Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

AbstractBackgroundImagery techniques have been used as essential parts of diagnostic workup for patients suspected for 2019-nCoV infection, Multiple studies have reported the features of chest computed tomography (CT) scans among a number of 2019-nCoV patients.MethodStudy Identification was carried out in databases (PubMed, Embase and Cochrane Library) to identify published studies examining the diagnosis, the 2019 novel coronavirus (2019-nCoV). Heterogeneity among reported prevalence was assessed by computing p-values of Cochrane Q-test and I2 -statics. The pooled prevalence of treatment failure was carried out with a fixed effects meta-analysis model, generating the pooled 95% confidence interval. A random-effect model was used to pool the results since this model could incorporate the heterogeneity of the studies and therefore proved a more generalized result.ResultsAccording to the combined results of meta-analysis, the total 55% of corona patients were males. The mean age of the patients was 41.31 (34.14, 48.47). Two prevalent clinical symptoms between patients were fever, cough with prevalence of 85%, and 62%, respectively. Either Ground Glass Opacity GGO or consolidation was seen in 86% but 14% had NO GGO or consolidation.The other rare CT symptoms were pericardial effusion, and pleural effusion with 4, 5, 7% prevalence, respectively. The most prevalent event was Either GGO or consolidation in 85% of patients.ConclusionThe most CT-scan abnormality is Either Ground Glass Opacity GGO or consolidation however in few patients none of them might be observed, so trusting in just CT findings will lead to miss some patients.

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Clinical and Paraclinical Characteristics of COVID-19 patients: A systematic review and meta-analysis

10.1101/2020.03.26.20044057 ◽

2020 ◽

Cited By ~ 2

Author(s):

Keyvan Heydari ◽

Sahar Rismantab ◽

Amir Shamshirian ◽

Parisa Lotfi ◽

Nima Shadmehri ◽

...

Keyword(s):

Systematic Review ◽

Clinical Symptoms ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Series ◽

Ground Glass Opacity ◽

Border Crossings ◽

Cross Sectional ◽

Public Places

IntroductionRecently, a new strain of coronaviruses, which originated from Wuhan City, Hubei Province, China has been identified. According to the high prevalence of new coronavirus, further investigation on the clinical and paraclinical features of this disease seems essential. Hence, we carried out this systematic review and meta-analysis to figure out the unknown features.MethodsThis study was performed using databases of Web of Science, Scopus and PubMed. We considered English cross-sectional and case-series papers which reported clinical, radiological, and laboratory characteristics of patients with COVID-19. We used STATA v.11 and random effect model for data analysis.ResultsIn the present meta-analysis, 32 papers including 49504 COVID-19 patients were studied. The most common clinical symptoms were fever (84%), cough (65%) and fatigue (42%), respectively. The most common radiological and paraclinical features were bilateral pneumonia (61%), ground-glass opacity (50%), thrombocytopenia (36%) and lymphocytopenia (34%). The study also showed that the frequency of comorbidities and early symptoms was higher in critically severe patients. Moreover, we found the overall mortality rate of three percent.ConclusionAccording to that there are many cases without Computed Tomography Scan findings or clear clinical symptoms, it is recommended to use other confirming methods such RNA sequencing in order to identification of suspicious undiagnosed patients. Moreover, while there is no access to clinical and paraclinical facilities in in public places such as airports and border crossings, it is recommended to consider factors such as fever, cough, sputum and fatigue.

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Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Additional Drug on Non-proliferative Diabetic Retinopathy: A systematic review and meta-analysis of high-quality studies

10.21203/rs.3.rs-51831/v1 ◽

2020 ◽

Author(s):

Xuedong an ◽

de jin ◽

liyun duan ◽

shenghui zhao ◽

rongrong zhou ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Fixed Effects ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Number Of Patients

Abstract Background Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment of non-proliferative DR (NPDR) with Western medicine (WM) alone are still insufficient. At present, the treatment of NPDR with the combination of traditional Chinese medicine (TCM) and WM is universally applied, and we would evaluate the effectiveness and safety of TCM as an additional drug for NPDR with systematic reviews and meta-analysis. Method Data before July 6, 2019 were searched as randomized controlled trials (RCTs) of TCM for the treatment of NPDR with WM, which were collected from China National Knowledge Infrastructure , Wanfang Database , China Biomedical Database , Pubmed , Embase and Cochrane Library . Relevant data was extracted by two reviewers respectively. I 2 statistics was adopted to appraise the heterogeneity, if I 2 <50% then the fixed-effects model would be employed, otherwise the random-effect model would be employed. (PROSPERO: CRD42019134947) Result 18 RCTs (1522 patients) were included according to the inclusion criteria. The results showed that compared with WM, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others)+ WM for NPDR could improve overall efficiency [n=1686,RR1.24(1.18,1.30), P <0.00001, I 2 =0%], and reduce the level of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P =0.0001, I 2 =72%], triglyceride and total cholesterol, but not Qiming Granule. Moreover, no serious adverse events were reported. Conclusion Compared with WM alone, TCM+WM could significantly improve NPDR, and also reduced the correlation levels of risk factors, considering the sample size and the number of patients included in the study, there might be publication bias, so the corresponding results should be treated with caution.

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Coronavirus disease (COVID-19) pandemic: an overview of systematic reviews

BMC Infectious Diseases ◽

10.1186/s12879-021-06214-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Israel Júnior Borges do Nascimento ◽

Dónal P. O’Mathúna ◽

Thilo Caspar von Groote ◽

Hebatullah Mohamed Abdulazeem ◽

Ishanka Weerasekara ◽

...

Keyword(s):

Systematic Reviews ◽

Troponin I ◽

Clinical Symptoms ◽

Meta Analysis ◽

Severe Disease ◽

Ground Glass Opacity ◽

Cochrane Library ◽

Reactive Protein ◽

Overview Of Systematic Reviews ◽

The Impact

Abstract Background Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. Methods Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. Results Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as “critically low”. Identified symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8–12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. Conclusions In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was “critically low”. Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.

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Novel oral anticoagulats for the treatment of left ventricle thrombosis: a systematic review and meta-analysis

EP Europace ◽

10.1093/europace/euab116.532 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

M Serenelli ◽

F Vitali ◽

R Pavasini ◽

E Tonet ◽

G Pompei ◽

...

Keyword(s):

Primary Outcome ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Left Ventricular ◽

Left Ventricular Thrombus ◽

Cochrane Library ◽

Secondary Outcome ◽

Ventricular Thrombus

Abstract Funding Acknowledgements Type of funding sources: None. Background novel oral anticoagulants (NOACs) are not guideline-recommanded treatment for left ventricular thrombus. Purpose: the aim of this meta-analysis is to compare NOACs versus vitamin-K atagonsits (VKAs) efficacy in treating left ventricular thrombus (LVT). Methods: we systematically searched MEDLINE, Cochrane Library, Biomed Central, and Web of Science for trials comparing NOACs versus VKAs in the setting of LVT. Five studies, out of the 74 initially selected after first screening, were included in the meta-analysis. For the development of this meta-analysis, the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. The shortlisted studies were retrieved as full articles and appraised independently by two unblinded reviewers. The Mantel-Haensel method with a random effect model was used for the pooled analysis. The primary outcome was the occurrence of stroke and systemic embolism. Secondary outcome was occurrence of left ventricular thrombosis resolution during treatment. Results: 707 patients were included in the analysis for the primary outcome. Of these, 230 were treated with NOACs and 477 with VKAs. The pooled OR for the primary outcome was 0.71 (95% CI 0.18-2.86, I2 67%), thus showing similar effect in term of ischaemic protection. A total of 698 patients, 228 on NOACs and 470 on VKAs were included in the analysis of the secondary outcome. The pooled OR for the secondary outcome pooled OR 0.97, 95% CI 0.56-1.68, I2 46%. Conclusions and Relevance: NOACs seem to have a similar efficacy profile compare to VKAs and so they should be considered as an alternative treatment for left ventricular thrombosis. Large prospective randomized clinical trials are needed to confirm this exploratory finding. Abstract Figure 1

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Prevalence of Human Papilloma Virus in Patients With Colorectal Cancer: A Systematic Review and Meta-analysis

International Journal of Enteric Pathogens ◽

10.15171/ijep.2019.23 ◽

2019 ◽

Vol 7 (4) ◽

pp. 106-112

Author(s):

Masoud Dadashi ◽

Shaian Tavakolian ◽

Ebrahim Faghihloo

Keyword(s):

Colorectal Cancer ◽

Meta Analysis ◽

Scientific Information ◽

Random Effect ◽

Random Effect Model ◽

Hpv Infection ◽

High Rate ◽

Cochrane Library ◽

High Risk Behaviors ◽

The World

Background: Human papillomavirus (HPV) is considered as one of the most common carcinogenic viruses in humans throughout the world and is mostly associated with gynecologic malignancies. However, it is also one of the environmental factors that is involved in colorectal cancer (CRC). Objective: A meta-analysis was performed to investigate the prevalence of HPV infection in patients suffering from the CRC. Methods: The frequency of the HPV in patients with CRC was studied from 2001 to 2016. To this end, several databases were reviewed, including PubMed, Web of Science, Embase, Cochrane Library, Google Scholar, Iranmedex, and the Scientific Information Database. Then, the analysis was done by Comprehensive Meta-Analysis (V2.0, Biostat) software. Considering heterogeneity between different studies, the random effect model was used and then the results were checked with Cochran’s Q-statistic. Results: The meta-analysis revealed that the frequency of HPV infection in patients with CRC was 33.7% (a 95% CI of 28.4-39.5). The additional stratified analysis also showed that HPV infection in CRC patients was more widespread in European countries compared to Asian and American countries. Conclusion: The high rate of HPV infection is a major concern in sexually transmitted diseases around the world, therefore, controlling high-risk behaviors, vaccination, screening, and HPV subtyping can be useful in managing HPV infections.

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Mean Platelet Volume and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Journal of Diabetes Research ◽

10.1155/2018/1985026 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 10

Author(s):

Zhongwei Zhou ◽

Hongmei Chen ◽

Mingzhong Sun ◽

Huixiang Ju

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Mean Platelet Volume ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Platelet Volume

Aim. To evaluate the association between mean platelet volume (MPV) and gestational diabetes mellitus (GDM). Methods. A systematic literature search was performed in PubMed, EMBASE, Web of Science, and The Cochrane Library up to 4 September 2017. Pooled standardized mean differences (SMD) and 95% confidence interval (CI) were calculated using a random-effect model. Results. Nineteen studies comprising 1361 GDM patients and 1911 normal pregnant women were included. MPV was increased in GDM patients when compared with healthy pregnant women (SMD: 0.79; 95% CI: 0.43–1.16; P<0.001). Subgroup analyses revealed that such trend was consistent in the third-trimester (SMD: 1.35; 95% CI: 0.72–1.98), Turkish (SMD: 0.81; 95% CI: 0.43–1.19), and Italian (SMD: 2.78; 95% CI: 2.22–3.34) patients with GDM and the patients diagnosed based on Carpenter and Coustan criteria (SMD: 1.04; 95% CI: 0.42–1.65). Significantly higher MPV also were observed within cross-sectional studies (SMD: 0.99; 95% CI: 0.49–1.49). Remarkable between-study heterogeneity and potential publication bias were observed in this meta-analysis; however, sensitivity analysis indicated that the results were not unduly influenced by any single study. Conclusions. GDM patients are accompanied by increased MPV, strengthening the clinical evidence that MPV may be a predictive marker for GDM.

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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.

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The Associations between VEGF Gene Polymorphisms and Diabetic Retinopathy Susceptibility: A Meta-Analysis of 11 Case-Control Studies

Journal of Diabetes Research ◽

10.1155/2014/805801 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 19

Author(s):

Liyuan Han ◽

Lina Zhang ◽

Wenhua Xing ◽

Renjie Zhuo ◽

XiaLu Lin ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Recessive Model ◽

Cochrane Library ◽

Published Data ◽

Case Control Studies ◽

Asian Populations ◽

Effect Model

Aims. Published data on the associations of VEGF polymorphisms with diabetic retinopathy (DR) susceptibility are inconclusive. A systematic meta-analysis was undertaken to clarify this topic.Methods. Data were collected from the following electronic databases: PubMed, Embase, OVID, Web of Science, Elsevier Science Direct, Excerpta Medica Database (EMBASE), and Cochrane Library with the last report up to January 10, 2014. ORs and 95% CIs were calculated for VEGF–2578C/A (rs699947), –1154G/A (rs1570360), –460T/C (rs833061), −634G>C (rs2010963), and +936C/T (rs3025039) in at least two published studies. Meta-analysis was performed in a fixed/random effect model by using the software STATA 12.0.Results. A total of 11 studies fulfilling the inclusion criteria were included in this meta-analysis. A significant relationship between VEGF+936C/T (rs3025039) polymorphism and DR was found in a recessive model (OR = 3.19, 95% CI = 1.20–8.41, andP(z)=0.01) in Asian and overall populations, while a significant association was also found between –460T/C (rs833061) polymorphism and DR risk under a recessive model (OR = 2.12, 95% CI = 1.12–4.01, andP(z)=0.02).Conclusions. Our meta-analysis demonstrates that +936C/T (rs3025039) is likely to be associated with susceptibility to DR in Asian populations, and the recessive model of –460T/C (rs833061) is associated with elevated DR susceptibility.

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β lactam monotherapy versus β lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials

BMJ ◽

10.1136/bmj.38028.520995.63 ◽

2004 ◽

Vol 328 (7441) ◽

pp. 668 ◽

Cited By ~ 330

Author(s):

Mical Paul ◽

Ishay Benuri-Silbiger ◽

Karla Soares-Weiser ◽

Leonard Leibovici

Keyword(s):

Relative Risk ◽

Combination Therapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Randomised Trials ◽

Intention To Treat ◽

Relative Risks ◽

Development Of Resistance

AbstractObjective To compare β lactam monotherapy with β lactam-aminoglycoside combination therapy for severe infections.Data sources Medline, Embase, Lilacs, Cochrane Library, and conference proceedings, to 2003; references of included studies; contact with all authors. No restrictions, such as language, year of publication, or publication status.Study selection All randomised trials of β lactam monotherapy compared with β lactam-aminoglycoside combination therapy for patients without neutropenia who fulfilled criteria for sepsis.Data selection Two reviewers independently applied selection criteria, performed quality assessment, and extracted the data. The primary outcome assessed was all cause fatality by intention to treat. Relative risks were pooled with the random effect model (relative risk < 1 favours monotherapy).Results 64 trials with 7586 patients were included. There was no difference in all cause fatality (relative risk 0.90, 95% confidence interval 0.77 to 1.06). 12 studies compared the same β lactam (1.02, 0.76 to 1.38), and 31 studies compared different β lactams (0.85, 0.69 to 1.05). Clinical failure was more common with combination treatment overall (0.87, 0.78 to 0.97) and among studies comparing different β lactams (0.76, 0.68 to 0.86). There was no advantage to combination therapy among patients with Gram negative infections (1835 patients) or Pseudomonas aeruginosa infections (426 patients). There was no difference in the rate of development of resistance. Nephrotoxicity was significantly more common with combination therapy (0.36, 0.28 to 0.47). Heterogeneity was not significant for these comparisons.Conclusions In the treatment of sepsis the addition of an aminoglycoside to β lactams should be discouraged. Fatality remains unchanged, while the risk for adverse events is increased.

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Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

BioMed Research International ◽

10.1155/2014/453012 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Guo Tian ◽

Jia-Ning Liang ◽

Zhuo-Yun Wang ◽

Dian Zhou

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Subgroup Analysis ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Number Of Patients ◽

The Impact

Background. The incidence of breast cancer in RA patients remains controversial. Thus we performed a meta-analysis to investigate the impact of RA on breast cancer.Methods. Published literature was available from PubMed, Embase, and Cochrane Library. Pooled standardized incidence rate (SIR) was computed by random-effect model analysis.Results. We identified 16 separate studies in the present study, in which the number of patients ranged from 458 to 84,475. We did not find the increased cancer risk in RA patients (SIR=0.86, 95%CI=0.72–1.02). However, subgroup analysis showed that breast cancer risk in RA patients was positively different in Caucasians (SIR=0.82, 95%CI=0.73–0.93) and non-Caucasians (SIR=1.21, 95%CI=1.19–1.23), respectively. In subgroup analysis by style, a reduced incidence was found in hospital-based case subjects (SIR=0.82, 95%CI=0.69–0.97). Similarly, subgroup analysis for adjusted factors indicated that in A3 (age and sex) and A4 (age, sex, and race/ethnicity) the risk was decreased (SIR=0.87, 95%CI=0.76–0.99;SIR=0.63, 95%CI=0.59–0.67).Conclusions. The meta-analysis revealed no increased breast cancer risk in RA patients. However, in the subgroup analysis, the risk of breast cancer is increased in non-Caucasians patients with RA while it decreased in Caucasian population, hospital-based case subjects, and A3 group. Such relationship may provide preference for risk of breast cancer in different population.

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