scholarly journals The protective association between statins use and adverse outcomes among COVID-19 patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ronald Chow ◽  
James Im ◽  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Before And After ◽  
Statin Usage ◽  
Similar Risk ◽  
Ventilation Studies

ABSTRACTIntroductionStatins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.MethodsLiteratures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsThirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).ConclusionPatients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

scholarly journals The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253576
Author(s):  
Ronald Chow ◽  
James Im ◽  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Before And After ◽  
Statin Usage ◽  
Similar Risk ◽  
Ventilation Studies

Introduction Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage. Methods Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88). Conclusion Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

scholarly journals Colchicine use in patients with COVID-19: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Leonard Chiu ◽  
Ronald Chow ◽  
Nicholas Chiu ◽  
Chun-Han Lo ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Observational Studies ◽  
Trial Design ◽  
Meta Analysis ◽  
Point Estimate ◽  
Randomized Controlled ◽  
Risk Of Mortality ◽  
Prospective Investigation

ABSTRACTIntroductionColchicine may inhibit inflammasome signaling and reduce proinflammatory cytokines, a purported mechanism of COVID-19 pneumonia. The aim of this systematic review and meta-analysis is to report on the state of the current literature on the use of colchicine in COVID-19 and to investigate the reported clinical outcomes in COVID-19 patients by colchicine usage.MethodsThe literature was searched from January 2019 through January 28, 2021. References were screened to identify studies that reported the effect of colchicine usage on COVID-19 outcomes including mortality, intensive care unit (ICU) admissions, or mechanical ventilation. Studies were meta-analyzed for mortality by the subgroup of trial design (RCT vs observational) and ICU status. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsSix studies, reporting on 5,033 patients, were included in this review. Across the six studies, COVID-19 patients who had colchicine had a lower risk of mortality – HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.36 (95% CI: 0.17, 0.76). Among the three observational studies, COVID-19 patients who received colchicine had a lower risk of mortality – HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.21 (95% CI: 0.06, 0.71). Among three randomized controlled trials, the summary point estimate suggests a direction toward benefit in mortality that is not statistically significant among patients receiving colchicine versus placebo– OR of 0.49 (95% CI: 0.20, 1.24).ConclusionColchicine may reduce the risk of mortality in individuals with COVID-19. Further prospective investigation is warranted to determine the efficacy of colchicine as treatment in COVID-19 patients in various care settings of the disease.

scholarly journals Colchicine use in patients with COVID-19: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261358
Author(s):  
Leonard Chiu ◽  
Chun-Han Lo ◽  
Max Shen ◽  
Nicholas Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Trial Design ◽  
Long Term Care ◽  
Meta Analysis ◽  
Term Care ◽  
Risk Of Mortality ◽  
Prospective Investigation

Introduction Colchicine may inhibit inflammasome signaling and reduce proinflammatory cytokines, a purported mechanism of COVID-19 pneumonia. The aim of this systematic review and meta-analysis is to report on the state of the current literature on the use of colchicine in COVID-19 and to investigate the reported clinical outcomes in COVID-19 patients by colchicine usage. Methods The literature was searched from January 2019 through January 28, 2021. References were screened to identify studies that reported the effect of colchicine usage on COVID-19 outcomes including mortality, intensive care unit (ICU) admissions, or mechanical ventilation. Studies were meta-analyzed for mortality by the subgroup of trial design (RCT vs observational) and ICU status. Studies reporting an risk ratio (RR), odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Eight studies, reporting on 16,248 patients, were included in this review. The Recovery trial reported equivalent mortality between colchicine and non-colchicine users. Across the other studies, patients who received colchicine had a lower risk of mortality—HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.22 (95% CI: 0.09, 0.57). There was no statistical difference in risk of ICU admissions between patients with COVID-19 who received colchicine and those who did not–OR of 0.26 (95% CI: 0.06, 1.09). Conclusion Colchicine may reduce the risk of mortality in individuals with COVID-19. Further prospective investigation may further determine the efficacy of colchicine as treatment in COVID-19 patients in various care settings of the disease, including post-hospitalization and long-term care.

scholarly journals Prevalence of Current Smoking and Association with Adverse Outcome in Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Konstantinos Farsalinos ◽  
Konstantinos Poulas ◽  
Riccardo Polosa ◽  
Anastasia Barbouni ◽  
Pasquale Caponnetto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Adverse Outcome ◽  
Smoking Status ◽  
Meta Analysis ◽  
Hospitalized Patients ◽  
Adverse Outcomes ◽  
Prevalence Odds Ratio ◽  
Current Smoking ◽  
Former Smokers

Background: The purpose of this study was to examine the prevalence and effects of current smoking on adverse outcomes among hospitalized COVID-19 patients. Methods: We performed a systematic review of the literature (PubMed) for studies published until April 25. Studies were included into the analysis if they satisfied all of the following criteria: 1. To present hospitalized patients with COVID-19. 2. To classify patients into less and more severe disease, irrespective of the severity definition (defined as “adverse ourtcome”). 3. To present data on the smoking status, separately for each severity classification. We identified 18 (from a total of 1398) relevant studies. Pooled current smoking prevalence was compared with the gender-adjusted, population-based expected prevalence by calculating Prevalence Odds Ratio (POR). The association between current, compared to non-current and former, smoking and adverse outcome was examined by calculating Odds Ratio (OR). All analyses were performed using random-effects meta-analysis. Results: Among 6515 patients, 440 of whom were current smokers, the pooled prevalence of current smoking was 6.8% (95%CI: 4.8-9.1%) and the POR was 0.21 (95%CI: 0.16-0.26, P < 0.001). In Chinese studies only, the POR was 0.22 (95%CI: 0.17-0.27, P < 0.001). Current smokers were more likely to have an adverse outcome compared to non-current smokers (OR: 1.53, 95%CI: 1.06-2.20, P = 0.022). However, they were less likely to have an adverse outcome compared to former smokers (OR: 0.42, 95%CI: 0.27-0.74, P = 0.003). Conclusion: An unexpectedly low prevalence of current smoking was observed among hospitalized patients with COVID-19. Hospitalized current smokers had higher odds compared to non-current smokers but lower odds compared to former smokers for an adverse outcome. The possibility that nicotine may have a protective effect in COVID-19 which may be masked by smoking-related toxicity and by the abrupt cessation of nicotine intake when smokers are hospitalized should be explored.

scholarly journals Long-term Risk of Mortality and Other Adverse Outcomes After Acute Kidney Injury: A Systematic Review and Meta-analysis

2009 ◽  
Vol 53 (6) ◽  
pp. 961-973 ◽  
Author(s):  
Steven G. Coca ◽  
Bushra Yusuf ◽  
Michael G. Shlipak ◽  
Amit X. Garg ◽  
Chirag R. Parikh
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Risk Of Mortality

scholarly journals Cereal fibre intake and risk of mortality from all causes, CVD, cancer and inflammatory diseases: a systematic review and meta-analysis of prospective cohort studies

2016 ◽  
Vol 116 (2) ◽  
pp. 343-352 ◽  
Author(s):  
Maryam Hajishafiee ◽  
Parvane Saneei ◽  
Sanaz Benisi-Kohansal ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Dietary Fibre ◽  
Lower Risk ◽  
Inflammatory Diseases ◽  
Meta Analysis ◽  
Fibre Intake ◽  
Prospective Cohort Studies ◽  
Risk Of Mortality

AbstractDietary fibre intake has been associated with a lower risk of mortality; however, findings on the association of different sources of dietary fibre with mortality are conflicting. We performed a systematic review and meta-analysis of the prospective cohort studies to assess the relation between cereal fibre intake and cause-specific mortality. Medline/PubMed, SCOPUS, EMBASE, ISI web of Science and Google scholar were searched up to April 2015. Eligible prospective cohort studies were included if they provided hazard ratios (HR) or relative risks (RR) and corresponding 95 % CI for the association of cereal fibre intake and mortality from all causes, CVD, cancer and inflammatory diseases. The study-specific HR were pooled by using the random-effects model. In total, fourteen prospective studies that examined the association of cereal fibre intake with mortality from all causes (n 48 052 death), CVD (n 16 882 death), cancer (n 19 489 death) and inflammatory diseases (n 1092 death) were included. The pooled adjusted HR of all-cause mortality for the highest v. the lowest category of cereal fibre intake was 0·81 (95 % CI 0·79, 0·83). Consumption of cereal fibre intake was associated with an 18 % lower risk of CVD mortality (RR 0·82; 95 % CI 0·78, 0·86). Moreover, an inverse significant association was observed between cereal fibre intake and risk of death from cancer (RR 0·85; 95 % CI 0·81, 0·89). However, no significant association was seen between cereal fibre intake and inflammation-related mortality. This meta-analysis provides further evidence that cereal fibre intake was protectively associated with mortality from all causes, CVD and cancer.

scholarly journals Prevalence and Prognosis of HFimpEF Developed From Patients With Heart Failure With Reduced Ejection Fraction: Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yibo He ◽  
Yihang Ling ◽  
Wei Guo ◽  
Qiang Li ◽  
Sijia Yu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Ejection Fraction ◽  
Lower Risk ◽  
Meta Analysis ◽  
Left Ventricular Ejection ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Risk Of Mortality ◽  
Patients With Heart Failure

Background: Heart failure with improved ejection fraction (HFimpEF) is classified as a new type of heart failure, and its prevalence and prognosis are not consistent in previous studies. There is no systematic review and meta-analysis regarding the prevalence and prognosis of the HFimpEF.Method: A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library from inception to May 22, 2021 (PROSPERO registration: CRD42021260422). Studies were included for analysis if the prognosis of mortality or hospitalization were reported in HFimpEF or in patients with heart failure with recovered ejection fraction (HFrecEF). The primary outcome was all-cause mortality. Cardiac hospitalization, all-cause hospitalization, and composite events of mortality and hospitalization were considered as secondary outcomes.Result: Nine studies consisting of 9,491 heart failure patients were eventually included. During an average follow-up of 3.8 years, the pooled prevalence of HFimpEF was 22.64%. HFimpEF had a lower risk of mortality compared with heart failure patients with reduced ejection fraction (HFrEF) (adjusted HR: 0.44, 95% CI: 0.33–0.60). HFimpEF was also associated with a lower risk of cardiac hospitalization (HR: 0.40, 95% CI: 0.20–0.82) and the composite endpoint of mortality and hospitalization (HR: 0.56, 95% CI: 0.44–0.73). Compared with patients with preserved ejection fraction (HFpEF), HFimpEF was associated with a moderately lower risk of mortality (HR: 0.42, 95% CI: 0.32–0.55) and hospitalization (HR: 0.73, 95% CI: 0.58–0.92).Conclusion: Around 22.64% of patients with HFrEF would be treated to become HFimpEF, who would then obtain a 56% decrease in mortality risk. Meanwhile, HFimpEF is associated with lower heart failure hospitalization. Further studies are required to explore how to promote left ventricular ejection fraction improvement and improve the prognosis of persistent HFrEF in patients.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260422, identifier: CRD42021260422.

scholarly journals Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 864
Author(s):  
Chi-Hone Lien ◽  
Ming-Dar Lee ◽  
Shun-Long Weng ◽  
Chao-Hsu Lin ◽  
Lawrence Yu-Min Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Subgroup Analysis ◽  
Lower Risk ◽  
Meta Analysis ◽  
Colchicine Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Risk Of Mortality ◽  
Significant Difference

Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine treatment. From inception to May 31, 2021, databases, including PubMed, EMbase, medRxiv, and Research Square were searched, and 11 studies were enrolled. A total of 17,205 COVID-19 patients with male predominance (62.9%) were analyzed. Patients with colchicine treatment had a significantly lower risk of mortality (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.38–0.87, I2: 72%; p < 0.01) and a non-significantly lower rate of mechanical ventilation (OR: 0.67, 95%CI: 0.39–1.15). The side effects were mild and not significantly different (OR: 2.03, 95%CI: 0.51–8.09). Subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI: 0.44–1.46, I2: 33%; p = 0.22). In conclusion, our meta-analysis found that colchicine treatment was associated with a significantly lower risk of mortality in patients with COVID-19. However, this benefit was not observed in the subgroup analysis of randomized controlled trials. Further randomized controlled studies are required to confirm the potential benefits of colchicine treatment.

scholarly journals D-dimer, disease severity, and deaths (3D-study) in patients with COVID-19: a systematic review and meta-analysis of 100 studies

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seshadri Reddy Varikasuvu ◽  
Saurabh Varshney ◽  
Naveen Dutt ◽  
Manne Munikumar ◽  
Shahir Asfahan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Progression ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Strong Association ◽  
Rapid Assessment ◽  
Hazard Ratio ◽  
Adverse Outcomes ◽  
Prognostic Information ◽  
D Dimer

AbstractHypercoagulability and the need for prioritizing coagulation markers for prognostic abilities have been highlighted in COVID-19. We aimed to quantify the associations of D-dimer with disease progression in patients with COVID-19. This systematic review and meta-analysis was registered with PROSPERO, CRD42020186661.We included 113 studies in our systematic review, of which 100 records (n = 38,310) with D-dimer data) were considered for meta-analysis. Across 68 unadjusted (n = 26,960) and 39 adjusted studies (n = 15,653) reporting initial D-dimer, a significant association was found in patients with higher D-dimer for the risk of overall disease progression (unadjusted odds ratio (uOR) 3.15; adjusted odds ratio (aOR) 1.64). The time-to-event outcomes were pooled across 19 unadjusted (n = 9743) and 21 adjusted studies (n = 13,287); a strong association was found in patients with higher D-dimers for the risk of overall disease progression (unadjusted hazard ratio (uHR) 1.41; adjusted hazard ratio (aHR) 1.10). The prognostic use of higher D-dimer was found to be promising for predicting overall disease progression (studies 68, area under curve 0.75) in COVID-19. Our study showed that higher D-dimer levels provide prognostic information useful for clinicians to early assess COVID-19 patients at risk for disease progression and mortality outcomes. This study, recommends rapid assessment of D-dimer for predicting adverse outcomes in COVID-19.

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