scholarly journals High admission blood glucose is an independent risk factor of poor prognosis in COVID-19: A systematic review and dose-response meta-analysis

2020 ◽  
Author(s):  
Gilbert Lazarus ◽  
Jessica Audrey ◽  
Vincent Kharisma Wangsaputra ◽  
Alice Tamara ◽  
Dicky L. Tahapary
Keyword(s):  
Blood Glucose ◽  
Random Effects ◽  
Dose Response ◽  
Poor Prognosis ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Generalized Least Squares ◽  
Response Analysis ◽  
Non Linear ◽  
Quality Evidence

Aims To investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. Materials and methods Eligible studies evaluating the prognostic value of fasting BG (FBG) and random BG (RBG) levels in predicting COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects high-vs-low meta-analysis followed by dose-response analysis using generalized least squares model in a two-stage random-effects meta-analysis were conducted. Potential non-linear association was explored using restricted cubic splines and pooled using restricted maximum likelihood model in a multivariate meta-analysis. Results The search yielded 35 studies involving a total of 14,502 patients. We discovered independent association between admission FBG and poor prognosis in COVID-19 patients. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity<0.001), where each 1 mmol/L increase augmented the risk of COVID-19 severity by 33% (risk ratio 1.33 [95% CI: 1.26-1.40]). Albeit exhibiting similar trends, study scarcity limited the strength of evidence on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes, while the other assessments yielded very low-to-low quality. Conclusion High level of FBG at admission was independently associated with poor prognosis in COVID-19 patients. Further researches to confirm the observed prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and on COVID-19 severity are required.

scholarly journals Prognosis of Pregnancy-associated Breast Cancer: A Meta-analysis

2020 ◽  
Author(s):  
Chunchun SHAO ◽  
Zhi gang YU ◽  
Juan XIAO ◽  
Li yuan LIU ◽  
Fan zhen HONG ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Dose Response ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Breast Cancer Diagnosis ◽  
Response Analysis ◽  
Subgroup Analyses ◽  
Definition Of ◽  
Overall Mortality

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or the postpartum period. Definitions of the duration of the postpartum period have been controversial, and this variability may lead to diverse results regarding prognosis. Moreover, evidence on the dose-response association between the time from the last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Library for observational studies on the prognosis of PABC published up to June 1, 2019. We estimated summary-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosis time, PABC definition, geographic region, year of publication and estimation procedure for HR were performed. Additionally, dose-response analysis was conducted by using the variance weighted least-squares regression (VWLS) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC was associated with poor prognosis for overall survival (OS), disease-free survival (DFS) and cause-specific survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. The corresponding reference category was non-PABC patients. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a nonlinear association between the time from the last delivery to breast cancer diagnosis and the HR of overall mortality (P<0.001). Compared to nulliparous women, the mortality was almost 60% higher in women with PABC diagnosed at 12 months after the last delivery (HR=1.59, 95% CI 1.30-1.82), and the mortality was not significantly different at 70 months after the last delivery (HR=1.14, 95% CI 0.99-1.25). This finding suggests that the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum (70 months after the last delivery) to capture the increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum.

scholarly journals Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies

2011 ◽  
Vol 15 (4) ◽  
pp. 725-737 ◽  
Author(s):  
Jusheng Zheng ◽  
Tao Huang ◽  
Yinghua Yu ◽  
Xiaojie Hu ◽  
Bin Yang ◽  
...  
Keyword(s):  
Dose Response ◽  
Fish Consumption ◽  
Meta Analysis ◽  
Dietary Assessment ◽  
Generalized Least Squares ◽  
Fish Intake ◽  
Response Analysis ◽  
Least Squares Regression ◽  
Restricted Cubic Splines ◽  
High Fish

AbstractObjectiveResults of studies on fish consumption and CHD mortality are inconsistent. The present updated meta-analysis was conducted to investigate the up-to-date pooling effects.DesignA random-effects model was used to pool the risk estimates. Generalized least-squares regression and restricted cubic splines were used to assess the possible dose–response relationship. Subgroup analyses were conducted to examine the sources of heterogeneity.SettingPubMed and ISI Web of Science databases up to September 2010 were searched and secondary referencing qualified for inclusion in the study.SubjectsSeventeen cohorts with 315 812 participants and average follow-up period of 15·9 years were identified.ResultsCompared with the lowest fish intake (<1 serving/month or 1–3 servings/month), the pooled relative risk (RR) of fish intake on CHD mortality was 0·84 (95 % CI 0·75, 0·95) for low fish intake (1 serving/week), 0·79 (95 % CI 0·67, 0·92) for moderate fish intake (2–4 servings/week) and 0·83 (95 % CI 0·68, 1·01) for high fish intake (>5 servings/week). The dose–response analysis indicated that every 15 g/d increment of fish intake decreased the risk of CHD mortality by 6 % (RR = 0·94; 95 % CI 0·90, 0·98). The method of dietary assessment, gender and energy adjustment affected the results remarkably.ConclusionsOur results indicate that either low (1 serving/week) or moderate fish consumption (2–4 servings/week) has a significantly beneficial effect on the prevention of CHD mortality. High fish consumption (>5 servings/week) possesses only a marginally protective effect on CHD mortality, possibly due to the limited studies included in this group.

scholarly journals Prognosis of Pregnancy-associated Breast Cancer: A Meta-analysis

2020 ◽  
Author(s):  
Chunchun SHAO ◽  
Zhi gang YU ◽  
Juan XIAO ◽  
Li yuan LIU ◽  
Fan zhen HONG ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Dose Response ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Breast Cancer Diagnosis ◽  
Response Analysis ◽  
Subgroup Analyses ◽  
Definition Of ◽  
Overall Mortality

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or the postpartum period. Definitions of the duration of the postpartum period have been controversial, and this variability may lead to diverse results regarding prognosis. Moreover, evidence on the dose-response association between the time from the last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Library for observational studies on the prognosis of PABC published up to June 1, 2019. We estimated summary-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosis time, PABC definition, geographic region, year of publication and estimation procedure for HR were performed. Additionally, dose-response analysis was conducted by using the variance weighted least-squares regression (VWLS) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC was associated with poor prognosis for overall survival (OS), disease-free survival (DFS) and cause-specific survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. The corresponding reference category was non-PABC patients. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a nonlinear association between the time from the last delivery to breast cancer diagnosis and the HR of overall mortality ( P <0.001). Compared to nulliparous women, the mortality was almost 60% higher in women with PABC diagnosed at 30 months after the last delivery (HR=1.58, 95% CI 1.39-1.74), and the mortality was not significantly different at 68 months after the last delivery (HR=1.11, 95% CI 0.99-1.24). This finding suggests that the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum (68 months after the last delivery) to capture this ongoing increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum.

scholarly journals High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis

2021 ◽  
Vol 171 ◽  
pp. 108561
Author(s):  
Gilbert Lazarus ◽  
Jessica Audrey ◽  
Vincent Kharisma Wangsaputra ◽  
Alice Tamara ◽  
Dicky L. Tahapary
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Dose Response ◽  
Poor Prognosis ◽  
Meta Analysis

Blood Glucose Levels and Mortality in Patients With Sepsis: Dose–Response Analysis of Observational Studies

2019 ◽  
Vol 36 (2) ◽  
pp. 182-190
Author(s):  
Wen Wang ◽  
Wenwen Chen ◽  
Yanmei Liu ◽  
Ling Li ◽  
Sheyu Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cohort Studies ◽  
Dose Response ◽  
Meta Analysis ◽  
Current Evidence ◽  
Response Analysis ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Diabetes Status

Background: We undertook a systematic review and meta-analysis to investigate the relationship between blood glucose levels and mortality in patients with sepsis. Methods: Medline and EMBASE were searched from inception to April 8, 2018. Cohort studies or case–control studies reported the association between blood glucose and mortality in patients with sepsis were selected. Study characteristics, baseline characteristics, definition of hyperglycemia, and outcomes of interest were extracted. We performed a dose–response meta-analysis to assess the effect of blood glucose level on mortality. We also conducted meta-analysis for patients with or without diabetes separately. Results: Ten cohort studies involving 26 429 patients were included, of which 5 were prospective studies and 5 retrospective studies. Dose–response analysis showed that the effect of blood glucose on mortality may differ in patients with versus without diabetes. There was a U-shaped relationship for patients with diabetes and a J-shaped relationship for patients without diabetes, with blood glucose at 145 to 155 mg/dL corresponding to lowest mortality both in patients with and without diabetes. Conclusions: Current evidence suggested U-shaped relationship between blood glucose and mortality in all patients irrespective of their diabetes status. Diabetic patients with blood glucose below 145 mg/dL may have poorer prognosis compared to patients without established diabetes.

scholarly journals Maternal caffeine intake during pregnancy and risk of pregnancy loss: a categorical and dose–response meta-analysis of prospective studies

2015 ◽  
Vol 19 (7) ◽  
pp. 1233-1244 ◽  
Author(s):  
Ling-Wei Chen ◽  
Yi Wu ◽  
Nithya Neelakantan ◽  
Mary Foong-Fong Chong ◽  
An Pan ◽  
...  
Keyword(s):  
Dose Response ◽  
Prospective Studies ◽  
Pregnancy Loss ◽  
Meta Analysis ◽  
Generalized Least Squares ◽  
Caffeine Intake ◽  
Response Analysis ◽  
Caffeine Consumption ◽  
High Intake ◽  
Random Effects Models

AbstractObjectiveTo assess the association between maternal caffeine intake and risk of pregnancy loss using a systematic review and meta-analysis.DesignCategorical and dose–response meta-analysis of prospective studies.SettingRelevant articles were identified by searching MEDLINE and SCOPUS databases through 30 January 2015. Two authors independently extracted information from eligible studies. Random-effects models were used to derive the summary relative risks (RR) and corresponding 95 % CI for specific categories of caffeine consumption and for a continuous association using generalized least-squares trend estimation.SubjectsA total of 130 456 participants and 3429 cases in fourteen included studies.ResultsCompared with the reference category with no or very low caffeine intake, the RR (95 % CI) of pregnancy loss was 1·02 (0·85, 1·24;I2=28·3 %) for low intake (50–149 mg/d), 1·16 (0·94, 1·41;I2=49·6 %) for moderate intake (150–349 mg/d), 1·40 (1·16, 1·68;I2=18·6 %) for high intake (350–699 mg/d) and 1·72 (1·40, 2·13;I2=0·0 %) for very high intake (≥700 mg/d). In the dose–response analysis, each 100 mg/d increment in maternal caffeine intake (~1 cup of coffee) was associated with 7 % (95 % CI 3 %, 12 %) higher risk of pregnancy loss. Our results may have been affected by publication bias, but the association remained significant for the subset of larger studies. Furthermore, adjustment for smoking and pregnancy symptoms may have been incomplete, potentially resulting in residual confounding.ConclusionsAlbeit inconclusive, higher maternal caffeine intake was associated with a higher risk of pregnancy loss and adherence to guidelines to avoid high caffeine intake during pregnancy appears prudent.

scholarly journals Carotenoid Intake and Circulating Carotenoids Are Inversely Associated with the Risk of Bladder Cancer: A Dose-Response Meta-analysis

2019 ◽  
Vol 11 (3) ◽  
pp. 630-643 ◽  
Author(s):  
Shenghui Wu ◽  
Yanning Liu ◽  
Joel E Michalek ◽  
Ruben A Mesa ◽  
Dorothy Long Parma ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Random Effects ◽  
Dose Response ◽  
Meta Analysis ◽  
Epidemiologic Studies ◽  
Cochrane Library ◽  
Response Analysis ◽  
Random Effects Models ◽  
The Cochrane Library ◽  
Β Carotene

ABSTRACT Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. We conducted a systematic review and meta-analysis of case-control and cohort studies investigating the relation between carotenoid intake or circulating carotenoid concentrations and BC risk in men and women. All relevant epidemiologic studies were identified by a search of PubMed and Scopus databases, and the Cochrane Library from inception to April 2019 with no restrictions. A random-effects model was used to calculate pooled RRs and their 95% CIs across studies for high compared with low categories of intake or circulating concentrations. We also performed a dose-response meta-analysis using the Greenland and Longnecker method and random-effects models. A total of 22 studies involving 516,740 adults were included in the meta-analysis. The pooled RRs of BC for the highest compared with the lowest category of carotenoid intake and circulating carotenoid concentrations were 0.88 (95% CI: 0.76, 1.03) and 0.36 (95% CI: 0.12, 1.07), respectively. The pooled RR of BC for the highest compared with lowest circulating lutein and zeaxanthin concentrations was 0.53 (95% CI: 0.33, 0.84). Dose-response analysis showed that BC risk decreased by 42% for every 1 mg increase in daily dietary β-cryptoxanthin intake (RR: 0.58; 95% CI: 0.36, 0.94); by 76% for every 1 μmol/L increase in circulating concentration of α-carotene (RR: 0.24; 95% CI: 0.08, 0.67); by 27% for every 1 μmol/L increase in circulating concentration of β-carotene (RR: 0.73; 95% CI: 0.57, 0.94); and by 56% for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin (RR: 0.44; 95% CI: 0.28, 0.67). Dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene, and lutein and zeaxanthin were inversely associated with BC risk. The protocol was registered at PROSPERO as CRD42019133240.

scholarly journals Prognosis and Expanded Definition of Pregnancy-associated Breast Cancer: A Dose-Response Meta-Analysis

2019 ◽  
Author(s):  
Chunchun Shao ◽  
Zhi Gang Yu ◽  
Juan Xiao ◽  
Li Yuan Liu ◽  
Fan Zhen Hong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Dose Response ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Breast Cancer Diagnosis ◽  
Response Analysis ◽  
Subgroup Analyses ◽  
Definition Of ◽  
Overall Mortality

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or postpartum period. Definitions of the duration in the postpartum have controversial and this variability may led to diverse results on the prognosis. Moreover, evidence on the dose-response association between the time from last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Database for observational studies about the prognosis of PABC published up to June 1, 2019. We estimated summary adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosed time, PABC definition, geographic region, year of publication and the way of HR estimate were performed. Additionally, the dose–response analysis was conducted by using the variance weighted least-squares regression (vwls) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC is associated with poor prognosis on overall survival (OS), disease-free survival (DFS) and cause-special survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a non-linear association between the time from last pregnancy to breast cancer diagnosis and overall mortality ( P <0.001). Compared with nulliparous women, PABC had a HR for all cause death that peaked at 1.62 (95% CI, 1.46-1.80) at 28 months since last pregnancy, starting from 78 months since last pregnancy became insignificant 1.07(95%CI, 0.99-1.26). It suggested that the definition of PABC should be extended to include cases diagnosed up to about six-years postpartum (78 months since last pregnancy) in order to capture this ongoing increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include cases diagnosed up to about six-years postpartum.

A Dose–Response Meta-Analysis Between Maternal Fish Oil Supplement And Risk of Asthma/Wheeze In Offspring

2021 ◽  
Author(s):  
Yin Jia ◽  
Yafang Huang ◽  
Huili Wang ◽  
Haili Jiang
Keyword(s):  
Fish Oil ◽  
Allergic Asthma ◽  
Dose Response ◽  
Childhood Asthma ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Response Analysis ◽  
Omega 3 ◽  
Maternal Supplementation ◽  
The Cochrane Library

Abstract Background: Prenatal exposure to omega-3 polyunsaturated fatty acids (n-3 PUFA) present in oily fish may prevent asthma or wheeze in childhood.Objective: By limiting this systematic review to fish oil intervention that commenced in the gestational period, we aim to find more clear evidences about the relationship between supplement with fish oil during pregnancy and the risk of asthma/wheeze in offspring, and to improve the life satisfaction of children who suffered asthma.Methods: A comprehensive literature search was conducted in the following database: PubMed, Medline, Web of Science, the Cochrane library, and Embase up to February 2021. Two reviewers independently selected studies, extracted data of the characteristics, and assessed risk of bias. Eight randomized controlled trials totaling 3,037 mother-infant pairs were analyzed in the end. “Allergic asthma” and “asthma and/or wheeze” were assessed in our meta-analysis. Subgroup analysis and sensitivity analysis were conducted. Dose–response data was examined using the robust-error meta-regression method.Results: This meta-analysis showed that n-3 PUFA during pregnancy did not significantly reduce the risk of asthma/wheeze (RR 0.93; 95% CI 0.82 to1.04, p=0.21) and allergic asthma (RR 0.66, 95% CI 0.24 to 1.86, p=0.44). Subgroup analyses revealed that the risk of childhood asthma/wheeze was significantly decreased: (1) in Europe (RR 0.69; 95% CI 0.53 to 0.89), (2) when the dose was ≥1200 mg/d (RR 0.69; 95% CI 0.55 to 0.88), (3) when supplementation started after gestational age 22 (RR 0.65; 95%CI 0.50 to 0.85), (4) when supplementation was from pregnancy to lactation (RR 0.69; 95% CI 0.51 to 0.95). Furthermore, the linear dose–response analysis showed that when maternal supplementation of n-3 PUFA increased by 100mg/d, the risk of asthma/wheeze was reduced by 2%.Conclusions: Although perinatal replenishment of n-3 PUFA did not prevent allergic disease in offspring, under some conditions, it could reduce the incidence of asthma/wheeze and allergic asthma in children, and the higher the dose, the better the protective effect it has. Additional research is needed to confirm the hypothesis of a link between n-3 PUFA intake and prevention of childhood asthma/wheeze.

scholarly journals An Evidence Base for School Health Policy during the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Saif Badran ◽  
Omran Musa ◽  
Somaya Al-maadeed ◽  
Egon Toft ◽  
Suhail Doi
Keyword(s):  
Dose Response ◽  
Case Fatality Rate ◽  
School Health ◽  
Meta Analysis ◽  
Case Fatality ◽  
Evidence Base ◽  
Mortality Data ◽  
Response Analysis ◽  
Fatality Rate ◽  
Epidemiological Characteristics

Objective: Children represent a small fraction of confirmed COVID-19 cases, with a low case fatality rate (CFR). In this paper, we lay out an evidence-based policy for reopening schools. Methods: We gathered age-specific COVID-19 case counts and identified mortality data for 14 countries. Dose-response meta-analysis was used to examine the relationship of the incremental case fatality rate (CFR) to age. In addition, an evidence-to-decision framework (EtD) was used to correlate the dose-response data with other epidemiological characteristics of COVID-19 in childhood. Results: In the dose-response analysis, we found that there was an almost negligible fatality below age 18. CFR rose little between ages 5 to 50 years. The confidence intervals were narrow, suggesting relative homogeneity across countries. Further data suggested decreased childhood transmission from respiratory droplets and a low viral load among children. Conclusions: Opening up schools and kindergartens is unlikely to impact COVID-19 case or mortality rates in both the child and adult populations. We outline a robust plan for schools that recommends that general principles not be micromanaged, with authority left to schools and monitored by public health authorities.

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