scholarly journals Are men who smoke at higher risk for a more severe case of COVID-19 than women who smoke? A Systematic Review

2020 ◽  
Author(s):  
Aoife Rodgers ◽  
Emilie Kruke Indreberg ◽  
Lenah Alfallaj ◽  
Manasi Nadkarni ◽  
Zubair Kabir
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Clinical Manifestations ◽  
Severe Case ◽  
Smoking History ◽  
Male Population ◽  
Crude Odds Ratio ◽  
Smoking Trends ◽  
The Impact ◽  
Gender Specific

AbstractBackgroundThe novelty of the Covid-19 pandemic is reflected in the lack of literature available for the impact of smoking on the intensity of the COVID-19 clinical manifestations. Our study tries to address this gap.MethodSix cohorts from China were analysed and a crude odds ratio was manually calculated.ResultsPatients with a smoking history were approximately 2 times (95% CI= 1.036-1.883) as likely to suffer from severe clinical manifestations of COVID-19 compared to patients without a smoking history. A higher percentage of males suffer more severe symptoms of COVID-19 in comparison to females, but this could be associated with the gender specific smoking trends observed in China.ConclusionThe gender specific smoking trends could be associated with the increased severity of COVID-19 disease manifestations in the male population.

scholarly journals Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis

BMJ ◽  
2018 ◽  
pp. k4738 ◽  
Author(s):  
Joanna C Crocker ◽  
Ignacio Ricci-Cabello ◽  
Adwoa Parker ◽  
Jennifer A Hirst ◽  
Alan Chant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Lived Experience ◽  
Odds Ratio ◽  
Public Involvement ◽  
Meta Analysis ◽  
Patient And Public Involvement ◽  
Retention Rates ◽  
The Impact

AbstractObjectiveTo investigate the impact of patient and public involvement (PPI) on rates of enrolment and retention in clinical trials and explore how this varies with the context and nature of PPI.DesignSystematic review and meta-analysis.Data sourcesTen electronic databases, including Medline, INVOLVE Evidence Library, and clinical trial registries.Eligibility criteriaExperimental and observational studies quantitatively evaluating the impact of a PPI intervention, compared with no intervention or non-PPI intervention(s), on participant enrolment and/or retention rates in a clinical trial or trials. PPI interventions could include additional non-PPI components inseparable from the PPI (for example, other stakeholder involvement).Data extraction and analysisTwo independent reviewers extracted data on enrolment and retention rates, as well as on the context and characteristics of PPI intervention, and assessed risk of bias. Random effects meta-analyses were used to determine the average effect of PPI interventions on enrolment and retention in clinical trials: main analysis including randomised studies only, secondary analysis adding non-randomised studies, and several exploratory subgroup and sensitivity analyses.Results26 studies were included in the review; 19 were eligible for enrolment meta-analysis and five for retention meta-analysis. Various PPI interventions were identified with different degrees of involvement, different numbers and types of people involved, and input at different stages of the trial process. On average, PPI interventions modestly but significantly increased the odds of participant enrolment in the main analysis (odds ratio 1.16, 95% confidence interval and prediction interval 1.01 to 1.34). Non-PPI components of interventions may have contributed to this effect. In exploratory subgroup analyses, the involvement of people with lived experience of the condition under study was significantly associated with improved enrolment (odds ratio 3.14v1.07; P=0.02). The findings for retention were inconclusive owing to the paucity of eligible studies (odds ratio 1.16, 95% confidence interval 0.33 to 4.14), for main analysis).ConclusionsThese findings add weight to the case for PPI in clinical trials by indicating that it is likely to improve enrolment of participants, especially if it includes people with lived experience of the health condition under study. Further research is needed to assess which types of PPI work best in particular contexts, the cost effectiveness of PPI, the impact of PPI at earlier stages of trial design, and the impact of PPI interventions specifically targeting retention.Systematic review registrationPROSPERO CRD42016043808.

scholarly journals Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeong Yee ◽  
Woorim Kim ◽  
Ji Min Han ◽  
Ha Young Yoon ◽  
Nari Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Fetal Death ◽  
Web Of Science ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Current Review ◽  
The Mean ◽  
The Impact

Abstract This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

Hepatitis B reactivation in patients with solid tumors: A systematic review and meta-analysis.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 138-138 ◽  
Author(s):  
Lisa K. Hicks ◽  
Jordan J. Feld ◽  
Ronak Saluja ◽  
Judy Truong ◽  
Adam E. Haynes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis B ◽  
Solid Tumors ◽  
Solid Tumor ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Hbv Reactivation ◽  
Antiviral Prophylaxis ◽  
Chronic Hbv ◽  
The Impact

138 Background: Hepatitis B virus (HBV) affects over 250 million people worldwide. Most people with chronic HBV (HBsAg positive) have no signs or symptoms of infection. However, when exposed to immunosuppression they are at risk of HBV reactivation which can cause hepatitis, liver failure and death. The risk of HBV reactivation in patients receiving chemotherapy for solid tumors, the efficacy of antiviral prophylaxis, and the clinical impact of HBV reactivation in this setting are uncertain. Primary Aim: To estimate the risk of clinical HBV reactivation (increased HBV DNA + transaminitis) among HBsAg-positive patients administered chemotherapy for a solid tumor. Secondary Aims: To estimate the efficacy of anti-viral prophylaxis and the risk of death from HBV reactivation in patients receiving chemotherapy for solid tumors. Methods: A systematic review and meta-analysis of the English language literature on HBV reactivation was completed (OVID Medline, 1946 to Aug 2013). All citations were reviewed by two or more authors. Data from patients with hematologic malignancies were excluded. Pooled probabilities of HBV reactivation risk, death from HBV reactivation, and odds ratio for the impact of anti-viral prophylaxis were estimated with a random effects model. Results: 2,667 citations were identified; 19 were eligible for inclusion. The pooled estimate for clinical HBV reactivation in HBsAg-positive patients receiving chemotherapy for a solid tumor was 21.9% (95% CI; 16.5% to 27.3%) in those not receiving anti-viral prophylaxis, and 2.4% (95% CI 0.7% to 4.2%) in those receiving anti-viral prophylaxis. The odds ratio for clinical HBV reactivation with antiviral prophylaxis compared to no prophylaxis was 0.12 (95% CI 0.06 to 0.25). In the absence of viral prophylaxis, the risk of dying from HBV reactivation in HBsAg-positive solid tumor patients was estimated at 1.3% with a 95% CI of 0.3% to 2.3%. Conclusions: Patients with chronic HBV who are administered chemotherapy for a solid tumor appear to be at substantial risk of clinical HBV reactivation; this risk may be mitigated by anti-viral prophylaxis. In the absence of anti-viral therapy, patients may experience a small but important risk of dying from HBV reactivation.

scholarly journals Unique and Varied Contributions of Traditional CVD Risk Factors: A Systematic Literature Review of CAD Risk Factors in China

2013 ◽  
Vol 7 ◽  
pp. CMC.S10225 ◽  
Author(s):  
Joanne Foody ◽  
Yong Huo ◽  
Linong Ji ◽  
Dong Zhao ◽  
Dylan Boyd ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Real World ◽  
Odds Ratio ◽  
Lipid Levels ◽  
Artery Disease ◽  
The Impact ◽  
Cad Risk

This study is the first systematic review of risk factors for stroke in China and supports the importance of current public health initiatives to manage the risk factors appropriately to reduce risk of stroke in high risk patients. Additionally, this study has been co-authored by prominent Chinese and US physicians and researchers with expertise in cardiovascular disease, neurologic disorders, epidemiology, and real world data. While there have been several systematic reviews of real world associations of risk factors for coronary artery disease, none focus specifically on the population of China, where there is growing evidence that such risk factors are poorly treated or uncontrolled, especially in rural areas. Background To better understand the impact of traditional cardiovascular risk factors on risk of coronary artery disease (CAD) in China, a systematic review of all Chinese observational studies published in either English or Chinese in MEDLINE and EMBASE over the last 5 years was performed and the association between any of 5 traditional risk factors (ie, hypertension, diabetes, elevated lipid levels, obesity, and smoking) and the risk of CAD was studied. Methods and Results The study found a consistent relationship between lipid levels and CAD. Higher low-density lipoprotein cholesterol values were associated with greater risk of CAD, with an odds ratio as high as 3.31. Other factors found to be significant contributors to the risk of CAD included hypertension (crude odds ratio range of 1.40-5.11), diabetes (1.50-5.97), and smoking (1.37-5.19). An association between obesity and CAD in China was observed, but the evidence supporting this was considered weak due to the paucity of studies found as part of this review. Conclusions This review provides a systematic summary of CAD risk factors in China and demonstrates the important differences that exist in CAD risk factors between countries and regions. Approaches to reduce CAD globally must take into account the unique risk factors that drive CAD in each country and region as is demonstrated by these findings.

scholarly journals A systematic review of the impact of the Alpha and Gamma variants of concern on hospitalization and symptomatic rates of SARS-CoV-2

2021 ◽  
Author(s):  
Alexandra Schroeder ◽  
Matthew R. MacLeod
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Odds Ratio ◽  
Armed Forces ◽  
Canadian Armed Forces ◽  
Age Related ◽  
Two Parameters ◽  
The Impact ◽  
Epidemiological Parameters

AbstractThe hospitalization and symptomatic rates of Severe Acute Respiratory Syndrome Coronavirus Disease 2019 (SARS-CoV-2) are key epidemiological parameters affecting risk analyses conducted for the Canadian Armed Forces (CAF) during the Coronavirus Disease-19 (COVID-19) pandemic. As one of the criteria of a variant of concern (VOC) is that it affects disease severity, the authors sought to understand whether the Alpha and Gamma VOCs are significantly different in these two parameters than the original wildtype of SARS-CoV-2, the most prevalent in relevant areas of Canada as of study initiation. Searches for studies were conducted in Scopus and PubMed, and located through following citations and receiving studies from daily literature scans. For the hospitalization outcome, effect ratios relative to original wildtype were included. For the symptomatic ratio, the ratio itself for each variant was used. Analysis of age-related effects was of particular value, as CAF members are primarily adults under the age of 60. The firmest conclusion of this review is that the Alpha VOC comes with a higher relative risk of hospitalization compared to the original wildtype, most likely above 1.4, while unlikely to be above 2, with the balance of evidence being that the relative risk is not significantly modified by age. The evidence for Gamma is more limited, but the odds ratio may be above 2, and potentially much greater than that, especially for those 20-39 years of age. For both VOCs reports on symptomatic ratio differed on whether there was an effect, as well as its potential direction.

scholarly journals The impact of atrial fibrillation type on the risks of thromboembolic recurrence, mortality and major haemorrhage in patients with previous stroke: A systematic review and meta-analysis of observational studies

2020 ◽  
Vol 5 (2) ◽  
pp. 155-168
Author(s):  
Antonia Mentel ◽  
Terence J Quinn ◽  
Alan C Cameron ◽  
Kennedy R Lees ◽  
Azmil H Abdul-Rahim
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Major Haemorrhage ◽  
Risk Of Bias ◽  
Previous Stroke ◽  
The Impact

Introduction There is conflicting evidence on the impact of atrial fibrillation (AF) type, i.e. non-paroxysmal AF or paroxysmal AF, on thromboembolic recurrence. The consensus of risk equivalence is greatly based on historical evidence, focussing on initial stroke risks. We conducted a systematic review and meta-analysis to describe the impact of AF type on the risk of thromboembolic recurrence, mortality and major haemorrhage in patients with previous stroke. Methods We systematically searched four multidisciplinary databases from inception to December 2018. We selected observational studies investigating clinical outcomes in patients with ischaemic stroke and AF, stratified by AF type. We assessed all included studies for risk of bias using the ‘Risk of Bias In Non-randomised Studies – of Exposures’ tool. The Comprehensive Meta-Analysis Software was used to calculate odds ratios from crude event rates. Results After reviewing 14,127 citations, we selected 108 studies for full-text screening. We extracted data from a total of 26 studies, reporting outcomes on 23,054 patients. Overall, risk of bias was moderate. The annual incidence rates of thromboembolism in patients with non-paroxysmal AF and paroxysmal AF were 7.1% (95% confidence interval: 4.2–11.7) and 5.2% (95% confidence interval: 3.2–8.2), respectively. The odds ratio for thromboembolism in patients with non-paroxysmal AF versus paroxysmal AF was 1.47 (95% confidence interval: 1.08–1.99, p = 0.013). The annual mortality rates in patients with non-paroxysmal AF and paroxysmal AF were 20.0% (95% confidence interval: 13.2–28.0) and 10.1% (95% confidence interval: 5.4–17.3), respectively, and odds ratio was 1.90 (95% confidence interval: 1.43–2.52, p < 0.001). There was no difference in rates of major haemorrhage, odds ratio  = 1.01 (95% confidence interval: 0.61–1.69, p = 0.966). Conclusion In patients with prior stroke, non-paroxysmal AF is associated with significantly higher risk of thromboembolic recurrence and mortality than paroxysmal AF. Although current guidelines make no distinction between non-paroxysmal AF and paroxysmal AF for secondary stroke prevention, future guidance and risk stratification tools may need to consider this differential risk (PROSPERO ID: CRD42019118531).

scholarly journals One-Seventh of Patients with COVID-19 Had Olfactory and Gustatory Abnormalities as Their Initial Symptoms: A Systematic Review and Meta-Analysis

Life ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 158 ◽  
Author(s):  
Hsin Chi ◽  
Nan-Chang Chiu ◽  
Chun-Chih Peng ◽  
Chao-Hsu Lin ◽  
Yu-Lin Tai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Diagnostic Testing ◽  
Clinical Manifestations ◽  
Pooled Prevalence ◽  
Initial Symptoms ◽  
Wide Range ◽  
Cardinal Symptoms ◽  
Negative Controls

Coronavirus disease 2019 (COVID-19) patients exhibited protean clinical manifestations. Olfactory and gustatory abnormalities (anosmia and ageusia) were observed in COVID-19 patients, but the reported prevalence varied. In this systematic review, the prevalence of olfactory and gustatory abnormalities (OGA) was evaluated in laboratory-confirmed COVID-19 patients. On 8 May 2020, 14,506 articles were screened, while 12 of them were enrolled. A total of 1739 COVID-19 patients were analyzed, with a wide range of prevalence observed (5.6–94%). The pooled prevalence was 48.5% with high heterogeneity (I2, 98.8%; p < 0.0001). In total, 15.5% had OGA as their first symptom (I2, 22.6%; p = 0.27) among the patients analyzed. Contradictory to COVID-19 negative controls, patients with COVID-19 had a higher risk of OGA (odds ratio, 5.3; I2, 66.5%; p = 0.03). In conclusion, approximately half of COVID-19 patients had OGA, and one-seventh of them had OGA as their initial symptoms. OGA were cardinal symptoms of COVID-19, which may serve as clues for early diagnosis. Diagnostic testing for SARS-CoV-2 was suggested in patients with OGA during the COVID-19 pandemic to ensure timely diagnosis and appropriate quarantine.

The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis

2011 ◽  
Vol 42 (8) ◽  
pp. 1567-1580 ◽  
Author(s):  
G. Geulayov ◽  
D. Gunnell ◽  
T. L. Holmen ◽  
C. Metcalfe
Keyword(s):  
Suicidal Behaviour ◽  
Affective Disorders ◽  
Odds Ratio ◽  
Fixed Effects ◽  
Attempted Suicide ◽  
Meta Analysis ◽  
Female Offspring ◽  
Crude Odds Ratio ◽  
Increased Risk ◽  
The Impact

BackgroundChildren whose parents die by, or attempt, suicide are believed to be at greater risk of suicidal behaviours and affective disorders. We systematically reviewed the literature on these associations and, using meta-analysis, estimated the strength of associations as well as investigated potential effect modifiers (parental and offspring gender, offspring age).MethodWe comprehensively searched the literature (Medline, PsycINFO, EMBASE, Web of Science), finding 28 articles that met our inclusion criteria, 14 of which contributed to the meta-analysis. Crude odds ratio and adjusted odds ratio (aOR) were pooled using fixed-effects models.ResultsControlling for relevant confounders, offspring whose parents died by suicide were more likely than offspring of two living parents to die by suicide [aOR 1.94, 95% confidence interval (CI) 1.54–2.45] but there were heterogeneous findings in the two studies investigating the impact on offspring suicide attempt (aOR 1.31, 95% CI 0.73–2.35). Children whose parents attempted suicide were at increased risk of attempted suicide (aOR 1.95, 95% CI 1.48–2.57). Limited evidence indicated that exposure to parental death by suicide is associated with subsequent risk of affective disorders. Maternal suicidal behaviour and younger age at exposure were associated with larger effect estimates but there was no evidence that the association differed in sons versus daughters.ConclusionsParental suicidal behaviour is associated with increased risk of offspring suicidal behaviour. Findings suggest that maternal suicidal behaviour is a more potent risk factor than paternal, and that children are more vulnerable than adolescents and adults. However, there is no evidence of a stronger association in either male or female offspring.

scholarly journals Factors Affecting the Apparent Efficacy and Safety of Tissue Plasminogen Activator in Thrombotic Occlusion Models of Stroke: Systematic Review and Meta-Analysis

2010 ◽  
Vol 30 (12) ◽  
pp. 1905-1913 ◽  
Author(s):  
Emily S Sena ◽  
Catherine L Briscoe ◽  
David W Howells ◽  
Geoffrey A Donnan ◽  
Peter AG Sandercock ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Odds Ratio ◽  
Infarct Volume ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Thrombotic Occlusion ◽  
Tissue Plasminogen ◽  
The Impact

Thrombolysis with recombinant tissue plasminogen activator (rtPA) improves outcome in animal models of stroke and in clinical trial, but is associated with increased intracranial hemorrhage. Here, we explore the impact of biologic and experimental design factors on efficacy and bleeding. We conducted a systematic review of studies describing the effect of tPA in thrombotic occlusion models of ischemic stroke followed by random effects meta-analysis, meta-regression, and trim and fill. We identified 202, 66, 128, and 54 comparisons reporting infarct volume, neurobehavioral score, hemorrhage, and mortality, respectively. The rtPA reduced infarct volume by 25.2% (95% confidence interval=21.8 to 28.6, 3388 animals), improved neurobehavioral score by 18.0% (12.6% to 23.3%, n=1243), increased the risk of hemorrhage (odds ratio=1.71, 1.42 to 2.07, n=2833) and had no significant effect on mortality (odds ratio=0.82, 0.62 to 1.08, n=1274). There was an absolute reduction in efficacy of 1.1% (0.7% to 1.4%) for every 10 minutes delay to treatment. Cumulative meta-analysis showed that the estimate of efficacy fell as more data became available. Publication bias inflated efficacy by 5.1% (infarct volume) and 8.1% (neurobehavioral score). This data set was large enough to be adequately powered to estimate with precision the impact of biologic and experimental factors on the efficacy and safety of rtPA.

scholarly journals Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Jeong Yee ◽  
Woorim Kim ◽  
Ji Min Han ◽  
Ha Young Yoon ◽  
Nari Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Fetal Death ◽  
Web Of Science ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Current Review ◽  
The Mean ◽  
The Impact

Abstract This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval (CI). Nine studies involving with 93 pregnant women with COVID-19 and 103 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 3214.7g. Fetal death, severe neonatal asphyxia, and detection of SARS-CoV-2 were observed in about 2%, whereas no neonatal death was found. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

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