scholarly journals Aspirin Use is Associated with Decreased Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

Author(s):  
Pramod savarapu ◽  
Nischit Baral ◽  
Govinda Adhikari ◽  
Maxwell Akanbi ◽  
Basel Abdelazeem ◽  
...  

Background: Novel Corona Virus Disease 2019 (COVID-19) has resulted in more than three and half million deaths worldwide as of June 6, 2021. The role of aspirin in prevention of COVID-19 mortality has not been much studied. We aimed to study the relationship between aspirin use and covid-19 mortality. Methods: We searched PubMed, MEDLINE, EMBASE, and Cochrane database for studies from January 2019 till June 6, 2021 with inclusion criteria of RCT, Cohort study, studies reporting mortality, and comparison studies on aspirin versus non-aspirin. Statistical analysis was done with Review Manager 5.4 statistical software using the inverse variance method. We assessed the pooled hazard ratio (HR), and 95% confidence interval using the random effect model and I-squared test was used to determine statistical heterogeneity. Results: We included five retrospective cohort studies which met our inclusion criteria with total of 14065 participants in both groups. There were 6797 participants in the aspirin group and 7268 participants in the non-aspirin group. Our results show that the use of aspirin was associated with 53% decrease in mortality compared to non-aspirin in patients with COVID-19 (adjusted HR 0.47, 95% CI 0.35-0.63, P< 0.001, I2= 47%). In the analysis restricted to patients hospitalized for COVID-19, the use of aspirin was associated with a 49% reduction in the risk for in-hospital mortality (adjusted HR 0.51, 95% CI 0.33-0.80, P = 0.004, I2= 39%). Conclusions: Our results show that aspirin is associated with decrease in both overall mortality and in-hospital mortality in patients with COVID-19.

2020 ◽  
Author(s):  
Xiao-ce Dai ◽  
Xin-xin Yang ◽  
Lan Ma ◽  
Guan-min Tang ◽  
Yan-yun Pan ◽  
...  

Abstract Background. Our aim was to determine the relationship between the use of fluoroquinolones and the risk of aortic diseases. Methods. PubMed, EMBASE and the Web of Science were searched from inception to July 6, 2019, to identify observational studies that evaluated the risk of aortic diseases associated in users of fluoroquinolones compared with nonusers or users of other antibiotics. The primary outcome was the first occurrence of aortic diseases. We used the GRADE approach to rate the strength of evidence. We used the inverse variance method random-effect model to estimate the odds ratios (ORs) with 95% CIs, and statistical heterogeneity was assessed by the I 2 statistic. Results. This meta-analysis enrolled 2,829,385 patients reported the relationship between fluoroquinolones and the risk of aortic diseases. Compared with nonusers or users of other antibiotics, users of fluoroquinolone had a significantly increased risk of aortic diseases (adjusted OR, 2.10; 95% CI, 1.65-2.68; P =.000, I 2 =16.4%). The quality of evidence was moderate, and the number needed to harm (NNH) for aortic diseases among patients was estimated to be 1301. Conclusions. The fluoroquinolone use in patients significantly increases the risk of new-onset aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use. Key Words: Fluoroquinolones; aortic aneurysm; aortic dissection; meta-analysis


2020 ◽  
Author(s):  
Xiao-ce Dai ◽  
Xin-xin Yang ◽  
Lan Ma ◽  
Guan-min Tang ◽  
Yan-yun Pan ◽  
...  

Abstract Background. Our aim was to determine the relationship between the use of fluoroquinolones and the risk of aortic diseases.Methods. PubMed, EMBASE and the Web of Science were searched from inception to July 6, 2019, to identify observational studies that evaluated the risk of aortic diseases associated in users of fluoroquinolones compared with nonusers or users of other antibiotics. The primary outcome was the first occurrence of aortic diseases. We used the GRADE approach to rate the strength of evidence. We used the inverse variance method random-effect model to estimate the odds ratios (ORs) with 95% CIs, and statistical heterogeneity was assessed by the I2 statistic.Results. This meta-analysis enrolled 2,829,385 patients reported the relationship between fluoroquinolones and the risk of aortic diseases. Compared with nonusers or users of other antibiotics, users of fluoroquinolone had a significantly increased risk of aortic diseases (adjusted OR, 2.10; 95% CI, 1.65-2.68; P=.000, I2=16.4%). The quality of evidence was moderate, and the number needed to harm (NNH) for aortic diseases among patients was estimated to be 1301.Conclusions. The fluoroquinolone use in patients significantly increases the risk of new-onset aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use.


2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Tiziana Ciarambino ◽  
Orazio Valerio Giannico ◽  
Amalia Campanile ◽  
Antonella Fischetti ◽  
Elena Barabgelata ◽  
...  

The aim was to evaluate whether intra-hospital mortality from ischemic stroke is different in female patients. Methods. Studies were found in PubMed, Web of Science. We excluded 119 records because they did not include relevant reports or data. Studies were eligible for inclusion if enrolled adult patients with ischemic stroke and if the odds ratio (OR) of intra-hospital mortality in females compared to males is provided. Three retrospective cohort studies were eligible for inclusion criteria and so were included in the analysis. Findings: the random effect model showed a pooled significant higher risk of intra-hospital mortality [OR 1.34 (95% confidence interval 1.04, 1.74), P=0.026] in the female group compared to the male group. Our systematic review shows that intra-hospital mortality was significantly higher in female subjects compared to male.


Author(s):  
Nipith Charoenngam ◽  
Thanitsara Rittiphairoj ◽  
Ben Ponvilawan ◽  
Patompong Ungprasert

Background: Patients with psoriasis may have a higher risk of dementia because of the higher inflammatory burden, although results from previous epidemiological studies have been inconsistent. Aims: To determine the association between psoriasis and risk of dementia by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from Medline and EMBASE databases from inception to July 2019 using a search that comprised terms for “psoriasis” and “dementia.” Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic patients and individuals without psoriasis and followed them for incident dementia. Studies were also required to report standardized incidence ratio, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of dementia between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 8,861 articles were identified. After two rounds of independent review by three investigators, we included six cohort studies that met the eligibility criteria in the meta-analysis. The risk of dementia was significantly higher among psoriatic patients than in those without psoriasis with a pooled risk ratio of 1.16 (95% CI, 1.04–1.30; I2 95%). A funnel plot was relatively symmetric and was not suggestive of the presence of publication bias. Limitations: Limited accuracy of diagnosis of psoriasis and dementia as four included studies were coding-based studies, and high statistical heterogeneity among studies. Conclusion: This systematic review and meta-analysis indicates that psoriatic patients have a significantly elevated risk of developing dementia.


2020 ◽  
Author(s):  
Pranta Das ◽  
Nandeeta Samad ◽  
Abdul-Aziz Seidu ◽  
Richard Gyan Aboagye ◽  
Justice Kanor Tetteh ◽  
...  

Abstract Background: The 2019 Severe Acute Respiratory Syndrome Coronavirus (COVID-19) is an unexpected pandemic causing mortalities across all ages. However, the severity of its health implications is mostly reported in persons with chronic health conditions with obesity being identified as one of the leading predisposing factors in acquiring the novel virus and developing its adverse complications. This meta-analysis sought to determine the estimated association between obesity and adverse outcomes among COVID-19 patients. Methods: We followed the recommended PRISMA guidelines in executing this study. A systematic literature search was conducted in PubMed, Google Scholar, and ScienceDirect for published literature between December 1, 2019, and October 2, 2020. The data for the study were pooled from studies that contained the search terms "Obesity" AND (COVID-19 or 2019-nCoV or Coronavirus or SARS-CoV-2) AND ("ICU admission" OR "Hospitalization" OR "Disease severity" OR "Invasive mechanical ventilator" OR "Death" OR "Mortality"). All the online searches were supplemented by reference screening of retrieved studies for additional literature. The pooled odds ratio (OR) and confidence intervals (CI) from the retrieved studies were calculated using the random effect model (Inverse-Variance method). Findings: A total of five (5) studies with a combined sample size of 335,192 patients were included in the meta-analysis. The pooled OR from the final analysis showed that patients who are severely obese were more likely to experience adverse outcome (death or ICU admission or needing IMV or hospitalization) compared to the normal patients [OR = 2.81, 95% CI = 2.33 – 3.40, I2 = 29%].Conclusion: Severe obesity is a risk factor in developing adverse outcomes among COVID-19 patients. The finding of the study signifies promotive, preventive, and curative attention to be accorded patients diagnosed with severe obesity and COVID-19.


Author(s):  
Ferda Fibi Tyas Nurkholifa ◽  
◽  
Eti Poncorini Pamungkasari ◽  
Hanung Prasetya ◽  
◽  
...  

ABSTRACT Background: Many studies reported the importance of exclusive breastfeeding for infants. However, there are many obstacles faced by lactating mothers to provide exclusive breastfeeding for their children. This study aimed to investigate the effect of secondary education on exclusive breastfeeding using a meta-analysis. Subjects and Method: Meta-analysis and systematic review were conducted by collecting articles from PubMed, Science Direct, and Google Scholar databases. Keywords used exclusive breastfeeding” AND “secondary education” OR “education for breastfeeding” AND “cross sectional” AND “adjusted odd ratio”. The study population was postpartum mothers. Intervention was secondary education with comparison primary education. The study outcome was exclusive breastfeeding. The inclusion criteria were full text, using English or Indonesian language, and reporting adjusted odds ratio. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using random effect model run on Revman 5.3. Results: 7 studies from Peru, China, Nigeria, Korea, Ireland, Sub-Sahara, and South Australia were met the inclusion criteria. There was high heterogeneity between groups (I2= 94%; p<0.001). This study reported that secondary education reduced exclusive breastfeeding, but it was statistically non-significant (aOR= 0.86; 95% CI= 0.60 to 1.24; p= 0.430). Conclusion: Secondary education reduced exclusive breastfeeding, but it was statistically non-significant. Keywords: exclusive breastfeeding, secondary education, postpartum Correspondence: Ferda Fibi Tyas Nurkholifa. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285655778863. DOI: https://doi.org/10.26911/the7thicph.03.131


Author(s):  
Shiva Aflahiyah ◽  
◽  
Didik Gunawan Tamtomo ◽  
Hanung Prasetya ◽  
◽  
...  

ABSTRACT Backgrund: A growing body of evidence suggests that activity of the stress-responsive hypothalamic-pituitary-adrenal axis and its end-product cortisol also may be associated with perinatal emotional well-being. A number of preventive interventions, such as Yoga, targeting psychosocial and physiological risk factors for perinatal depression have utilized mind-body practices, which embody the idea that the mind interacts with the body to influence physical functioning, improve symptoms, and promote health. This study aimed to investigate effectiveness of prenatal yoga in reducing cortisol hormone in pregnancy Subjects and Method: This was a meta-analysis and systematic review. This study collected published articles during 2000 to 2020 from PubMed, Science Direct, Springer, Proquest, and Chocrane electronic databases. The inclusion criteria were full text, randomized controlled trial, and prenatal yoga intervention. The study subjects were pregnant women who received prenatal yoga for 8 to 20 weeks. Outcome was cortisol hormone reduction during pregnancy. The selected articles were analyzed by PRISMA flow chart and RevMan 5.3. Results: 5 articles from America and Asia were met the inclusion criteria. This study had high heterogeneity (I2=88%; p<0.001). Therefore, this study used random effect model (REM). Prenatal yoga reduced cortisol level 0.59 times in pregnancy (Mean Difference= -0.59; 95% CI= 1.18 to 0.01; p= 0.050). Conclusion: Prenatal yoga is effective to reduce cortisol level in pregnant women. Keywords: prenatal yoga, cortisol hormone, pregnant women Correspondence: Shiva Aflahiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. DOI: https://doi.org/10.26911/the7thicph.05.47


Author(s):  
Astika Candra Nirwana ◽  
◽  
Yulia Lanti Retno Dewi ◽  
Bhisma Murti ◽  
◽  
...  

ABSTRACT Background: Prophylactic oral iron is recommended during pregnancy to meet the increased requirement during the antenatal period. The most commonly used iron preparation for anemia in pregnancy is iron sucrose complex (ISC). The purpose of this study was to compare the effects of ferric carboxymaltose versus iron sucrose on the ferritin level in pregnant women with anemia. Subjects and Method: This was a meta-analysis study. The study was conducted by collecting published articles from 2010 to 2019 in PubMed, Science Direct, and Google Scholar databases. The keywords used to search the articles including “Ferric Carboxymaltose”, “Ferric Carboxymaltose and anemia in pregnancy”, and “the effect of Ferric Carboxymaltose for anemia”. The inclusion criteria was full text with randomized control trial study, anemia therapy provision using ferric carboxymaltose versus iron sucrose, and the study subjects were pregnant women with anemia. The selected articles were analyzed using Revman 5.3. Results: 5 articles that meet the inclusion criteria were selected for this study. There was high heterogeneity between experiment group (I2 = 96%; p= 0.020). Therefore, this study used random effect model. Ferric carboxymaltose provision increased feritin level 0.89 times than iron sucrose (Mean Difference= 0.89; 95% CI= 0.12 to 1.66; p<0.001). Conclusion: Ferric carboxymaltose is effective to increased feritin level in pregnant women. Keywords: ferric carboxymaltose, iron sucrose, randomized controlled trial Correspondence: Astika Candra Nirwana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085640018896 DOI: https://doi.org/10.26911/the7thicph.05.48


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chol Techorueangwiwat ◽  
Chanavuth Kanitsoraphan ◽  
Jakrin Kewcharoen

Introduction: Studies have shown that the use of antiplatelet and anticoagulant increases the risk of cardiac implantable electronic device (CIED) infection following the implantation. However, results were contradicting. In this study, we performed a systematic review and meta-analysis to explore the effect of antiplatelets and anticoagulants and the risk of CIED infection following the implantation. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published studies of patients undergoing CIED implantations which reported effect size of the use of either antiplatelet or anticoagulant, or both, on the risk of CIED infections. CIED infection was defined as either device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate effect size and 95% confidence intervals (CI). Results: Fifteen studies from 2008-2019 involving a total of 72,028 patients were included. In random-effect model, we found that the use of antiplatelet was not associated with an increased risk of CIED infections (risk ratio (RR) =1.13, 95% CI: 0.89-1.44, p=0.314, I 2 =51.3%), while the use of anticoagulant was associated with increased risk of CIED infections (RR =1.50, 95%CI: 1.02-2.21, p=0.038, I 2 =75%). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that the use of anticoagulant significantly increases the risk of CIED infection following the implantation by up to 1.50-fold, however, this effect was not observed with antiplatelet use. Our study suggested that patients on anticoagulation considering CIED implantations should proceed with caution.


Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 1-8
Author(s):  
Xiaoling Zhou ◽  
Aijie Shi ◽  
Xiao Zhou

AbstractObjective This meta-analysis aims to investigate the diagnostic performance of serum homocysteine (Hcy) as a biomarker for diabetic nephropathy (DN).Methods Clinical publications relevant to serum Hcy level and DN were systematic searched in the electronic databases of; Pubmed, Cochrane Library, Embase, Web of science, CNKI and CBM. The diagnostic data from each included original study was extracted and pooled by the effect size of diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likely hood ratio (-LR), diagnostic odds ratio (DOR) and area under the symmetric ROC curve (AUC).Results 18 publications relevant to serum Hcy and DN were included in the meta-analysis. The I2 test demonstrated significant statistical heterogeneity across the 18 studies for the effect size of diagnostic. The pooled diagnostic sensitivity, specificity, +LR, -L, DOR, AUC were 0.76 (95%CI: 0.74-0.78), 0.84 (95%CI:0.82-0.86), 5.05 (95%CI:3.52-7.24), 0.27 (95%CI:0.19-0.39), 21.68 (95% CI:11.15to 42.14) and 0.90 respectively in the random effect model.Conclusion Based on the present publications, serum Hcy is a promising serological marker for DN diagnosis.


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