scholarly journals Thrombocytopenia Is Associated with COVID-19 Severity and Outcome: An Updated Meta-Analysis of 5637 Patients with Multiple Outcomes

2020 ◽  
Vol 52 (1) ◽  
pp. 10-15
Author(s):  
Xiaolong Zong ◽  
Yajun Gu ◽  
Hongjian Yu ◽  
Zhenyu Li ◽  
Yuliang Wang
Keyword(s):  
Distress Syndrome ◽  
Meta Analysis ◽  
Binary Outcomes ◽  
Severe Illness ◽  
Multiple Outcomes ◽  
Weighted Mean ◽  
Data Synthesis ◽  
Platelet Number ◽  
Mean Differences ◽  
Poor Outcomes

Abstract The COVID-19 pandemic is persistent worldwide. A prior meta-analysis suggested the association of thrombocytopenia (TCP) with more severe COVID-19 illness and high mortality. Considering newly published studies, we updated the previous meta-analysis to confirm and explain the association of TCP with COVID-19 severity and multiple outcomes. Twenty-four studies with 5637 patients with COVID-19 were included in this study. The weighted incidence of TCP in COVID-19 was 12.4% (95% confidence interval [CI], 7.9%–17.7%). Data synthesis showed that the platelet number was lower in patients with either more severe illness or poor outcomes and even lower in nonsurvivors, with weighted mean differences of −24.56 × 109/L, −22.48 × 109/L, and −49.02 × 109/L, respectively. The meta-analysis of binary outcomes (with and without TCP) indicated the association between TCP and 3-fold enhanced risk of a composite outcome of intensive care unit admission, progression to acute respiratory distress syndrome, and mortality (odds ratio [OR], 3.49; 95% CI, 1.57–7.78). Subgroup analysis by endpoint events suggested TCP to be significantly associated with mortality (OR, 7.37; 95% CI, 2.08–26.14). Overall, the present comprehensive meta-analysis indicated that approximately 12% of hospitalized patients with COVID-19 have TCP, which also represents a sign of more severe illness and poor outcomes.

scholarly journals The Predictive Value of Myoglobin for COVID-19-Related Adverse Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chaoqun Ma ◽  
Dingyuan Tu ◽  
Jiawei Gu ◽  
Qiang Xu ◽  
Pan Hou ◽  
...  
Keyword(s):  
Troponin I ◽  
Meta Analysis ◽  
Severe Disease ◽  
Cardiac Injury ◽  
Case Fatality ◽  
Adverse Outcomes ◽  
Cardiac Biomarkers ◽  
Severe Illness ◽  
Poor Outcomes ◽  
Meta Analyses

Objective: Cardiac injury is detected in numerous patients with coronavirus disease 2019 (COVID-19) and has been demonstrated to be closely related to poor outcomes. However, an optimal cardiac biomarker for predicting COVID-19 prognosis has not been identified.Methods: The PubMed, Web of Science, and Embase databases were searched for published articles between December 1, 2019 and September 8, 2021. Eligible studies that examined the anomalies of different cardiac biomarkers in patients with COVID-19 were included. The prevalence and odds ratios (ORs) were extracted. Summary estimates and the corresponding 95% confidence intervals (95% CIs) were obtained through meta-analyses.Results: A total of 63 studies, with 64,319 patients with COVID-19, were enrolled in this meta-analysis. The prevalence of elevated cardiac troponin I (cTnI) and myoglobin (Mb) in the general population with COVID-19 was 22.9 (19–27%) and 13.5% (10.6–16.4%), respectively. However, the presence of elevated Mb was more common than elevated cTnI in patients with severe COVID-19 [37.7 (23.3–52.1%) vs.30.7% (24.7–37.1%)]. Moreover, compared with cTnI, the elevation of Mb also demonstrated tendency of higher correlation with case-severity rate (Mb, r = 13.9 vs. cTnI, r = 3.93) and case-fatality rate (Mb, r = 15.42 vs. cTnI, r = 3.04). Notably, elevated Mb level was also associated with higher odds of severe illness [Mb, OR = 13.75 (10.2–18.54) vs. cTnI, OR = 7.06 (3.94–12.65)] and mortality [Mb, OR = 13.49 (9.3–19.58) vs. cTnI, OR = 7.75 (4.4–13.66)] than cTnI.Conclusions: Patients with COVID-19 and elevated Mb levels are at significantly higher risk of severe disease and mortality. Elevation of Mb may serve as a marker for predicting COVID-19-related adverse outcomes.Prospero Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020175133, CRD42020175133.

scholarly journals Melatonin and Cardioprotection in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Alberto Domínguez-Rodríguez ◽  
Pedro Abreu-González ◽  
Néstor Báez-Ferrer ◽  
Russel J. Reiter ◽  
Pablo Avanzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Left Ventricular Ejection ◽  
Favorable Effect ◽  
Controlled Trials ◽  
Weighted Mean ◽  
Randomized Controlled ◽  
Mean Differences

Myocardial ischemia/reperfusion (IR) injury represents a critical problem associated with interventional approaches for coronary reperfusion. Pharmacological cardioprotective interventions are advocated to ameliorate IR injury. Melatonin is an anti-inflammatory and antioxidant agent with a wide range of therapeutic properties that may contribute to its cardioprotective effects. No systematic review or meta-analysis has compared melatonin vs. placebo as a cardioprotective agent in humans. The present study, based on a systematic review and meta-analysis, was carried out to assess melatonin's efficacy as a cardioprotective treatment. We performed a systematic review of the available literature. Randomized controlled trials (RCTs) were identified and information was extracted using predefined data extraction forms. The primary outcomes were (a) left ventricular ejection fraction (LVEF) and (b) blood troponin levels in patients who underwent myocardial revascularization and were randomized to melatonin or placebo. The inverse-variance random-effects method was used to pool the estimates. Heterogeneity and publication bias were assessed. Weighted mean differences or standardized mean differences were calculated. A total of 283 records were screened and seven RCTs met all the inclusion criteria. After the pooled analysis, the results on LVEF were consistent across all studies, and a significant heterogeneity was found in the results on troponin levels. The melatonin-treated patients had on average higher LVEF than the placebo-treated individuals with a weighted mean difference = 3.1% (95% CI 0.6–5.5, p = 0.01). Five works compared the levels of troponin after melatonin or placebo treatment. The melatonin-treated patients had lower levels of troponin with a standardized mean difference = −1.76 (95% CI −2.85 to −0.67, p = 0.002). The findings of this meta-analysis revealed that melatonin administration in humans as a cardioprotective agent attenuated heart dysfunction with a favorable effect on the LVEF.

Meta-analysis of immunogenicity and safety of human rabies vaccination under Zagreb and Essen regimens

2020 ◽  
Author(s):  
Ting Li ◽  
Xin Wang ◽  
Hongbin Cheng
Keyword(s):  
Adverse Events ◽  
Safety Profile ◽  
Meta Analysis ◽  
Neutralizing Antibody ◽  
Human Rabies ◽  
Antibody Concentration ◽  
Weighted Mean ◽  
Mean Differences ◽  
Risk Ratios ◽  
Rabies Vaccination

Aim: To assess the immunogenicity and safety of rabies vaccination under the Zagreb and Essen regimens by performing a meta-analysis. Methods: Electronic databases were searched for eligible studies. Risk ratios and weighted mean differences with 95% CIs were used to calculate estimates. Results: A total of 18 studies were included. Rabies virus neutralizing antibody concentration was comparable between the two regimens at D7 and 14. No significant differences were observed in seroconversion rates from D14 and 42. Incidence of fever was higher in Zagreb group (risk ratio: 1.55 [1.37–1.76]); but no significant differences were present for other common adverse events. Conclusion: Rabies vaccination under the Zagreb regimen was noninferior to the Essen regimen in immunogenicity and had an acceptable safety profile.

scholarly journals 109 Comparative Efficacy and Tolerability of Lurasidone Versus Other Oral Atypical Antipsychotics for Pediatric Schizophrenia: A Network Meta Analysis

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 70-71
Author(s):  
Celso Arango ◽  
Daisy Ng-Mak ◽  
Elaine Finn ◽  
Aidan Byrne ◽  
Krithika Rajagopalan ◽  
...  
Keyword(s):  
Weight Gain ◽  
Atypical Antipsychotics ◽  
Meta Analysis ◽  
Credible Interval ◽  
Similar Efficacy ◽  
Binary Outcomes ◽  
Trial Duration ◽  
Study Objective ◽  
Syndrome Scale ◽  
Mean Differences

AbstractStudy ObjectiveThis analysis assessed the relative efficacy and tolerability of lurasidone versus other atypical antipsychotics in the treatment of pediatricschizophrenia.MethodsA systematic literature review identified 13 randomized-controlled trials for the treatment of pediatric schizophrenia. A Bayesian network meta-analysis compared the efficacy and tolerability of the following atypical antipsychotics: aripiprazole, asenapine, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, andziprasidone. Patients were 7-17 years old and trial duration ranged from 6-12 weeks. Outcomes included Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity (CGI-S), weight gain, all-cause treatment discontinuation, and extrapyramidal symptoms. Results from the fixed effect models were reported as mean differences for continuous outcomes and odds ratios for binary outcomes; each with a 95% credible interval.ResultsLurasidone had significantly greater improvement compared with placebo for PANSS (-7.95 [-11.76, -4.16]) and CGI-S (-0.44 [-0.67, -0.22]), but did not differ from comparators. The differences in weight gain for lurasidone relative to comparators were as follows: clozapine (-3.81kg [-8.03, 0.42]), olanzapine (-3.62kg [-4.84, -2.41]), quetiapine (-2.13kg [-3.20, -1.08]), risperidone (-1.16kg [-2.14, -0.17]), asenapine (-0.98kg [-1.71, -0.24]), paliperidone (-0.85kg [-1.57, -0.14]), aripiprazole (-0.15kg [-0.88, 0.58]), and ziprasidone (0.38kg [-0.49, 1.24]); all were statistically significant except for clozapine, aripiprazole, and ziprasidone. Rates of all-cause discontinuation andextrapyramidal symptoms were similar for lurasidone and comparators, except aripiprazole and paliperidone, which had higher rates of all-cause discontinuation.ConclusionsIn this network meta-analysis of atypical antipsychotics for the treatment of adolescent schizophrenia, lurasidone was associated with similar efficacy, but less weight gain than active comparators.Funding AcknowledgementsThis study was funded by Sunovion Pharmaceuticals Inc.

scholarly journals Effectiveness of cognitive behavioural therapy on quality of life in patients with prostate cancer after androgen deprivation therapy: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049314
Author(s):  
Fan Yuan ◽  
Degui Chang ◽  
Mingyi Jing ◽  
Baohua Zhu ◽  
Yaodong You
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Side Effects ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Data Synthesis ◽  
Cognitive Behavioural ◽  
Mean Differences

IntroductionProstate cancer (PCa), as a malignant tumour with rapid development in recent years, significantly affects men’s health, work, life and economy. Androgen deprivation therapy (ADT) plays an important role in the treatment of PCa and can be used as a complementary therapy in the late stage of castration-resistant prostate cancer. Though ADT targeting PCa shows an effective therapeutic effect, the underlying side effects (cognitive disorder, hot flashes, a decrease in sexuality) cannot be ignored. At present, cognitive behavioural therapy (CBT) has been widely used for patients with PCa after ADT due to its confirmed efficacy, fewer side effects and lower economic burden. However, the effectiveness of CBT for patients with PCa after ADT is still controversial. Therefore, we will conduct a systematic review and meta-analysis of the effectiveness of CBT for patients with PCa after ADT.Methods and analysisLiteratures will be searched from establishment of the database to 31 May 2021 with the language restrictions of English and Chinese in eight online databases (PubMed, Embase, the Web of Science, Cochrane Library, VIP, CNKI, CBM, and WAN FANG). This study will include RCTs that performed CBT as the main method of the experimental group for patients with PCa after ADT. Two or more reviewers will independently conduct the selection of studies, data extraction and data analysis. The risk ratios with 95% CIs will be used to present the data synthesis result of dichotomous data, while weighted mean differences or standardised mean differences with 95% CIs will be used to present the data synthesis result of continuous data. Meanwhile, evidence quality of outcome will be assessed by using the Grading of Recommendations Assessment, Development and Evaluation method. Stata V.13.0 and Review Manager software V.5.3 will be used for analysis and synthesis.Ethics and disseminationThis protocol is a second study based on a completed randomised controlled study. Thus, ethical approval is not required, and no additional data are available.OSF registration numberDOI 10.17605/OSF.IO/FUVEA

DERIVING TREATMENT RECOMMENDATIONS FROM EVIDENCE WITHIN RANDOMIZED TRIALS The Role and Limitation of Meta-Analysis

1999 ◽  
Vol 15 (2) ◽  
pp. 304-315 ◽  
Author(s):  
Nick Freemantle ◽  
James Mason ◽  
Martin Eccles
Keyword(s):  
Meta Analysis ◽  
Development Project ◽  
Weighted Mean ◽  
The North ◽  
Guidelines Development ◽  
Substantial Investment ◽  
Mean Differences ◽  
Meta Analyses ◽  
Robust Measures ◽  
Choice Of Therapy

Meta-analysis is commonly used in reviews of the effectiveness of medical technologies, but this approach has not been used in direct support of guidelines development groups. This paper describes the approach of the North of England Guidelines Development Project in describing the evidence using meta-analyses that were conducted explicitly to address questions on the choice of therapy raised by the guidelines development groups. Particular emphasis is placed on the context within which the contributing trials were conducted and the extent to which systematic differences between trials (heterogeneity) was observed, described, and explained. There is a trade-off between internal and external validity for different metrics when presenting the results of trials. More interpretable metrics, such as risk differences or weighted mean differences, are confounded by study design issues and strong assumptions. More robust measures such as odds ratios or standardized weighted mean differences are difficult to interpret physically. Individual patient data may prove particularly helpful in addressing pivotal questions on the magnitude of effects of interventions, though accessing and reanalyzing these data requires a substantial investment in time and other resources.

IL-17A in COVID-19 Cases: a meta-analysis

2021 ◽  
Vol 15 (11) ◽  
pp. 1630-1639
Author(s):  
Sukayna Fadlallah ◽  
Marcel S Sham Eddin ◽  
Elias A Rahal
Keyword(s):  
Autoimmune Disease ◽  
Severe Acute Respiratory Syndrome ◽  
Confidence Interval ◽  
Random Effects ◽  
Proinflammatory Cytokine ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Weighted Mean ◽  
Disease Pathogenesis ◽  
Mean Differences

Introduction: Numerous reviews, commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). IL-17A is a proinflammatory cytokine attributed with homeostatic roles but that is also involved in autoimmune disease pathogenesis. While some studies have reported an increase in IL-17A in COVID-19 cases, no significant associations were found by others. Hence, we undertook this meta-analysis to study serum IL-17A levels in COVID-19 patients in relation to disease severity. Methodology: Multiple databases were systematically reviewed for literature published on the topic from January 1, 2019 to April 30, 2021. A random effects model was used to calculate weighted mean differences (WMDs) and 95% confidence interval (CIs) as well as the

scholarly journals Obesity and Pro12Ala Polymorphism of Peroxisome Proliferator-Activated Receptor-Gamma Gene in Healthy Adults: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 67 (2) ◽  
pp. 104-118 ◽  
Author(s):  
Anahita Mansoori ◽  
Maryam Amini ◽  
Fariba Kolahdooz ◽  
Ensiyeh Seyedrezazadeh
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Adults ◽  
Peroxisome Proliferator ◽  
Dominant Model ◽  
Weighted Mean ◽  
Pro12ala Polymorphism ◽  
Peroxisome Proliferator Activated Receptor ◽  
Mean Differences ◽  
The Relationship

Background: The aim of this systematic review was to evaluate the relationship between obesity and peroxisome proliferator-activated receptor-gamma (PPARγ) Pro12Ala polymorphism in healthy adults. Summary: Weighted mean differences (WMDs) of body mass index (BMI) were calculated for different inheritance models and subgroups. Fifty-six studies were eligible for inclusion in the meta-analysis. The result shows that the Ala allele of this polymorphism was associated with increased WMD in mean BMI (WMD = 0.29, 95% CI 0.10-0.48, p = 0.003). The Ala carriers were associated with increased WMD in mean BMI values in both genders and in the Caucasian subgroup. The associations were seen among people with higher levels of BMI (BMI ≥35). Message: The Ala allele of the PPARγ Pro12Ala polymorphism in healthy adults was associated with increased BMI under a dominant model of inheritance.

Effects of the FIFA 11 training program on injury prevention and performance in football players: a systematic review and meta-analysis

2016 ◽  
Vol 31 (5) ◽  
pp. 651-659 ◽  
Author(s):  
Mansueto Gomes Neto ◽  
Cristiano Sena Conceição ◽  
Alécio Jorge Alves de Lima Brasileiro ◽  
Camila Santana de Sousa ◽  
Vitor Oliveira Carvalho ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Injury Prevention ◽  
Dynamic Balance ◽  
Meta Analysis ◽  
Mean Difference ◽  
Football Players ◽  
Weighted Mean ◽  
Standard Mean Difference ◽  
And Performance ◽  
Mean Differences

Objective: To investigate the effects of FIFA 11 training on injury prevention and performance in football players. Design and methods: Systematic review and meta-analysis. We conducted a systematic search using four databases (CINAHL, Cochrane Library, EMBASE, and PubMed) to find controlled trials evaluating the effects of FIFA 11 on injury prevention and performance among football players. Weighted mean differences, standard mean differences, risk ratios, and 95% confidence intervals were calculated, and heterogeneity was assessed using the I2 test. Results: We analyzed 11 trials, including 4700 participants. FIFA 11 resulted in a significant reduction in injury risk (risk ratio = 0.69; 95% confidence interval, 0.49–0.98; P = 0.02) and improvements in dynamic balance (weighted mean difference = 2.68; 95% confidence interval, 0.44–4.92; P = 0.02) and agility (standard mean difference = −0.36; 95% confidence interval, 0.70–0.02; P = 0.04). The meta-analysis indicated a non-significant improvement in jump height (standard mean difference = 0.25; 95% confidence interval, 0.08–0.59; P = 0.14) and running sprint (standard mean difference = −0.24; 95% confidence interval, 0.58–0.10; P = 0.17) in the FIFA 11 group. Conclusions: FIFA 11 can be considered as a tool to reduce the risk of injury. It may improve dynamic balance and agility and can be considered for inclusion in the training of football players.

scholarly journals Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis

2016 ◽  
Vol 116 (7) ◽  
pp. 1153-1164 ◽  
Author(s):  
Alexandra Ferreira Vieira ◽  
Rochelle Rocha Costa ◽  
Rodrigo Cauduro Oliveira Macedo ◽  
Leandro Coconcelli ◽  
Luiz Fernando Martins Kruel
Keyword(s):  
Aerobic Exercise ◽  
Carbohydrate Metabolism ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Plasma Concentrations ◽  
Fat Oxidation ◽  
Metabolic Effects ◽  
Weighted Mean ◽  
Fed State ◽  
Mean Differences

AbstractThis study aimed to verify the effect of aerobic exercise performed in the fasted v. fed states on fat and carbohydrate metabolism in adults. Searches were conducted in March 2015, and updated in July 2016, using PubMed®, Scopus and Cochrane databases (terms: ‘fasting’, ‘exercise’, ‘aerobic exercise’, ‘substrate’, ‘energy metabolism’, ‘fat’, ‘glucose’, ‘insulin’ and ‘adult’) and references from selected studies. Trials that compared the metabolic effects of aerobic exercise (duration ≤120 min) performed in the fasted v. fed states in adults were accepted. The outcomes evaluated were fat oxidation during exercise and the plasma concentrations of insulin, glucose and NEFA before and immediately after exercise; two independent reviewers extracted the data (A. F. V. and L. C.). The results were presented as weighted mean differences between treatments, with 95 % CI. Of 10 405 articles identified, twenty-seven studies – with a total of 273 participants – were included. There was a significant increase in fat oxidation during exercise performed in the fasted, compared with fed, state (−3·08 g; 95 % CI −5·38, −0·79; I2 39·1 %). The weighted mean difference of NEFA concentrations was not significantly different between states (0·00 mmol/l; 95 % CI −0·07, 0·08; I2 72·7 %). However, the weighted mean differences of glucose (0·78 mmol/l; 95 % CI 0·43, 1·14; I2 90·8 %) and insulin concentrations (104·5 pmol/l; 95 % CI 70·8, 138·2; I2 94·5 %) were significantly higher for exercise performed in the fed state. We conclude that aerobic exercise performed in the fasted state induces higher fat oxidation than exercise performed in the fed state.

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