scholarly journals The effect of eye protection on SARS-CoV-2 transmission: a systematic review

Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Justin Clark ◽  
Peter Collignon ◽  
Paul Glasziou

Background: The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. Methods: We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. Findings: We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, googles and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. Interpretation: Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.

2021 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Justin Clark ◽  
Peter Collignon ◽  
Paul Glasziou

Abstract Background: The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. Methods: We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2.Results: We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low.Conclusions: Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.


Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Justin Clark ◽  
Peter Collignon ◽  
Paul Glasziou

Abstract Background The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. Methods We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. Results We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case–control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. Conclusions Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.


2020 ◽  
Vol 162 (6) ◽  
pp. 818-825
Author(s):  
David Forner ◽  
Daniel J. Lee ◽  
Chris Walsh ◽  
Ian J. Witterick ◽  
S. Mark Taylor ◽  
...  

Objective Parotidectomies are commonly performed procedures by head and neck surgeons. Although parotidectomies are historically inpatient procedures, recent observational evidence has highlighted the potential for parotidectomies to be performed on an outpatient basis. This systematic review and meta-analysis sought to compare complications and unplanned health care utilization between patients undergoing outpatient versus inpatient parotidectomy. Data Sources A systematic review was performed using MEDLINE, EMBASE, and the Cochrane Library. Review Methods Studies comparing the outcomes of outpatient parotidectomy with those of inpatient parotidectomy were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Postoperative complications (hematoma, facial nerve dysfunction, seroma, fistulisation, Frey syndrome, and wound infection) and rates of 30-day readmission, reintervention, and emergency department presentation were compared. Results We screened 1018 nonduplicate articles to include 5 studies, all of which were retrospective cohort studies. There were fewer complications found in the outpatient group (relative risk = 0.61, 95% confidence interval: 0.40-0.93). Outpatient procedures were more commonly performed on patients who lived close to the hospital, had fewer comorbidities, and had less extensive planned surgery. Conclusion Outpatient parotidectomy appears safe in select patients with outcomes comparable with inpatient surgery. However, evidence overall is of low quality, and further work is needed to delineate a satisfactory set of criteria for appropriate patient identification.


2021 ◽  
Author(s):  
Huairong Xiang ◽  
Bei He ◽  
Yun Li ◽  
Xuan Cheng ◽  
Qizhi Zhang ◽  
...  

Background: Bamlanivimab is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in worldwide. We performed a meta-analysis to investigate the efficacy and safety of bamlanivimab treatment in patients with COVID-19. Methods: We searched articles from Web of Science, PubMed, Embase, the Cochrane Library and MedRxiv between 30 January 2020 and August 5, 2021. We selected randomized clinical trials (RCTs) and observational studies with a control group to assess the efficiency of bamlanivimab in treating patients with COVID-19. Results: Our meta-analysis retrieved 3 RCTs and 7 cohort studies including 14461 patients. Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease. The combination of bamlanivimab and etesevimab may had a greater potential for positive treatment outcome. Conclusion: Bamlanivimab has demonstrated clinical efficacy on mild or moderate ill patients with COVID-19 to prevent hospitalization, reduce severity and mortality from the disease. Combinations of two or more monoclonal antibody increase the effect. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients'population that could benefit from bamlanivimab are warranted in the future.


Author(s):  
Xiang Zhang ◽  
Guo-Tao Pan ◽  
Zeng-Li Zhang ◽  
Shasha Tao

Background: Diabetic retinopathy (DR) is one of the most prominent pathological microvascular complications in diabetes. A series of studies reported that vitamin D deficiency was associated with increased prevalence of retinopathy in diabetic patients but the results were inconsistent. In this study we focused on evaluating the relationship between vitamin D deficiency and DR by conducting a meta-analysis of observational studies. Methods: Systematic computerized searches were performed in PubMed, MEDLINE, and the Cochrane Library for relevant original articles till November 20, 2016. The pooled odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated to assess the associated value of vitamin D deficiency to the risk of DR. 9 studies including 6332 participants were subjected to final analysis. Results: The results indicated that vitamin D deficiency increases the risk of DR (OR = 1.57, 95% CI 1.32-1.87) with a little heterogeneity (I2 = 23%). In addition, the subgroup analysis demonstrated that there were obvious heterogeneities in T2DM (I2 = 47.8%). Sensitivity analysis showed that the results were relatively stable and reliable. Conclusion: our meta-analysis demonstrated that vitamin D deficiency could increase the risk of DR.


Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1174 ◽  
Author(s):  
Fausto Petrelli ◽  
Michele Ghidini ◽  
Antonio Ghidini ◽  
Gianluca Perego ◽  
Mary Cabiddu ◽  
...  

The association between antibiotic use and risk of cancer development is unclear, and clinical trials are lacking. We performed a systematic review and meta-analysis of observational studies to assess the association between antibiotic use and risk of cancer. PubMed, the Cochrane Library and EMBASE were searched from inception to 24 February 2019 for studies reporting antibiotic use and subsequent risk of cancer. We included observational studies of adult subjects with previous exposure to antibiotics and available information on incident cancer diagnoses. For each of the eligible studies, data were collected by three reviewers. Risk of cancer was pooled to provide an adjusted odds ratio (OR) with a 95% confidence interval (CI). The primary outcome was the risk of developing cancer in ever versus non-antibiotic users. Cancer risk’s association with antibiotic intake was evaluated among 7,947,270 participants (n = 25 studies). Overall, antibiotic use was an independent risk factor for cancer occurrence (OR 1.18, 95%CI 1.12–1.24, p < 0.001). The risk was especially increased for lung cancer (OR 1.29, 95%CI 1.03–1.61, p = 0.02), lymphomas (OR 1.31, 95%CI 1.13–1.51, p < 0.001), pancreatic cancer (OR 1.28, 95%CI 1.04–1.57, p = 0.019), renal cell carcinoma (OR 1.28, 95%CI 1.1–1.5, p = 0.001), and multiple myeloma (OR 1.36, 95%CI 1.18–1.56, p < 0.001). There is moderate evidence that excessive or prolonged use of antibiotics during a person’s life is associated with slight increased risk of various cancers. The message is potentially important for public health policies because minimizing improper antibiotic use within a program of antibiotic stewardship could also reduce cancer incidence.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Xia ◽  
Changhao Chen ◽  
Zhiqiang Liu ◽  
Xiangfen Luo ◽  
Chunyan Guo ◽  
...  

Objectives: Healthcare workers (HWs) experienced high levels of work stress during the COVID-19 pandemic, leading to a high risk of sleep disturbances. This meta-analysis aimed to explore the prevalence of sleep disturbances and sleep quality in Chinese HWs during the COVID-19 pandemic.Methods: English (PubMed, EMBASE, PsycINFO, Web of Science, and the Cochrane Library) and Chinese databases (WanFang, Chinese National Knowledge Infrastructure, and SinoMed) were systematically and independently searched for relevant studies published from December 1, 2019, to May 20, 2020. The pooled prevalence of sleep disturbances and sleep quality were calculated using a random-effects model.Results: A total of 17 studies involving 12,682 Chinese HWs were included in the meta-analysis. The pooled prevalence of sleep disturbances in Chinese HWs was 45.1% (95% CI: 37.2–53.1%). We found that the prevalence of sleep disturbances varied among frontline, infected, and non-frontline HWs (Q = 96.96, p &lt; 0.001); females and males (Q = 9.10, p = 0.003); studies using different assessment instruments (Q = 96.05, p &lt; 0.001); and studies with different sample sizes (Q = 5.77, p = 0.016) and cut-off values (Q = 62.28, p &lt; 0.001). The pooled mean total score of the Pittsburgh Sleep Quality Index (PSQI) was 9.83 (95% CI: 8.61–11.04). HWs in Wuhan had a higher total PSQI score than those in other regions (Q = 9.21, p = 0.002).Conclusion: Sleep disturbances were common in Chinese HWs during the COVID-19 pandemic, particularly in frontline and infected HWs. Our results indicate the heavy mental health burden on HWs during the COVID-19 pandemic in China and can provide other countries with valuable information to assist HWs during the crisis.


2018 ◽  
Vol 24 (8) ◽  
pp. 6130-6135
Author(s):  
M. Gozali Arif ◽  
Rizal A. H Hamid

To evaluate clinical data from published trials on efficacy and adverse events of intermittent androgen deprivation therapy (IAD) and continuous androgen deprivatin therapy (CAD). This study searched Medline, Sience direct and the Cochrane Library through August 2016 without year restriction but only english journal were included suplemented using Preferred Reporting Items for Systematic Reviews and Meta-analysis of Observational Studies in Epidemiology Guidelines. Result: 10 Studies were identified and up to 4403 patients were pooled. When compared to CAD, IAD was not statistically difference in term of overall mortality and 3 years PSA progression. But when compared to CAD, IAD was statistically better than CAD in the term reduce pain burden. Conclusions: This study conclude that the efficacy between CAD and IAD was not significant different. IAD is better to minimize pain as adverse events than CAD.


2020 ◽  
Vol 11 (5) ◽  
pp. 619-624
Author(s):  
Mark N. Awori ◽  
Jonathan A. Awori ◽  
Nikita P. Mehta ◽  
Obed Makori

Monocusp valves are thought to reduce early operative mortality and morbidity associated with pediatric tetralogy of Fallot repair. As there are no published randomized clinical trials comparing outcomes with and without a monocusp valve, we performed a meta-analysis of observational studies in accordance with established protocols. After systematically searching PubMed, the Cochrane Library, and Google Scholar, 12 studies were included. The operative mortality was compared in 695 patients, and we found no difference between patients with and patients without a monocusp valve. Monocusp valves may not improve operative mortality of tetralogy of Fallot repair in pediatric patients.


2020 ◽  
Author(s):  
GUSTAVO Arruda Viani ◽  
Juliana Fernandes Pavoni ◽  
Ligia Issa de Fendi

Objectives: The effectiveness and safety of STAR in patients with refractory ventricular tachycardia (VT) to catheter ablation are limited to small series. We performed a meta-analysis of observational studies to summarize existing data about efficacy and toxicity following START for VT. Methods: Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through March 2020. We followed the PRISMA and MOOSE guidelines. An estimative of % VT burden reduction at 6 months higher than 85% was considered effective. A rate of any grade 3 or higher toxicity lower than 10% and no grade 4 or 5 were considered safe. Results: Four observational studies with a total of 39 patients treated were included. The % of VT burden reduction at 6 months was 91% (CI95% from 83 to 100%). The consumption of lower than 2 anti-arrhythmia drugs (AAD) at 6 months was 81%. The ejection fraction improved in 12.8%, unchanged 82%, and decreased by 5.2%. The overall survival (OS) was 92% and 82 % in 6 and 12 months. The cardiac death and disease-specific survival at 12 months were 12% and 88.5%. Late grade 3 toxicity 5% with no grade 4-5. Conclusion: STAR produced satisfactory % of VT burden reduction, with a significant reduction in the consumption of AAD at 6 months, and no severe toxicity. These findings support the continued work to develop new trials and to adopt STAR as a treatment option for medical practice.


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