scholarly journals What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

Author(s):  
Wei Xu ◽  
Xue Li ◽  
Marshall Dozier ◽  
Yazhou He ◽  
Amir Kirolos ◽  
...  

ABSTRACTBackgroundIt is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place.MethodsWe conducted a systematic review and meta-analysis to investigate the extent of SARS-CoV-2 transmission in schools. We performed risk of bias evaluation of all included studies using the Newcastle-Ottawa Scale (NOS).Results2,178 articles were retrieved and 11 studies were included. Five cohort studies reported a combined 22 student and 21 staff index cases that exposed 3,345 contacts with 18 transmissions [overall infection attack rate (IAR): 0.08% (95% CI: 0.00%–0.86%)]. IARs for students and school staff were 0.15% (95% CI: 0.00%–0.93%) and 0.70% (95% CI: 0.00%–3.56%) respectively. Six cross-sectional studies reported 639 SARS-CoV-2 positive cases in 6,682 study participants tested [overall SARS-CoV-2 positivity rate: 8.00% (95% CI: 2.17%–16.95%)]. SARS-CoV-2 positivity rate was estimated to be 8.74% (95% CI: 2.34%–18.53%) among students, compared to 13.68% (95% CI: 1.68%–33.89%) among school staff. Gender differences were not found for secondary infection (OR: 1.44, 95% CI: 0.50-4.14, P= 0.49) and SARS-CoV-2 positivity (OR: 0.90, 95% CI: 0.72-1.13, P= 0.36) in schools. Fever, cough, dyspnea, ageusia, anosmia, rhinitis, sore throat, headache, myalgia, asthenia, and diarrhoea were all associated with the detection of SARS-CoV-2 antibodies (based on two studies). Overall, study quality was judged to be poor with risk of performance and attrition bias, limiting the confidence in the results.ConclusionsThere is limited high-quality evidence available to quantify the extent of SARS-CoV-2 transmission in schools or to compare it to community transmission. Emerging evidence suggests lower IAR and SARS-CoV-2 positivity rate in students compared to school staff. Future prospective and adequately controlled cohort studies are necessary to confirm this finding.

2019 ◽  
Vol 12 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Karolinny Borinelli de Aquino Moura ◽  
Paula Marques Prates Behrens ◽  
Rafaela Pirolli ◽  
Aimee Sauer ◽  
Dayana Melamed ◽  
...  

Abstract Background The aim of this study was to report the prevalence and mortality associated with anticoagulant-related nephropathy (ARN) through a systematic review of the literature. Methods Electronic searches were conducted in the Medline and EMBASE databases, and manual searches were performed in the reference lists of the identified studies. The studies were selected by two independent researchers, first by evaluating the titles and abstracts and then by reading the complete texts of the identified studies. Case series, cross-sectional studies, cohort studies and case–control studies reporting the prevalence and factors associated with ARN were selected. The methodological quality was assessed using the Newcastle–Ottawa scale. Meta-analyses of the prevalence of ARN and 5-year mortality using the random effects model were performed when possible. Heterogeneity was assessed using the I2 statistic. Results Five studies were included. Prevalence of ARN ranged from 19% to 63% among the four included cohort studies. Meta-analysis of these resulted in high heterogeneity [I2 96%, summary effect 31%; 95% confidence interval (CI) 22–42%]. Subgroup meta-analysis yielded an ARN prevalence of 20% among studies that included patients with fewer comorbidities (I2 12%; 95% CI 19–22%). In a direct comparison, meta-analysis of the 5-year mortality rate between anticoagulated patients who had experienced ARN and anticoagulated patients without ARN, patients with ARN were 91% more likely to die (risk ratio = 1.91; 95% CI 1.22–3; I2 87%). Risk factors for ARN that were reported in the literature included initial excessive anticoagulation, chronic kidney disease, age, diabetes, hypertension, cardiovascular disease and heart failure. Conclusions ARN studies are scarce and heterogeneous, and present significant methodological limitations. The high prevalence of ARN reported herein suggests that this entity is underdiagnosed in clinical practice. Mortality in patients with ARN seems to be high compared with patients without this condition in observational studies.


2021 ◽  
Vol 2 ◽  
Author(s):  
Lin-Lin Kang ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
Ching-Wen Chien

Objectives: The purpose of this study was to determine the association between asthma and migraine and assess the risk for migraine in patients with asthma.Methods: We systematically searched the Cochrane Library, PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica dataBASE (EMBASE) databases from inception to September 26, 2021, for indexed observational studies that examined either the odds or risk of migraine in subjects with asthma. The qualities of the included studies were evaluated using the Newcastle–Ottawa Scale. A random-effects meta-analysis was performed to calculate the odds ratio for case-control and cross-sectional studies and the risk ratio for cohort studies.Results: Seven observational studies (four cross-sectional and three cohort studies) with a total of 549,534 study subjects were included in this systematic review and meta-analysis and selected for data extraction. Four articles were considered to be of moderate quality; other studies were considered to be of high quality. Asthma was associated with increased odds (OR, 1.85; 95%CI, 1.39–2.45) and risk of migraine (RR, 1.70; 95%CI, 1.52–1.90).Conclusions: The available evidence that supports the existence of an association between asthma and migraine is limited. Clinicians should be aware that patients with asthma show both increased prevalence and incidence of migraine. Further studies are warranted to further clarify the relationship between asthma and migraine.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=185881, identifier: CRD42020185881.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Luke Furtado O'Mahony ◽  
Arnav Srivastava ◽  
Puja Mehta ◽  
Coziana Ciurtin

Abstract Background/Aims  The aetiology of primary chronic pain syndromes (CPS) is highly disputed. One theory suggests that pain is due to a pro-inflammatory cytokine milieu leading to nociceptive activation. We performed a systematic review and meta-analysis aiming to assess differences in cytokines levels in CPS patients versus healthy controls (HC). Methods  Human studies published in English from PubMed, MEDLINE/Scopus and Cochrane databases were searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with cytokine measurements in CPS patients and HC. We excluded studies with underlying organic pathology. Quality assessment was completed using a modified version of the Newcastle-Ottawa Scale. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. Study registered with PROSPERO (CRD42020193774). Results  Initial search yielded 324 papers, 36 studies (3229 participants) eligible for systematic review and 26 studies (2048 participants) suitable for metaanalysis. There were reproducible findings supporting trends of cytokine levels comparing CPS patients with HC. Eotaxin (chemokine) however was consistently raised in CPS. Meta-analysis showed significantly increased tumour necrosis factor (TNF) (SMD=0.39, p = 0.0009, %95I=0.16-0.63, p < 0.001; I2=70%, Q2 p < 0.001), interleukin (IL)-6 (SMD=0.15, 8 (SMD=0.26, p = 0.01, 95%CI =0.05-0.47; I2=61%, Q2 p = 0.005) and IL-10 (SMD=0.61; %95 = 0.34-0.89, p < 0.001; I2 = 10%, Q2 p = 0.34) in CPS compared to HC. Conclusion  We found significant differences in peripheral blood cytokine profiles of CPS patients compared to HC. However, the distinctive profile associated with CPS includes both pro-inflammatory (TNF-α, IL-6, IL-8), and anti-inflammatory cytokines (IL-10) in pooled analysis, as well as chemokine (eotaxin) signatures. Disclosure  L. Furtado O'Mahony: None. A. Srivastava: None. P. Mehta: None. C. Ciurtin: None.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017567
Author(s):  
Shimels Hussien Mohammed ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Tesfa Dejenie Habtewold ◽  
Balewgizie Sileshi Tegegn ◽  
...  

IntroductionIndividuals living in poor neighbourhoods are at a higher risk of overweight/obesity. There is no systematic review and meta-analysis study on the association of neighbourhood socioeconomic status (NSES) with overweight/obesity. We aimed to systematically review and meta-analyse the existing evidence on the association of NSES with overweight/obesity.Methods and analysisCross-sectional, case–control and cohort studies published in English from inception to 15 May 2017 will be systematically searched using the following databases: PubMed, EMBASE, Web of Sciences and Google Scholar. Selection, screening, reviewing and data extraction will be done by two reviewers, independently and in duplicate. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence. Publication bias will be checked by visual inspection of funnel plots and Egger’s regression test. Heterogeneity will be checked by Higgins’s method (I2statistics). Meta-analysis will be done to estimate the pooled OR. Narrative synthesis will be performed if meta-analysis is not feasible due to high heterogeneity of studies.Ethics and disseminationEthical clearance is not required as we will be using data from published articles. Findings will be communicated through a publication in a peer-reviewed journal and presentations at professional conferences.PROSPERO registration numberCRD42017063889.


2019 ◽  
Author(s):  
Mehran Ghazalibina ◽  
Ali Shakerimoghaddam ◽  
Azad Khaledi

Abstract Background Diagnosis of fungal co-infections in patients with pulmonary tuberculosis has critical importance. In this review, we aimed to determine the prevalence of candida coinfection in patients with pulmonary tuberculosis.Methods The present systematic review of cross-sectional studies was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) Protocol. Studies published online in English from January 2001 to March 2019 were assessed. Literature search was performed in Web of Science, MEDLINE/PubMed, and Scopus databases using keywords combinations of “pulmonary fungal”, “pulmonary coinfection”, OR “pulmonary mycosis”, “pulmonary fungal infections/agents”, OR “polymicrobial infection”, OR “secondary infection”, OR “mixed infections”, “pulmonary candidiasis”, “fungi coinfection”, “fungal co-colonization”, AND “pulmonary tuberculosis”, OR “pulmonary TB”. Data was analyzed using Comprehensive Meta-Analysis software. Heterogeneity between studies was evaluated by Cochran's Q, and I 2 tests.Results The pooled global prevalence of candida coinfection among patients with pulmonary tuberculosis was 25.7% (95% CI: 23.7-27.9). C. albicans was the most prevalent Candida spp. with a pooled prevalence of 65.8% (95% CI: 54.3-75.7). Risk factors of candida coinfection included smoking, diabetes, advanced age, and low body mass index.Conclusion The present review showed the high rate of candida coinfection among patients suffering from pulmonary tuberculosis. Adequate measures are necessary to early diagnose and treat these infections.


2019 ◽  
Vol 122 (04) ◽  
pp. 376-387 ◽  
Author(s):  
J. Zhu ◽  
P. Xun ◽  
J. C. Bae ◽  
J. H. Kim ◽  
D. J. Kim ◽  
...  

AbstractAbnormal Ca homeostasis has been associated with impaired glucose metabolism. However, the epidemiological evidence is controversial. We aimed to assess the association between circulating Ca levels and the risk of type 2 diabetes mellitus (T2DM) or abnormal glucose homeostasis through conducting a systematic review and meta-analysis. Eligible studies were identified by searching electronic database (PubMed, Embase and Google Scholar) and related references withde novoresults from primary studies up to December 2018. A random-effects meta-analysis was performed to estimate the weighted relative risks (RR) and 95 % CI for the associations. The search yielded twenty eligible publications with eight cohort studies identified for the meta-analysis, which included a total of 89 165 participants. Comparing the highest with the lowest category of albumin-adjusted serum Ca, the pooled RR was 1·14 (95 % CI 1·05, 1·24) for T2DM (n51 489). Similarly, serum total Ca was associated with incident T2DM (RR 1·25; 95 % CI 1·10, 1·42) (n64 502). Additionally, the adjusted RR for 1 mg/dl increments in albumin-adjusted serum Ca or serum total Ca levels was 1·16 (95 % CI 1·07, 1·27) and 1·19 (95 % CI 1·11, 1·28), respectively. The observed associations remained with the inclusion of a cohort study with ionised Ca as the exposure. However, data pooled from neither case–control (n4) nor cross-sectional (n8) studies manifested a significant correlation between circulating Ca and glucose homeostasis. In conclusion, accumulated data from the cohort studies suggest that higher circulating Ca levels are associated with an augmented risk of T2DM.


2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Nashi Masnad Alreshidi ◽  
Hassan Haridi ◽  
Rana Alaseeri ◽  
Michelle Garcia ◽  
Fe Gaspar ◽  
...  

Background: Coronavirus disease 2019 (COVID-19) pandemic extended to reach most countries in the globe during few months. Preparedness of healthcare institutions and healthcare workers (HCWs) are crucial for applying effective prevention and control measures. This study aimed to assess HCWs knowledge, emotions and perception of preparedness of their institutions towards COVID-19 pandemic.Design: A cross-sectional, web-based survey was conducted among hospital HCWs in Saudi Arabia during April 27, 2020 to May 03, 2020.Results: Overall, 1004 completed responses were received. The majority were females (78.8), nurses (84.9%) at middle age 25-39 years (71.8%). Among participants, 95.5% reported receiving training on safely use of personal protective equipment (PPE) and 94.9% did fit the test for N95 respirator. The participants possessed a fair knowledge about COVID-19 disease with a mean knowledge score 6. 61±1.35 points on a scale of 10 points. Most participants (88.7%) were committed to continue work as a professional and ethical duty, however, 27.1% of them scored high on a negative emotional impact scale. Participants appreciated most aspects of institutional preparedness for COVID-19 pandemic; however, they were concerned with the continuous PPE supply. Factors that independently associated with good knowledge and negative emotional response were determined using multivariate logistic regression analysis.Conclusions: Findings revealed fair knowledge about COVID-19 pandemic among HCWs in Saudi hospitals. Concerns and worries were expressed regard working with the highly infectious COVID-19 patients. Participants, appreciated most aspects of institutional preparedness, however they were concerned about the continuous availability and supply of PPE.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yalewayker Tegegne ◽  
Daniel Asmelash ◽  
Sintayehu Ambachew ◽  
Setegn Eshetie ◽  
Ayenew Addisu ◽  
...  

Background. Malaria during pregnancy remains a major public health concern in tropical and subtropical countries. Moreover, malaria is increasingly associated with unwanted pregnancy outcomes such as an increased risk of abortion, stillbirth, premature delivery, and low-birthweight infants. Since pregnant women are most vulnerable to malaria, implementation of the appropriate prevention and control measures among this group is very important. Therefore, the current review was designed to assess the prevalence of both symptomatic and asymptomatic malaria among pregnant women in Ethiopia.Method. In this systematic review and meta-analysis we have followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The databases used were PubMed, Google Scholar, HINARI, and Science Direct literature. Search terms used were “prevalence”, “malaria”, “pregnant women”, and “Ethiopia”. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled meta-logistic regression was computed to present the pooled prevalence with a 95% confidence interval (CI).Result. Among a total of 10207 studies, seven studies were included in this analysis. The estimated pooled prevalence of malaria among pregnant women in Ethiopia was 12.72% (95% CI: 7.45, 17.98). In subgroup analysis, the prevalence of malaria showed a significant variation between asymptomatic and symptomatic cases, which was 7.83% (95% CI: 2.23, 13.43) and 17.97% (95% CI: 7.31, 28.92), respectively.Conclusion. The current systematic review and meta-analysis showed that the pooled prevalence of malaria among pregnant women was found to be relatively higher compared with the general population. Therefore, the existing prevention and control measures should be strengthen.


Author(s):  
Sharon A. Warren ◽  
Susan Armijo Olivo ◽  
Jorge Fuentes Contreras ◽  
Karen V. L. Turpin ◽  
Douglas P. Gross ◽  
...  

A systematic review/meta-analysis of literature addressing a possible association between traumatic injury and onset of multiple sclerosis was conducted. Medline, Embase, Cochrane DSR, Ovid HealthStar, CINAHL, ISI Web of Science and Scopus were searched for analytical studies from 1950 to 2011. Two investigators independently reviewed articles for inclusion, assessing their quality using the Newcastle-Ottawa Scale. Of the 13 case-control studies included, 8 were moderate quality and 5 low; of the 3 cohort studies 2 were high and 1 moderate. Meta-analysis including moderate and low quality case-control studies produced a modest but significant odds ratio: 1.41 (95% confidence interval: 1.03, 1.93). However, when low quality studies were excluded, the resulting odds ratio was non-significant. Cohort studies produced a non-significant standardized incidence ratio of 1.00 (95% confidence interval: 0.86, 1.16). These findings support the conclusion that there is no association between traumatic injury and multiple sclerosis onset; more high quality cohort studies would help to confirm this observation.


2021 ◽  
Vol 7 ◽  
Author(s):  
Long Wang ◽  
Zi-Ru Deng ◽  
Mei-Dan Zu ◽  
Juan Zhang ◽  
Yu Wang

Objective: Recent studies have indicated a pathophysiologic link between migraine and asthma. This meta-analysis aimed to comprehensively estimate the risk ratio for migraine in asthma as well as that of asthma in migraine based on available evidence.Method: We systematically searched the electronic databases including PubMed, Web of Science, and SCOPUS for population-based studies that measured either the odds or the risk of asthma in subjects with migraine as well as that of migraine in subjects with asthma. The titles and abstracts were screened by two independent reviewers to identify eligible studies, and this was followed by full-text review of the included studies. Newcastle–Ottawa Scale (NOS) was used to assess the risk of bias of included literature. A meta-analysis was conducted with Review Manager 5.3 Software to calculate the odds ratio (OR) for case-control and cross-sectional studies and either relative ratio (RR) or hazard ratio (HR) for cohort studies, and the source of heterogeneity was assessed. Subgroup and sensitivity analyses were conducted, and the I2 test were used to assess the source of heterogeneity. The funnel plot, Galbraith plot, and Egger's test were used to evaluate publication bias.Results: Fifteen published studies covering a total of 1,188,780 individuals were identified. Pooled analysis indicated that migraine was associated with increased odds (OR = 1.54; 95% CI: 1.34~1.77) and risk for asthma (HR = 1.42; 95% CI: 1.26~1.60), and asthma associated with increased odds (OR = 1.45; 95% CI: 1.22~1.72) and risk for migraine (HR = 1.47; 95% CI: 1.41~1.52).Conclusion: Migraine is a potential risk indicator for asthma, and vice versa, asthma is a potential risk indicator for migraine. However, future prospective cohort studies are warranted to provide more evidence concerning the detailed association between migraine and asthma.


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