana Poggio ◽

Laura Gutierrez ◽

María G Matta ◽

Natalia Elorriaga ◽

Vilma Irazola ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

General Population ◽

Prospective Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Meta Regression ◽

Cvd Mortality

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

Download Full-text

Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0259006 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0259006

Author(s):

Ashutosh Nath Aggarwal ◽

Ritesh Agarwal ◽

Sahajal Dhooria ◽

Kuruswamy Thurai Prasad ◽

Inderpaul Singh Sehgal ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Tuberculosis ◽

Patient Outcomes ◽

Meta Analysis ◽

Severe Disease ◽

Random Effects Models ◽

Tuberculosis Patients ◽

Active Pulmonary Tuberculosis ◽

Risk Of Mortality ◽

Related Mortality

Objective The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. Methods We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. Results We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56–2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05–2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91–3.81, from four studies), as compared to COVID-19 patients without tuberculosis. Conclusion Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.

Download Full-text

Systematic Review with Meta-Analysis: Endoscopic and Surgical Resection for Ampullary Lesions

Journal of Clinical Medicine ◽

10.3390/jcm9113622 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3622

Author(s):

Christian Heise ◽

Einas Abou Ali ◽

Dirk Hasenclever ◽

Francesco Auriemma ◽

Aiste Gulla ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Significant Risk ◽

Significant Heterogeneity ◽

Incomplete Resection ◽

Quality Of Data ◽

Surgical Interventions ◽

Random Effects Models ◽

Fixed And Random Effects

Ampullary lesions (ALs) can be treated by endoscopic (EA) or surgical ampullectomy (SA) or pancreaticoduodenectomy (PD). However, EA carries significant risk of incomplete resection while surgical interventions can lead to substantial morbidity. We performed a systematic review and meta-analysis for R0, adverse-events (AEs) and recurrence between EA, SA and PD. Electronic databases were searched from 1990 to 2018. Outcomes were calculated as pooled means using fixed and random-effects models and the Freeman-Tukey-Double-Arcsine-Proportion-model. We identified 59 independent studies. The pooled R0 rate was 76.6% (71.8–81.4%, I2 = 91.38%) for EA, 96.4% (93.6–99.2%, I2 = 37.8%) for SA and 98.9% (98.0–99.7%, I2 = 0%) for PD. AEs were 24.7% (19.8–29.6%, I2 = 86.4%), 28.3% (19.0–37.7%, I2 = 76.8%) and 44.7% (37.9–51.4%, I2 = 0%), respectively. Recurrences were registered in 13.0% (10.2–15.6%, I2 = 91.3%), 9.4% (4.8–14%, I2 = 57.3%) and 14.2% (9.5–18.9%, I2 = 0%). Differences between proportions were significant in R0 for EA compared to SA (p = 0.007) and PD (p = 0.022). AEs were statistically different only between EA and PD (p = 0.049) and recurrence showed no significance for EA/SA or EA/PD. Our data indicate an increased rate of complete resection in surgical interventions accompanied with a higher risk of complications. However, studies showed various sources of bias, limited quality of data and a significant heterogeneity, particularly in EA studies.

Download Full-text

Effect of Listening to Music on Wingate Anaerobic Test Performance. A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124564 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4564 ◽

Cited By ~ 1

Author(s):

Arkaitz Castañeda-Babarro ◽

Diego Marqués-Jiménez ◽

Julio Calleja-González ◽

Aitor Viribay ◽

Patxi León-Guereño ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Anaerobic Exercise ◽

Cochrane Library ◽

Analysis Model ◽

Wingate Anaerobic Test ◽

Beneficial Effects ◽

Mean Differences ◽

Anaerobic Test

Background: There are many athletes who like to listen to music while making a high intensity effort. However, research into the effects of listening to music on athletic performance has provided controversial results, and it is suggested that the timing and type of music might affect the anaerobic performance response. Purpose: The main aim of the current systematic review and meta-analysis was to analyze the effects while listening to music tasks via the 30 s Wingate anaerobic test (WAnT) on absolute performance and relative peak power (APP and RPP), absolute and relative mean power (AMP and RMP), and fatigue index (FI). Methods: PRISMA guidelines were used as a basis for conducting this systematic review, with inclusion criteria being set out according to the PICOS model. Computer-based literature research was undertaken until 10 March 2020 using the following online databases: PubMed/Medline, WOS, Cochrane Library, and Scopus. The literature was reviewed with regard to the effects of listening to music on the WAnT using several music variables on: APP, RPP, AMP, RMP and FI. Hedges’ g formula was used to calculate both standard mean differences and 95% confidence intervals, in order to establish continuous outcomes. Furthermore, the I2 statistic evaluated systematic differences (heterogeneity) together with a random effect meta-analysis model. Results: This systematic review included nine articles that researched into the effects of music on WAnT performance (six studies describe improvements in APP and/or RPP, four in AMP and/or RMP and three in FI). The random effects model was used to undertake a final meta-analysis, with standardized mean differences (SMD) and magnitude of standardized mean differences (MSMD) (Hedges’ g) being pooled accordingly. The resulting meta-analysis incorporated eight studies that had been previously published, with results showing that there were no apparent beneficial effects on APP (p = 0.09), AMP (p = 0.33) and FI (p = 0.46) as a consequence of listening to music. However, listening to music showed beneficial effects on RPP (SMD: 0.65; 95%: CI 0.35 to 0.96; MSMD: moderate; I2, 0%; p < 0.001) and RMP (SMD: 1.03; 95%: CI, 0.63 to 1.42; MSMD: trivial; I2, 0%; p < 0.001). Conclusion: This systematic review and meta-analysis has shown that listening to music during the WAnT might physiologically enhance relative anaerobic exercise performance, although reasons remain speculative.

Download Full-text

The Use of Prophylactic Anticonvulsants in Patients with Brain Tumours—A Systematic Review

Current Oncology ◽

10.3747/co.v13i6.107 ◽

2006 ◽

Vol 13 (6) ◽

pp. 222-229 ◽

Cited By ~ 3

Author(s):

J. Perry ◽

L. Zinman ◽

A. Chambers ◽

K. Spithoff ◽

N. Lloyd ◽

...

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Brain Tumours ◽

Best Practice ◽

Meta Analysis ◽

Significant Risk ◽

Practice Variation ◽

Cochrane Library ◽

Evidence Based ◽

Newly Diagnosed

Questions: Should patients with newly diagnosed brain tumours receive prophylactic anticonvulsants to reduce seizure risk? What is the best practice for patients with brain tumours who are taking anticonvulsant medications but who have never had a seizure? Perspectives: Patients with primary or metastatic brain tumours who have never had a seizure still have a 20% risk of experiencing a seizure over the course of their disease. Because considerable practice variation exists in regard to the management of patients with brain tumours who have never had a seizure, and because conflicting evidence has been reported, the Neuro-oncology Disease Site Group (DSG) of Cancer Care Ontario’s Program in Evidence-based Care felt that a systematic review of the evidence was warranted. Outcomes: Outcomes of interest were incidence of seizures and adverse effects of prophylactic anticonvulsant therapy. Methodology: The MEDLINE and Cochrane Library databases were systematically searched for relevant evidence. The review included fully published reports or abstracts of randomized controlled trials (RCTs), systematic reviews, meta-analyses, and practice guidelines. The present systematic review was reviewed and approved by the Neuro-oncology DSG, which comprises medical and radiation oncologists, surgeons, neurologists, a nurse, and a patient representative. Results: Quality of Evidence: The literature search located one evidence-based practice guideline, one systematic review, and five RCTs that addressed prophylactic anticonvulsants for patients with brain tumours. Evidence for the best management of seizure-naïve patients who are already taking anticonvulsants was limited to one retrospective study and exploratory analyses within several RCTs. Benefits and Harms: Pooled results of the five RCTs suggest that the incidence of seizures in patients who receive prophylactic anticonvulsants is not significantly different from that in patients who do not receive anticonvulsants (relative risk: 1.04; 95% confidence interval: 0.70 to 1.54; p = 0.84). This analysis accords with results from a published meta-analysis. Evidence is insufficient to determine whether patients who are currently taking anticonvulsants but who have never had a seizure should taper the anticonvulsants. Patients who received anticonvulsants reported adverse effects, including rash, nausea, and hypotension, but whether these effects are a result of the anticonvulsants or of other treatments could not be determined. Conclusions: Based on the available evidence, the routine use of postoperative anticonvulsants is not recommended in seizure-naïve patients with newly diagnosed primary or secondary brain tumours, especially in light of a significant risk of serious adverse effects and problematic drug interactions. Because data are insufficient to recommend whether anticonvulsants should be tapered in patients who are already taking anticonvulsants but who have never had a seizure, treatment must be individualized.

Download Full-text

A Systematic Review and Meta-analysis to Determine the Effect of Oral Anticoagulants on Incidence of Dementia in Patients with Atrial Fibrillation

10.22541/au.161555710.03366973/v1 ◽

2021 ◽

Author(s):

Mingjie Lin ◽

Wenqiang Han ◽

Jingquan Zhong ◽

Lin Wu

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Publication Bias ◽

Subgroup Analysis ◽

Meta Analysis ◽

Significant Risk ◽

Risk Of Bias ◽

Cochrane Library ◽

Adjusted Risk ◽

Incidence Of Dementia

Aims: To assess the effect of oral anticoagulant (OAC) administration on incidence of dementia in patients with atrial fibrillation (AF) with Systematic review and meta-analysis in according with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. Methods: We systematically searched the electronic databases including Pubmed, Embase, Cochrane library, and ClinicalTrails.gov for relevant articles. The primary outcome was the incidence of dementia. The adjusted risk ratio (RR), odds ratio, or hazard ratio were extracted and pooled by the random-effects models. Subgroup analysis was performed according to the setting observational window. Risk of bias was assessed using the Newcastle-Ottawa Scale, while publication bias was assessed by the Begg’s and Egger’s tests. Results: Nine studies included in this review (2 prospective and 7 retrospective observational studies, including 613,920 patients). The results presented the significant association between OAC therapy and the reduced risk of dementia compared with no treatment (RR [95%CI] =0.72 [0.60, 0.86], I2=97.2%; P =0.000). In the subgroup analysis, the pooled RR became statistically non-significant (including four studies, RR [95%CI] =0.75 [0.51, 1.10], I2=98.8%; P =0.000). There is no significant risk of bias and publication bias. Conclusions: This study indicated the protective effect of OAC therapy for dementia in patients with AF. However, the results are limited because of high heterogeneity, inconsistent direction of effect in subgroup analysis. Further prospective well-designed study is needed with longer follow-up duration in younger patients.

Download Full-text

Smoking and Incidence of Insomnia: a systematic review and meta-analysis of cohort studies

10.21203/rs.3.rs-27889/v3 ◽

2020 ◽

Author(s):

Nan Hu ◽

Chunyi Wang ◽

Yan Liao ◽

Qichen Dai ◽

Shiyi Cao

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Fixed Effects ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Pooled Analysis ◽

Study Characteristics ◽

Meta Analyses ◽

The Impact

Abstract Background: Both smoking and insomnia are worldwide problems and this study aims to investigate the impact of smoking on the incidence of insomnia. Methods: PubMed, EMBASE and OVID were searched through March, 2020. Cohort studies reporting the effect of smoking on the incidence of insomnia were included. We quantitatively analyzed the basic framework and study characteristics, and then pooled estimate effects with 95% confidence intervals (CIs) of outcomes of each included studies using fixed-effects meta-analyses. Results: This systematic review included six cohort studies involving 12445 participants. Quantitatively summarized results suggested smoking could significantly increase the incidence of insomnia (OR: 1.07, 95%CI: 1.02,1.13). Regular smoking was significantly associated with incidence of insomnia (OR=1.07, 95% CI:1.01,1.13). As for occasional smokers and ex-smokers, the pooled analysis didn’t indicate a significant association (occasional smoker: OR=2.09, 95% CI:0.44,9.95; ex-smoker; OR=1.02, 95% CI:0.67,1.54). Subgroup analysis by age, gender ratio and region showed statistically significant relationship between smoking and incidence of insomnia in specific groups. Conclusions: Integrated longitudinal observational evidence identified smoking as a significant risk factor of insomnia. Considering the limited amount of available studies, more high-quality and prospective cohort studies of large sample sizes are needed to explore details of this association.

Download Full-text

Effect of Cashew Nut on Lipid Profile: A Systematic Review and Meta-Analysis

Complementary Medicine Research ◽

10.1159/000506348 ◽

2020 ◽

Vol 27 (5) ◽

pp. 348-356 ◽

Cited By ~ 2

Author(s):

Mojgan Morvaridzadeh ◽

Mahdi Sepidarkish ◽

Farnaz Farsi ◽

Abolfazl Akbari ◽

Roghayeh Mostafai ◽

...

Keyword(s):

Systematic Review ◽

Lipid Profile ◽

Fixed Effects ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Density Lipoprotein ◽

Cochrane Library ◽

Analysis Model ◽

Beneficial Effects ◽

Cashew Nut

Introduction: Nuts are one of the dietary components which appear to have beneficial effects on cardiovascular disease biomarkers. Studies demonstrate beneficial effects of cashews on serum lipids concentration, but results in the literature remain inconclusive. We conducted a review to examine the effects of cashew nut supplementation on serum lipid profile. Methods: Two reviewers independently searched PubMed, Web of Science, Cochrane Library, Scopus, and EMBASE electronic databases from inception until June 2019 without language limitation. Random- and fixed-effects models were used to calculate 95% confidence intervals (CI) for studies. Results: Six randomized clinical trials comprising 531 participants were included in this systematic review. Three studies were included in the meta-analysis model. There were no significant changes for total cholesterol (TC) (standardized mean difference [SMD]: –0.02, 95% CI: –0.32, 0.28), triglycerides (TG) (SMD: –0.01, 95% CI: –0.22, 0.20), high-density lipoprotein (HDL) cholesterol (SMD: 0.09, 95% CI: –0.16, 0.34), or low-density lipoprotein (LDL) cholesterol (SMD: –0.18, 95% CI: –0.75, 0.39). Conclusion: The results of this analysis demonstrate that treatment with cashew nut supplementation alone did not significantly change serum levels of LDL, HDL, TC, or TG.

Download Full-text