scholarly journals Fatigue outcomes following coronavirus or influenza virus infection: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Kim Poole-Wright ◽  
Fiona Gaughran ◽  
Rachael Evans ◽  
Trudie Chalder
Keyword(s):  
Systematic Review ◽  
Influenza Virus ◽  
Virus Infection ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Influenza Virus Infection ◽  
Female Gender ◽  
Respiratory Viruses ◽  
Current Evidence

ABSTRACTObjectivesFatigue is a pervasive clinical symptom for many infected with respiratory viruses such as influenza or coronaviruses. Prior evidence from influenza and coronavirus epidemics suggest that fatigue symptomology may continue beyond the acute phase, lasting for several months to several years post-discharge. This systematic review aimed to examine long-term fatigue prevalence among survivors and among communities, as well as investigate the current evidence for associated factors.DesignSystematic review and meta-analysis.SettingHospitalised and community samples.ParticipantsPatient populations with a confirmed diagnosis of a named influenza virus or coronavirus.Main outcomes measuredFatigue, fatigue syndromesResultsTen studies met the inclusion criteria for a pooled prevalence analysis and five studies were identified as eligible for a means differences analysis. A fatigue prevalence of 41% (95% CI 0.299-0.488) was found among a total population of 1,310. Using the ‘vitality’ subscale of the SF-36 as a proxy for fatigue, the estimate for means differences indicated a lower mean vitality score for survivors compared to population norms (M -1.523, CI -13.53 – 10.48), although this was not significant (p = 0.803). The most common associations with fatigue were PTSD, depression and anxiety, female gender and higher age.ConclusionsThis study reveals that a significant proportion of survivors (41%) experienced fatigue following their recovery from novel respiratory viruses such as SARS, MERS, SARS-CoV2 or influenza and that this fatigue can be long-lasting. Also, some factors such as female gender and psychological factors may contribute to continuing fatigue outcomes for this population.Strengths and limitations(a) this study provides support for long-term fatigue outcomes in people with a confirmed influenza, SARS, MERS, SARS-CoV2 virus infection (b) the study suggests individual, psychological and social factors are associated with fatigue, (c) findings are limited by the availability of fatigue data and lack of pre-morbid fatigue information; (d) a meta-analysis on the associations was prohibited by the small number of studies investigating long-term fatigue correlates and (e) the heterogeneity of the studies (>75%) suggests the pooled estimates should be interpreted with caution.

scholarly journals Pregnancy as a risk factor for severe outcomes from influenza virus infection: A systematic review and meta-analysis of observational studies

Vaccine ◽  
2017 ◽  
Vol 35 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Dominik Mertz ◽  
Johanna Geraci ◽  
Judi Winkup ◽  
Bradford D. Gessner ◽  
Justin R. Ortiz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Virus ◽  
Risk Factor ◽  
Virus Infection ◽  
Observational Studies ◽  
Meta Analysis ◽  
Influenza Virus Infection

The Atrial Fibrillation Better Care (ABC) pathway in atrial fibrillation: a systematic review and meta-analysis of 285,000 patients

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
GF Romiti ◽  
D Pastori ◽  
JM Rivera-Caravaca ◽  
WY Ding ◽  
YX Gue ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Random Effect ◽  
Significant Proportion ◽  
Cardiovascular Death ◽  
Current Evidence ◽  
Meta Regression

Abstract Funding Acknowledgements Type of funding sources: None. Background The ‘Atrial Fibrillation Better Care’ (ABC) pathway has been recently proposed as a holistic approach for the comprehensive management of patients with Atrial Fibrillation (AF), standing on three main pillars: ‘A’ Avoid stroke (with Anticoagulants); ‘B’ Better symptom management; ‘C’ Cardiovascular and Comorbidity management. The ABC pathway is now recommended in several clinical guidelines, including the recent European Society of Cardiology (ESC) AF management guidelines. We performed a systematic review of the current evidence for use of the ABC pathway on clinical outcomes. Methods We performed a systematic review and meta-analysis according to PRISMA Guidelines. Pubmed and EMBASE were searched for studies reporting the prevalence of ABC pathway adherent management in AF patients, and its impact on clinical outcomes (all-cause death, cardiovascular death, stroke, and major bleeding). Metanalysis of odds ratio (OR) was performed with random-effect models; subgroup analysis and meta-regression were performed to account for heterogeneity; a CHA2DS2-VASc-stratified sensitivity analysis was also performed. Results Among 2862 records retrieved from the literature search, 8 studies were included. The pooled prevalence of ABC adherent management was 21% (95% confidence intervals (CI), 13-34%), with a high grade of heterogeneity; in a multivariable meta-regression model, adherence to each criteria of the ABC pathway explained most part of the heterogeneity (R2 = 98.9%). Patients treated according to the ABC pathway showed a lower risk of all-cause death (OR:0.42, 95%CI 0.31-0.56), cardiovascular death (OR:0.37, 95%CI 0.23-0.58), stroke (OR:0.55, 95%CI 0.37-0.82) and major bleeding (OR:0.69, 95%CI 0.51-0.94), with moderate heterogeneity. Meta-regressions showed that the increasing prevalence of diabetes mellitus, coronary artery disease, chronic heart failure and history of stroke were associated with a reduced effectiveness of the ABC pathway for all-cause and cardiovascular death; each comorbidity was able to explain a significant proportion of heterogeneity at univariate meta-regression. Conversely, longer follow-up time was associated with more effectiveness of the ABC pathway for all outcomes. Adherence to ABC pathway was associated with a progressively greater reduction of the all-cause death risk amongst patients with higher CHA2DS2-VASc scores; no difference in ABC pathway effectiveness was found across CHA2DS2-VASc strata for CV death and stroke occurrence. Conclusions Adherence to the ABC pathway was suboptimal, being adopted in 1 in every 5 patients. Adherence to the ABC pathway was associated with a reduction in the risk of major adverse outcomes. Our data supports extensive application of the ABC pathway for the management of AF. Abstract Figure.

scholarly journals Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chengxian Yang ◽  
Ge Li ◽  
Shenzhong Jiang ◽  
Xinjie Bao ◽  
Renzhi Wang
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Long Term Results ◽  
Current Evidence ◽  
Cochrane Library ◽  
Cure Rate ◽  
Short Term

Abstract Biochemical remission after transsphenoidal surgery is still unsatisfied in acromegaly patients with macroadenomas, especially with invasive macroadenomas. Concerning the impact of preoperative somatostatin analogues (SSAs) on surgical outcomes, previous studies with limited cases reported conflicting results. To assess current evidence of preoperative medical treatment, we performed a systematic review and meta-analysis of comparative studies. A literature search was conducted in Pubmed, Embase, and the Cochrane Library. Five randomized controlled trials (RCT) and seven non-RCT comparative studies were included. These studies mainly focused on pituitary macroadenomas though a small number of microadenoma cases were included. For safety, preoperative SSAs were not associated with elevated risks of postoperative complications. With respect to efficacy, the short-term cure rate was improved by preoperative SSAs, but the long-term cure rate showed no significant improvement. For invasive macroadenomas, the short-term cure rate was also improved, but the long-term results were not evaluable in clinical practice because adjuvant therapy was generally required. In conclusion, preoperative SSAs are safe in patients with acromegaly, and the favorable impact on surgical results is restricted to the short-term cure rate in macroadenomas and invasive macroadenomas. Further well-designed RCTs to examine long-term results are awaited to update the finding of this meta-analysis.

Urgent Carotid Endarterectomy for Patients with Unstable Symptoms: Systematic Review and Meta-Analysis of Outcomes

Vascular ◽  
2009 ◽  
Vol 17 (5) ◽  
pp. 243-252 ◽  
Author(s):  
Benjamin O. Patterson ◽  
Peter J. Holt ◽  
Robert J. Hinchliffe ◽  
Matt M. Thompson ◽  
Ian M. Loftus
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Long Term Results ◽  
Current Evidence ◽  
Ischemic Attack

Current evidence suggests that carotid endarterectomy (CEA) performed within 2 weeks of symptoms produces better long-term results than if it is delayed. Urgent endarterectomy following unstable presentations such as crescendo transient ischemic attack (cTIA) or progressive stroke has been associated with variable results. The evidence for this treatment strategy required reviewing. A systematic review of articles related to urgent CEA between 1980 and 2008 was performed. For cTIA, there was an odds ratio of 5.6 (95% confidence interval 3.3–9.7, p ≤ .0001) for combined stroke or death compared with surgery for “standard” indications. For unstable stroke, the odds ratio was 5.5 (95% confidence interval 3.1–9.3, p ≤ .0001). Patients with unstable neurologic presentations are at higher risk of complications if operated on urgently. Clearer definitions would help more precise patient selection to avoid inadvertently operating on patients with an unacceptably high risk of poor outcome.

scholarly journals Long-Term Growth in Phenylketonuria: A Systematic Review and Meta-Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2070 ◽  
Author(s):  
Fatma Ilgaz ◽  
Alex Pinto ◽  
Hülya Gökmen-Özel ◽  
Julio César Rocha ◽  
Esther van Dam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Normal Growth ◽  
Optimal Growth ◽  
Current Evidence ◽  
Eligibility Criteria ◽  
Dietary Practices ◽  
Dietary Treatments ◽  
The Impact

There is an ongoing debate regarding the impact of phenylketonuria (PKU) and its treatment on growth. To date, evidence from studies is inconsistent, and data on the whole developmental period is limited. The primary aim of this systematic review was to investigate the effects of a phenylalanine (Phe)-restricted diet on long-term growth in patients with PKU. Four electronic databases were searched for articles published until September 2018. A total of 887 results were found, but only 13 articles met eligibility criteria. Only three studies had an adequate methodology for meta-analysis. Although the results indicate normal growth at birth and during infancy, children with PKU were significantly shorter and had lower weight for age than reference populations during the first four years of life. Impaired linear growth was observed until the end of adolescence in PKU. In contrast, growth impairment was not reported in patients with mild hyperphenylalaninemia, not requiring dietary restriction. Current evidence indicates that even with advances in dietary treatments, “optimal” growth outcomes are not attained in PKU. The majority of studies include children born before 1990s, so further research is needed to show the effects of recent dietary practices on growth in PKU.

scholarly journals Role of Itk signalling in the interaction between influenza A virus and T-cells

2012 ◽  
Vol 93 (5) ◽  
pp. 987-997 ◽  
Author(s):  
Kewei Fan ◽  
Yinping Jia ◽  
Song Wang ◽  
Hua Li ◽  
Defeng Wu ◽  
...  
Keyword(s):  
T Cells ◽  
Influenza Virus ◽  
T Cell ◽  
Virus Infection ◽  
Influenza A Virus ◽  
T Cell Activation ◽  
Influenza A ◽  
Interleukin 2 ◽  
Significant Proportion ◽  
Influenza Virus Infection

Although the T-cell-mediated immune response to influenza virus has been studied extensively, little information is available on the direct interaction between influenza virus and T-cells that pertains to severe diseases in humans and animals. To address these issues, we utilized the BALB/c mouse model combined with primary T-cells infected with A/WSN/33 influenza virus to investigate whether influenza virus has an affinity for T-cells in vivo. We observed that small proportions of CD4+ T-cells and CD8+ T-cells in spleen and thymus expressed viral proteins in infected mice. A significant proportion of mouse primary T-cells displayed expression of α-2,6 sialic acid-linked influenza virus receptor and were infected directly by influenza A virus. These experiments reveal that there exists a population of T-cells that is susceptible to influenza A virus infection. Furthermore, we employed human Jurkat T-cells to investigate the virus–T-cell interaction, with particular emphasis on understanding whether Itk (interleukin-2-inducible T-cell kinase), a Tec family tyrosine kinase that regulates T-cell activation, is involved in virus infection of T-cells. Interestingly, influenza virus infection resulted in an increased recruitment of Itk to the plasma membrane and an increased level of phospholipase C-γ1 (PLC-γ1) phosphorylation, suggesting that Itk/PLC-γ1 signalling is activated by the virus infection. We demonstrated that depletion of Itk inhibited the replication of influenza A virus, whereas overexpression of Itk increased virus replication. These results indicate that Itk is required for efficient replication of influenza virus in infected T-cells.

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