scholarly journals Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Mostaured Khan ◽  
Md Nuruzzaman Khan ◽  
Md. Golam Mustagir ◽  
Juwel Rana ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Healthcare Providers ◽  
Cerebrovascular Diseases ◽  
Reference List ◽  
Trim And Fill

Abstract Background: Coronavirus disease 2019 (COVID-19), the most hectic pandemic of the era, is increasing exponentially and taking thousands of lives worldwide. This study aimed to assess the prevalence of pre-existing morbidities among COVID-19 infected patients and their mortality risks against each type of pre-existing morbidity category. Methods: To conduct this systematic review and meta-analysis, Medline, Web of Science, Scopus, and CINAHL databases were searched using specified relavent keywords. Further searches were conducted using the reference list of the selected studies, renowned pre-print servers (e.g., medRxiv, bioRixv, SSRN), and relevant journal websites. Studies written in the English language included if those were conducted among COVID-19 patients with and without comorbidities and presented survivor vs. non-survivor counts or hazard/odds of deaths or survivors against types of pre-existing morbidities. Comorbidities reported in the selected studies were grouped into eight categories. The pooled likelihoods of deaths in each category were estimated using a fixed or random-effect model, based on the heterogeneity assessment. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Eggers regression test. Trim and Fill method was used if there any publication bias was found. Results: A total of 42 studies included in this study comprised of 39,398 samples. The most common pre-existing morbidities in COVID-19 infected patients were hypertension (36.5%), cardiovascular disease (11.9%), and diabetes (22.0%). The higher likelihood of deaths was found among COVID-19 patients who had pre-existing cardiovascular diseases (OR: 3.32, 95% CI: 2.79-3.95), immune and metabolic disorders (OR: 2.39, 95% CI: 2.00-2.85), respiratory diseases (OR: 2.02, 95% CI: 1.80-2.26), cerebrovascular diseases (OR: 4.12, 95% CI: 3.04-5.58), any types of cancers (OR: 2.22, 95% CI: 1.63-3.03), renal (OR: 3.02, 95% CI: 2.60-3.52), and liver diseases (OR: 1.44, 95% CI: 1.21-1.71). Conclusions: This study provides evidence of a higher likelihood of deaths among COVID-19 patients against morbidity categories. These findings could potentially help healthcare providers to sort out the most endangered COVID-19 patients by comorbidities, take precautionary measures during hospitalization, assess susceptibility to death, and prioritize their treatment, which could potentially reduce the number of fatalities in COVID-19.

scholarly journals Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Giacchetta ◽  
M Chiavarini ◽  
G Naldini ◽  
R Fabiani
Keyword(s):  
Systematic Review ◽  
Malignant Melanoma ◽  
Publication Bias ◽  
Oral Contraceptives ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cutaneous Malignant Melanoma ◽  
Hormonal Factors ◽  
Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

scholarly journals Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

2020 ◽  
Vol 30 (8) ◽  
pp. 3073-3083 ◽  
Author(s):  
Walid El Ansari ◽  
Ayman El-Menyar ◽  
Brijesh Sathian ◽  
Hassan Al-Thani ◽  
Mohammed Al-Kuwari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Publication Bias ◽  
Surgical Approach ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

scholarly journals The Prevalence of Metabolic Syndrome in Ethiopian Population: A Protocol for Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Sintayehu Ambachew ◽  
Aklilu Endalamaw ◽  
Belete Biadgo ◽  
Abebaw Worede ◽  
Mulugeta Melku
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group Analysis ◽  
Published Data ◽  
The Metabolic Syndrome ◽  
Pooled Prevalence

Abstract Background: The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia and obesity which are risk factors for cardiovascular disease, type 2 diabetes, stroke and all-cause mortality. The burden of metabolic syndrome is emerging alarmingly in low-and middle income countries like Ethiopia. This is the protocol to determine the pooled prevalence of metabolic syndrome in Ethiopian population.Methods: This systematic review and meta-analysis will include original articles of observational studies published in the English language. Searches will be carried out in PubMed, Google Scholar, and Africa Journals up to April 2019. A Fixed/Random-effect model will be used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity will be assessed using I² statistic. Sub-group analysis will also be conducted based on sex, study subjects, and methodological differences. Funnel plots and egger’s and Begg’s test will be used to asses publication bias.Ethics and dissemination: The review is based on published data; therefore, ethical approval is not required. The systematic review and meta-analysis will summarize the existing data on the prevalence of metabolic syndrome in Ethiopian population. This provides the empirical evidence necessary for researchers, policy-makers, and public health stakeholders to derive health-promoting policies, allocate resources, and set priorities for monitoring future trends. The final result will be presented at annual scientific meetings, conferences, and seminars. Moreover, it will also be published in the peer-reviewed reputable journal. We also plan to review every 5 years to provide updated information.Protocol registration number: PROSPERO International Prospective Register of Systematic Reviews (CRD42018090944)

scholarly journals Association of human papilloma Virus infection other than cervical cancer: Systematic Review and Meta Analysis

2021 ◽  
Vol 44 (1) ◽  
pp. 119-128
Author(s):  
Habtamu Molla ◽  
Habtamu Temesgen ◽  
Dereje Beyene
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Human Papilloma Virus ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Hpv Infection ◽  
Papilloma Virus ◽  
Pooled Prevalence

Human Papilloma Virus (hpv) infection causes different cancer diseases. Cervical cancer is the most common hpv related disease. hpv infection also causes cancer of anus, vulva, vagina, penis, skin, bladder, prostate, breast, oral and others because the hpv virus is epithelium-tropic. But the association of hpv infection other than cervical cancer, for example breast cancer, bladder cancer, prostate cancer etc is still inconclusive. Thus, the objective of this review was to collect published information on hpv infection other than cervix to explore the pooled prevalence of hpv infection as well as related types of cancers.  Publish research articles of hpv infection and cancer risks other than cervical cancer were systematically searched through Internet. The preferred reporting items for systematic review and meta-analysis guidelines were followed. Joanna Brigg’s Institute Meta-Analysis of Statistics Assessment and Review Instrument (jbi-mastari) adapted for cross sectional/case control study design was used for quality assessment of each individual study. A total of 22 studies were extracted and analyzed using stata 14. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression was performed to identify the probable source of heterogeneity. Both Egger’s and Begg’s tests were used to check publication bias.  The totals of 486 studies were retrieved and 22 studies were included in this meta- analysis. The meta-analysis result showed that the pooled prevalence of hpv infection other than cervix was 34.36% (95% CI: 23.75, 44.97) with severe heterogeneity (I2 = 99.5%; p<0.001) with no publication bias. The highest pooled prevalence of hpv infection other than cervix was related to genital cancer which is 58.63% (95% CI: 51.86, 65.39), followed by oral cancer (47.15% with 95% CI: 19.67, 74.63). Although cervical cancer is primarily hpv induced cancer which well articulated with so many researches, other cancer types (based on the location of the hpv infection) are also increasing across the world based on this systematic and meta-analysis study. hpv infection increases the risk of developing cancers other than cervical cancer.

scholarly journals The risk of smoking with stroke in Asia : meta-analysis

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Fadhilatul Hasnah ◽  
Yuniar Lestari ◽  
Abdiana Abdiana
Keyword(s):  
Ischemic Stroke ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Haemorrhagic Stroke ◽  
Fixed Effect Model ◽  
Stroke Subtype ◽  
Effect Model ◽  
Trim And Fill

This study uses a systematic method of review and meta-analysis to look at the risk of smoking with stroke in Asia. Further analysis based on the stroke subtype (ischemic stroke and haemorrhagic stroke was also carried out. Literature search was carried out in the PubMed, EBSCO and Google Scholar databases. Q tests were performed to determine the heterogeneity of included studies. Funnel plot, Egger regression test and trim and fill methods were used to identified publication bias and with the transformation of the model between the fixed effect model and the random effect model for sensitivity analysis A total of 12 articles were included consisting of 9 studies with case control design studies and 3 studies with cohort designs. The meta-analysis results showed that people who smoke have risks pooled OR 2.04 times (95% CI 1.57-2.65) for having a stroke Analysis of the type of stroke, smokers had 2.3 times the risk of having an ischemic stroke or 2.77 times for having a haemorrhagic stroke. Eggers test showed no influence of publication bias on the meta-analysis of smoking with stroke to. From this meta-analysis, it can be concluded that smoking increasing risk for stroke. This study found the risk of smokers to have a haemorrhagic stroke is higher than ischemic stroke.

Profiling Inflammatory Cytokines Following Zinc Supplementation: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2021 ◽  
pp. 1-28
Author(s):  
Amir Hossein Faghfouri ◽  
Behzad Baradaran ◽  
Alireza Khabbazi ◽  
Yaser Khaje Bishak ◽  
Meysam Zarezadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Inflammatory Cytokines ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Controlled Trials ◽  
Tnf Α ◽  
Trim And Fill ◽  
The Impact

Abstract Chronic inflammation has been considered as the main cause of chronic diseases. Zn has anti-inflammatory effects by decreasing the expression of inflammatory markers. The present systematic review and meta-analysis study aims to evaluate the impact of Zn supplementation on inflammation. Pubmed (Medline), Scopus, Web of Science, and Embase databases were searched up to December 10th, 2020. Randomized placebo-controlled trials have investigated the effects of Zn supplementation on serum/plasma levels of inflammatory cytokines in >15 years’ subjects were included. A pooled meta-analysis was performed using a random-effect model. Sensitivity analysis was performed to determine the robustness of the observed effect sizes. Potential causes of heterogeneity were determined using subgroup analyses. The relationship between effect size and co-variables was explored using meta-regression. In the cases of the presence of publication bias, trim and fill analysis was carried out. Cochrane Collaboration’s tool was used for assessing the quality of the included studies. A total of 12 studies was included in meta-analysis. Zn could decrease IL-6 levels (SMD= -0.76 pg/ml; 95% CI: -1.28, -0.24; P= 0.004). There was no significant change in TNF-α (SMD= 0.42 pg/ml; 95% CI: -0.31, 1.16; P= 0.257) and IL-2 levels (SMD= 1.64 pg/ml; 95% CI: -1.31, 4.59; P= 0.277) following Zn supplementation. However, Zn could increase IL-2 significantly after deletion of one arm in sensitivity analysis (SMD= 2.96 pg/ml; 95% CI: 2.03, 3.88; P< 0.05). Conclusively, Zn supplementation can decrease the IL-6 level. Zn increased IL-2 level after sensitivity analysis. Zn supplementation has not ameliorative effects on TNF-α.

scholarly journals Frequency of pyrethroid resistance in human head louse treatment: systematic review and meta-analysis

Parasite ◽  
2021 ◽  
Vol 28 ◽  
pp. 86
Author(s):  
Jalal Mohammadi ◽  
Kourosh Azizi ◽  
Hamzeh Alipour ◽  
Mohsen Kalantari ◽  
Masoumeh Bagheri ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Pyrethroid Resistance ◽  
Head Louse ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Human Head ◽  
Gene Frequencies ◽  
Pediculus Humanus

Head lice (Pediculus humanus capitis) are one of the most common insects causing infestations in humans worldwide, and infestation is associated with adverse socio-economic and public health effects. The development of genetic insensitivity (e.g., target site insensitivity = knockdown resistance or kdr) to topical insecticides has impaired effective treatment. Therefore, this study was undertaken to review and meta-analyze the frequency of pyrethroid resistance in treated head louse populations from the beginning of 2000 to the end of June 2021 worldwide. In order to accomplish this, all English language articles published over this period were extracted and reviewed. Statistical analyses of data were performed using fixed and random effect model tests in meta-analysis, Cochrane, meta-regression and I2 index. A total of 24 articles from an initial sample size of 5033 were accepted into this systematic review. The mean frequency of pyrethroid resistance was estimated to be 76.9%. In collected resistant lice, 64.4% were homozygote and 30.3% were heterozygote resistant. Globally, four countries (Australia, England, Israel, and Turkey) have 100% kdr gene frequencies, likely resulting in the ineffectiveness of pyrethrin- and pyrethroid-based pediculicides. The highest resistance recorded in these studies was against permethrin. This study shows that pyrethroid resistance is found at relatively high frequencies in many countries. As a result, treatment with current insecticides may not be effective and is likely the cause of increased levels of infestations. It is recommended that resistance status be evaluated prior to insecticide treatment, to increase efficacy.

scholarly journals Prevalence and associated factors of khat chewing among students in Ethiopia: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021157 ◽  
Author(s):  
Wondale Getinet Alemu ◽  
Tadele Amare Zeleke ◽  
Wubet Worku Takele
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Forest Plot ◽  
Khat Chewing ◽  
Study Heterogeneity ◽  
Trim And Fill ◽  
Meta Analyses

IntroductionThese days, in Ethiopia, khat chewing is one of the widely spreading public health problems affecting the most productive segment of the population. The health implications of khat chewing among students are strongly linked with poor mental, physical and social performances. However, the national magnitude of khat chewing and the associated factors among Ethiopian students are unknown. Therefore, this systematic review and meta-analysis will answer the national prevalence of khat chewing and the associated factors among students in Ethiopia.MethodsPublished primary relevant articles will be accessed using various databases, such as Medline, PubMed, EMBASE and Scopus. Other electronic search engines, for instance, Google Scholar and Google, will be used. Furthermore, additional studies will be collected by communicating with the author(s) and following the references of relevant articles. To select eligible studies, the Joanna Briggs Institute quality appraisal checklist will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed to keep the scientific rigour of the study. Heterogeneity between studies will be examined through forest plot and I2heterogeneity tests. To identify influential studies, sensitivity analysis will be done. For substantial heterogeneity (I2>50%), the DerSimonian and Laird random-effects model will be employed. Subgroup analyses will be conducted using the random-effect model. Moreover, small studies’ publication bias will be checked by funnel plots and objectively by Egger’s regression test. If in case Egger’s test was found to be statistically significant (p<0.05), trim and fill (Duval and Tweedie) analysis will be performed. The presence of association will be declared using p≤0.05 and OR with corresponding 95% CI.Ethics and disseminationSince the intention of the study is to describe earlier primary studies qualitatively and pool the results of those articles, ethical clearance will not be a concern. The results of the study will be published in a reputable peer-reviewed journal and presented at different scientific research conferences. It will also be disseminated to academic as well as other concerned institutions.PROSPERO registration numberCRD-42,017,081,886.

scholarly journals COVID-19 clinical characteristics, and sex-specific risk of mortality: Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Mohammad Javad Nasiri ◽  
Sara Haddadi ◽  
Azin Tahvildari ◽  
Yeganeh Farsi ◽  
Mahta Arbabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
World Health ◽  
Laboratory Findings ◽  
Risk Of Mortality ◽  
Health Organization

Objectives: The rapidly evolving coronavirus disease 2019 (COVID-19), was declared a pandemic by the World Health Organization on March 11, 2020. It was first detected in the city of Wuhan in China and has spread globally resulting in substantial health and economic crisis in many countries. Observational studies have partially identified the different aspects of this disease. Up to this date, no comprehensive systematic review for the clinical, laboratory, epidemiologic and mortality findings has been published. We conducted this systematic review and meta-analysis for a better understanding of COVID-19. Methods: We reviewed the scientific literature published from January 1, 2019 to March 3, 2020. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA). The pooled frequency with 95% confidence intervals (CI) was assessed using random effect model. Publication bias was assessed and p <0.05 was considered a statistically significant publication bias. Results: Out of 1102 studies, 32 satisfied the inclusion criteria. A total of 4789 patients with a mean age of 49 years were evaluated. Fever (83.0%, CI 77.5 to 87.6), cough (65.2%, CI 58.6 to 71.2) and myalgia/fatigue (34.7, CI 26.0 to 44.4) were the most common symptoms. The most prevalent comorbidities were hypertension (18.5 %, CI 12.7 to 24.4) and Cardiovascular disease (14.9 %, CI 6.0 to 23.8). Among the laboratory abnormalities, elevated C-Reactive Protein (CRP) (72.0% (CI 54.3 to 84.6) and lymphopenia (50.1%, CI 38.0 to 62.4) were the most common findings. Bilateral ground-glass opacities (66.0%, CI 51.1 to 78.0) was the most common CT-Scan presentation. Pooled mortality rate was 6.6%, with males having significantly higher mortality compared to females (OR 3.4; 95% CI 1.2 to 9.1, P = 0.01). Conclusion: COVID-19 commonly presented with a progressive course of cough and fever with more than half of hospitalized patients showing leukopenia or a high CRP on their laboratory findings. Mortality associated with COVID19 was higher than that reported in studies in China with Males having a 3-fold higher risk of mortality in COVID19 compared to females.

scholarly journals Effect of anticholinergic medications on the risk of dementia: a Protocol of systematic review and meta-analysis

2021 ◽  
Author(s):  
Elham Maraghi ◽  
Ali Reza Safarpour ◽  
Maryam Hajmohammadi ◽  
Ali Akbar Oroojan ◽  
Amal Saki Malehi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Grey Literature ◽  
Random Effect ◽  
Random Effect Model ◽  
Forest Plot ◽  
Anticholinergic Drugs ◽  
Effect Model ◽  
Statistical Heterogeneity

Abstract Introduction: The most kind of dementia is Alzheimer's disease. Alzheimer’s is a type of degenerative cerebrovascular disorder which exacerbates over time. Meanwhile, anticholinergic drugs can potentially modify the risk factors. As different studies have achieved different results and the clinical findings of these interventions have not been conclusive, the objective of this research will be to evaluate the effect of anticholinergic drugs on the risk of dementia.Materials& Methods: This systematic review and meta-analysis with no language limitation between 1988.12.15 and 2020.12.15 will search WoS, EMBASE, MEDLINE/PubMed, Scopus, ProQuest electronic databases and grey literature. Our search strategy with suitability criteria evaluating the effect of anticholinergic drugs on the risk of dementia. Two authors will independently implement the selection phases, data extraction, and quality assessment. Any discrepancies between reviewers will be resolved by consensus; otherwise, the viewpoint of a third specialist person will be applied. The reviewers will evaluate the risk of bias using NOS. We will conduct a meta-analysis with Random Effect Model or Fixed Effect Model according to severity of methodological heterogeneity. The results will be presented via the forest plot for the composition of final studies’ data, to demonstrate the separated and combined frequency and their corresponding 95% CIs and summary tables and narrative summaries. Using I2 statistics and the Q-statistic test, the statistical heterogeneity will be evaluated. For evaluating the possible reporting bias, the Funnel plot will be used; also Begg's and Egger's tests will be applied for significant results of the publication bias, and the Fill & Trim method for reformed publication bias. Ethical and dissemination: The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.PROSPRO Registration: CRD42020219612

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