scholarly journals Are eyes the windows to COVID-19? Systematic review and meta-analysis

2020 ◽  
Vol 5 (1) ◽  
pp. e000563
Author(s):  
Rina La Distia Nora ◽  
Ikhwanuliman Putera ◽  
Dhiya Farah Khalisha ◽  
Indah Septiana ◽  
Asri Salima Ridwan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Systemic Disease ◽  
Case Series ◽  
Severe Form ◽  
Ocular Manifestation ◽  
Systemic Manifestation ◽  
Ocular Manifestations ◽  
Source Of Infection ◽  
Pooled Prevalence ◽  
Meta Analyses

ObjectiveTo review and critically appraise the ocular manifestation and the presence of SARS-CoV-2 through PCR positivity from ocular samples in COVID-19-related patients. Moreover, to evaluate the time and severity association of ocular manifestation to systemic disease of COVID-19.Methods and analysisA systematic literature search from PubMed, ScienceDirect and Google Scholar databases was performed using standardised Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Selected keywords were related to COVID-19, ocular manifestation and PCR testing of SARS-CoV-2. Studies were assessed for their validity, and the data were extracted by two independent reviewers. Observational, case series and case report studies were included if they met the selection criteria. Meta-analysis was performed to estimate the pooled prevalence of ocular manifestations and PCR positivity from tears.ResultsThirty-one articles were qualitatively reviewed, and 14 studies were included in the meta-analysis. The pooled prevalence of ocular manifestation among COVID-19-related patients was 0.05 (95% CI 0.02% to 0.08). The overall PCR from tears samples positivity rate from COVID-19-related patients presenting with ocular manifestation was 0.38 (95% CI 0.14% to 0.65). Ocular manifestation could precede systemic manifestation in about 0.28 (95% CI 0.05% to 0.58) of COVID-19-related patients with ocular manifestations. Besides, ocular manifestation was not associated with a severe form of COVID-19.ConclusionAlthough the overall number of ocular manifestation and SARS-CoV-2 PCR positivity rate from ocular samples was very low, around a quarter of COVID-19-related patients with ocular manifestation presented their ocular manifestation earlier than the systemic manifestation regardless of the severity. Interestingly, SARS-CoV-2 PCR was positive from one-third of ocular samples, which could potentially be the source of infection to the respiratory tract and the environment, although the infectivity is yet to be determined.

scholarly journals Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Naser Nasiri ◽  
Hamid Sharifi ◽  
Azam Bazrafshan ◽  
Atefeh Noori ◽  
Mohammad Karamouzian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Ocular Manifestations ◽  
Ocular Symptoms ◽  
Body Sensation ◽  
Pooled Prevalence ◽  
Using Data ◽  
Meta Analyses

Several studies have reported the characteristics of Coronavirus disease 2019 (COVID-19), yet there is a gap in our understanding of the ocular manifestations of COVID-19. In this systematic review and meta-analysis, we investigated the prevalence of ocular manifestations in COVID-19 patients. We searched Pubmed, Embase, Scopus, Web of Science, and medRxiv from December 1, 2019 to August 11, 2020. Two independent reviewers screened the articles, abstracted the data, and assessed the quality of included studies in duplicate. Thirty-eight studies were eligible after screening of 895 unique articles, with a total of 8,219 COVID-19 patients (55.3% female; n = 3,486 out of 6,308 patients). Using data extracted from cross-sectional studies, we performed randomeffects meta-analyses to estimate the pooled prevalence of ocular symptoms along with 95% confidence interval (CI). The prevalence of ocular manifestations was estimated to be 11.03% (95% CI: 5.71–17.72). In the studies that reported the details of observed ocular symptoms, the most common ocular manifestations were dry eye or foreign body sensation (n = 138, 16%), redness (n = 114, 13.3%), tearing (n = 111, 12.8%), itching (n = 109, 12.6%), eye pain (n = 83, 9.6%) and discharge (n = 76, 8.8%). Moreover, conjunctivitis had the highest rate among reported ocular diseases in COVID-19 patients (79 out of 89, 88.8%). The results suggest that approximately one out of ten COVID-19 patients show at least one ocular symptom. Attention to ocular manifestations, especially conjunctivitis, can increase the sensitivity of COVID-19 detection among patients.

scholarly journals More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Lopez-Leon ◽  
Talia Wegman-Ostrosky ◽  
Carol Perelman ◽  
Rosalinda Sepulveda ◽  
Paulina A. Rebolledo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Original Data ◽  
Long Term Effects ◽  
Pooled Prevalence ◽  
Attention Disorder ◽  
Initial Recovery ◽  
Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

scholarly journals P.041 Adult craniopharyngioma: case series, systematic review and meta-analysis

2017 ◽  
Vol 44 (S2) ◽  
pp. S24-S24
Author(s):  
C Dandurand ◽  
AA Sepehry ◽  
MH Asadi Lari ◽  
R Akagami ◽  
PA Gooderham
Keyword(s):  
Meta Analysis ◽  
Case Series ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Childhood Population ◽  
Institutional Experience ◽  
The Difference ◽  
Meta Analyses ◽  
Case Basis

Background: The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others support subtotal resection followed by adjuvant radiotherapy (STR + XRT). Methods: MEDLINE (1946 to July 1st 2016) and EMBASE (1980 to June 30th 2016) were systematically reviewed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. At our institution, from 1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma. 22 patients were included in the present case series. Results: Eligible studies (n=21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17 %, 27 % and 45%, respectively. This differs from childhood population. The difference in risk of recurrence after GTR vs. STR + XRT did not reach significance (OR: 0.63, 95% confidence interval: 0.33-1.24, P=0.18). This maybe because of low pooled sample size (n=99) who underwent STR+XRT. Conclusions: This is the first and largest meta-analysis examining rate of recurrence in adult craniopharyngioma. Thus, when safe and feasible, a goal of gross total resection should be favored. Each patient should be considered on a case-by-case basis.

scholarly journals Crimean-Congo hemorrhagic fever-induced liver injury: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Sawai Singh Rathore ◽  
Ade Harrison Manju ◽  
Qingqing Wen ◽  
Manush Sondhi ◽  
Reshma Pydi ◽  
...  
Keyword(s):  
Liver Injury ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
Fatality Rate ◽  
High Case Fatality Rate ◽  
Crimean Congo Hemorrhagic Fever ◽  
Pooled Prevalence

Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal acute tick-borne viral infection and a substantial emerging global public health threat. This illness has a high case fatality rate of up to 40%. The liver is one of the important target organs of the CCHF virus. Objective: The aim of this meta-analysis to evaluate the correlation between CCHF  and liver injury and draw more generalized inferences about the abnormal serum markers of liver injury such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) in CCHF patients. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible observational studies and case series were included from around the world. The inclusion criteria were articles describing liver injury biomarkers AST and ALT amongst patients diagnosed with CCHF. Results: Data from 18 studies, consisting of 1238 patients with CCHF  were included in this meta-analysis. The overall pooled prevalence of at least one raised liver injury biomarker was 77.95% (95% CI, I2 = 88.50%, p < 0.0001). Similarly, pooled prevalence of elevated AST and ALT was 85.92% (95% CI, I2 = 85.27%,  p < 0.0001) and 64.30% (95% CI, I2 = 88.32%,  p < 0.0001) respectively.  Both Egger and Begg-Mazumdar’s tests detected no apparent publication bias in all three meta-analyses(p > 0.05).  Conclusion: These elevated liver injury biomarkers have been identified as significant prognostic factors. Hence, Physicians must recognize and continuously monitor these biomarkers, since these aid early stratification of prognosis and the prevention of severe outcomes in infection with such a high case fatality rate.

scholarly journals Prevalence of Poor Diabetes Self-Management Behaviors among Ethiopian Diabetes Mellitus Patients: A Systematic Review and Meta- Analysis

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Teshome Tesfaye Habebo ◽  
Ebrahim Jaafari Pooyan ◽  
Ali Mohammad Mosadeghrad ◽  
Getachew Ossabo Babore ◽  
Blen Kassahun Dessu
Keyword(s):  
Quality Assessment ◽  
Addis Ababa ◽  
Meta Analysis ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Diabetic Patients ◽  
Pooled Prevalence ◽  
Meta Analyses ◽  
Management Behaviors

BACKGROUND: Diabetes has no cure so far, but appropriate self-management contributes to delay or control its progression. However, poor self-management by diabetic patients adds to disease burden. The pooled prevalence of overall, and its main components of poor self-management among Ethiopian diabetic patients remain elusive. Hence, this study aimed to determine the prevalence of poor diabetes self-management behaviors among diabetic patients in Ethiopia.METHOD: by using different combinations of search terms, we accessed articles done until February 15, 2020 through Pubmed, Scopus, Web of Science and Embase databases. Newcastle-Ottawa quality assessment scale was used for quality assessment, and STATA version 14 software along with the random-effects model was employed for statistical analyses. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA.) guideline was followed to report the results.RESULT: Twenty-one studies with 7,168 participants were included in this meta-analysis. The overall pooled prevalence of poor self-management behavior among diabetic patients in Ethiopia was 49.79% (95% CI: 43.58%, 56.01%). Based on subgroup analysis, the estimated magnitudes of poor selfmanagement by regions were 68.58% in Tigray, 55.46% in Harari, 54.74%, in Amhara, 40.90%, in SNNPRS and 37.06% in Addis Ababa. The worst (80.91%) and relatively better (24.65%) self-management components were observed on self-blood glucose monitoring and medication adherence, respectively.CONCLUSION: One in two diabetic patients in Ethiopia had poor self-management. Thus, we strongly recommend to the ministry of health and universities to train diabetes health educators, and the health facilities to deliver tailored diabetes health education.

scholarly journals Prevalence, main serovars, and antimicrobial resistance profiles of Non-typhoidal Salmonella in poultry samples from the Americas: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Daniel Diaz ◽  
Pavel Eduardo Hernandez-Carreño ◽  
Diana Zuleika Velazquez ◽  
Miguel Angel Chaidez-Ibarra ◽  
Arnulfo Montero-Pardo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Environmental Samples ◽  
Meta Analysis ◽  
National Level ◽  
Production Chain ◽  
National Differences ◽  
Pooled Prevalence ◽  
The Usa ◽  
Meta Analyses

Poultry and poultry-derived products such as meat and eggs are among the main sources of non-typhoidal Salmonella (NTS) transmission to the human. Therefore, we performed a systematic review and used random-effects meta-analyses to 1) estimate the prevalence of NTS in poultry samples from birds, products and subproducts, and environmental samples, 2) examine the diversity and frequency of their serovars, and 3) estimate the prevalence and profiles of antimicrobial resistance (AMR) in NTS isolates reported in studies from the Americas. We included 157 studies from 15 countries comprising 261,408 poultry samples and estimated an overall pooled prevalence of 17.9% (95% CI: 10.8–26.3) in birds, 21.8% (17.7–26.1) in products and subproducts, and 29.5% (24.2–35.1) in environmental samples. At the national level, the prevalence of NTS was heterogenous across countries with the highest values in Mexico, the USA, and Canada. In total, 131 serovars were identified from 13,388 isolates, Heidelberg, Kentucky, Enteritidis, and Typhimurium were the most prevalent in the overall top 10 ranking (range 6.5–20.8%). At the national level, Enteritidis and Typhimurium were identified in most of the countries, though with national differences in their ranks. The prevalence of AMR increased from 24.1% for 1 antibiotic, to 36.2% for 2-3 antibiotics, and 49.6% for ≥ 4 antibiotics. Kentucky, Heidelberg, Typhimurium, and Enteritidis were the serovars with the highest prevalence of AMR and tetracycline, ampicillin, streptomycin, ceftiofur, and amoxicillin-clavulanic acid were the top five antibiotics to which NTS isolates were resistant. In conclusion, NTS was distributed through the avian production chain with high and heterogenous values of prevalence in poultry samples. Besides, there were distinctive patterns of serovars distribution across countries and an alarming prevalence of AMR among zoonotic serovars.

scholarly journals Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hepatitis B Virus ◽  
Meta Analysis ◽  
Infection Group ◽  
Pooled Prevalence ◽  
B Virus ◽  
The Difference ◽  
Meta Analyses

Abstract Background Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. This study aimed to determine the prevalence of Plasmodium spp. and HBV co-infection in people living in endemic areas of both diseases and to assess the risk factors related to this co-infection. Methods The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. The methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of nonrandomized studies in meta-analyses, and heterogeneity among the included studies was assessed with Cochran's Q test and the I2 (inconsistency) statistic. The pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effects model, depending on the amount of heterogeneity there was among the included studies. The pooled odds ratio (OR) represented the difference in qualitative variables, whereas the pooled mean difference (MD) represented the difference in quantitative variables. Meta-analyses of the potential risk factors for Plasmodium spp. and HBV co-infection, including patient age and gender, were identified and represented as pooled odds ratios (OR) and 95% CIs. Publication bias among the included studies was assessed by visual inspection of a funnel plot to search for asymmetry. Results Twenty-two studies were included in the present systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran's Q statistic < 0.001, I2: 95.8%), with prevalences of 10% in Gambia (95% CI: 8–12%, weight: 4.95%), 8% in Italy (95% CI 5–12%, weight: 3.8%), 7% in Nigeria (95% CI 4–10%, weight: 53.5%), and 4% in Brazil (95% CI 2–5%, weight: 19.9%). The pooled prevalence estimate of Plasmodium spp. and HBV co-infection was higher in studies published before 2015 (7%, 95% CI 4–9%, Cochran's Q statistic < 0.001, I2: 96%) than in those published since 2015 (3%, 95% CI 1–5%, Cochran's Q statistic < 0.001, I2: 81.3%). No difference in age and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and the Plasmodium monoinfection group (p: 0.48, OR: 1.33, 95% CI 0.60–2.96). No difference in gender and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and HBV co-infection group and the Plasmodium monoinfection group (p: 0.09, OR: 2.79, 95% CI 0.86–9.10). No differences in mean aspartate aminotransferase (AST), mean alanine aminotransferase (ALT), or mean total bilirubin levels were found (p > 0.05) between the Plasmodium spp. and HBV co-infection group and the Plasmodium monoinfection group. Conclusions The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

scholarly journals COVID-19: is it just a lung disease? A case-based review

2020 ◽  
Vol 2 (9) ◽  
pp. 1401-1406 ◽  
Author(s):  
Valerio Spuntarelli ◽  
M. Luciani ◽  
E. Bentivegna ◽  
V. Marini ◽  
F. Falangone ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Systemic Disease ◽  
Case Series ◽  
Level Of Evidence ◽  
Acute Lung Failure ◽  
Clinical Presentations ◽  
Case Series Report ◽  
Lung Failure ◽  
Case Based ◽  
Clinical Cases

Abstract Due to its extreme virulence, COVID-19 virus has rapidly spread, developing a severe pandemic. SARS-COV-2 mostly affected the respiratory tract, causing a severe acute lung failure. Although the infection of airways, COVID-19 can be associated with chronic and systemic damages still not so much known. The purpose of this research is to collect recent evidence in literature about systemic diseases caused by COVID-19. The format of the present article has features of a systematic case-based review (level of evidence), and it is structured as a case series report (patients of our COVID-19 Medicine Ward have been selected as cases). Data for this review have been selected systematically, taking evidence only from indexed journals and databases: PubMed, Scopus, MEDLINE, and Cochrane systems. Papers chosen included systematic reviews, case series, clinical cases, meta-analysis studies, and RCTs. We start collecting studies since 2003. The main keywords used were “COVID-19” “OR” “SARS” “OR” “SARS – COV 2” “AND” “systemic disease” / “nephropathy” / “cardiac pathology” / “central nervous system.” Clinical cases belong to our COVID-19 Medicine Ward. One of the most severe COVID-19 clinical presentations includes cardiovascular problems, like myocarditis, pericarditis, and acute hearth failure. Cytokine release syndrome caused by COVID-19 develops severe acute kidney failure. It is still unknown the way coronavirus damages the liver, brain, and reproductive system. Considering the majority of the new studies about this pathology, it issues that COVID-19 is considered to be a multi-organ disease.

scholarly journals Prevalence and Determinants of Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Nuradin Abusha Katiso ◽  
Getachew Mullu Kassa ◽  
Gedefaw Abeje Fekadu ◽  
Abadi Kidanemariam Berhe ◽  
Achenef Asmamaw Muche
Keyword(s):  
Birth Weight ◽  
Prenatal Care ◽  
Low Birth Weight ◽  
Rural Areas ◽  
Meta Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Pooled Prevalence ◽  
Unpublished Studies ◽  
Meta Analyses

Introduction. Low birth weight (LBW) is the most significant risk factor for neonatal and infant mortality. It is one of the major public health problems in developing countries. Although there are various studies on low birth weight, findings were inconsistent and inconclusive. Therefore, this study was conducted to estimate the national-pooled prevalence of low birth weight and its associated factors in Ethiopia. Method. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. This meta-analysis employed a review of both published and unpublished studies conducted in Ethiopia. The databases used were PubMed, Google Scholar, CINAHL, and African Journals Online. Relevant search terms for prevalence and determinants of LBW were used to retrieve articles. The meta-analysis was conducted using STATA 14 software. Forest plots were used to present the findings. The Cochran Q test and I2 test statistics were used to test heterogeneity across studies. Egger’s test was used to assess the publication bias of included studies. The pooled prevalence and the odds ratios (OR) with 95% confidence intervals (CI) were computed and were presented using forest plots. Results. A total of 28 studies, 50,110 newborn babies, were included in this meta-analysis. The pooled prevalence of LBW in Ethiopia was 14.1% (95% CI = 11.2, 17.1). Higher variation in the prevalence of LBW in different regions across the country was observed. Significant association of LBW with sex of the newborn baby, higher odds among female babies (OR = 1.5 (95% CI = 1.2, 1.7)), prematurity (OR = 4.7 (95% CI = 1.5, 14.5)), not attending prenatal care (OR = 1.7 (95% CI = 1.4, 2.2)), pregnancy-induced hypertension (OR = 6.7 (95% CI = 3.5, 12.9)), and newborn babies whose mothers were from rural areas (OR = 1.8 (95% CI = 1.2, 2.6) were the factors associated with low birth weight. Conclusions. The prevalence of LBW in Ethiopia was high. LBW was associated with several maternal and newborn characteristics. The large disparity of LBW among the different regions in the country needs targeted intervention in areas with higher prevalence. Particular emphasis should be given to mothers residing in rural areas. Community-based programs are important to increase the use of prenatal care.

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

2020 ◽  
pp. 019459982095117
Author(s):  
Craig A. Bollig ◽  
David S. Lee ◽  
Angela L. Mazul ◽  
Katelyn Stepan ◽  
Sidharth V. Puram ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Random Effects ◽  
Meta Analysis ◽  
Second Primary ◽  
Random Effects Model ◽  
Treatment Information ◽  
Pooled Prevalence ◽  
Alive With Disease ◽  
Medical Librarian ◽  
Meta Analyses

Objective To systematically review the literature to determine the prevalence and clinical outcomes of second primary oropharyngeal squamous cell carcinoma (OPSCC). Data Sources Search strategies created with a medical librarian were implemented using multiple databases in October 2019. Review Methods The population of interest included adults age >18 years with a p16+ or human papillomavirus-positive OPSCC. The outcome was a synchronous or metachronous second primary OPSCC. Inclusion and exclusion criteria were designed to capture all study designs. In total, 685 records were identified by the search strategy. Two reviewers independently performed the review, extracted data, and performed a quality assessment. Primary Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A random-effects model was used for the meta-analysis. Results A total of 2470 patients with 35 second primary OPSCCs from 15 studies were identified. The pooled prevalence of second primary OPSCC was 1.4% (range, 0%-14.3%). In the random-effects model, the prevalence was estimated at 1.3% (95% CI, 0.7%-2.3%; P = .51, I2 = 52%). Of the 30 patients with treatment information, 26 (86.7%) received surgical treatment, while 4 (13.3%) underwent nonsurgical therapy. Of the 29 patients with available survival information, 22 (75.9%) had no evidence of disease at last follow-up, 5 (17.2%) ultimately died of disease, and 2 (6.9%) were alive with disease. Conclusion Overall, the rate of second primary OPSCC in patients with an index p16+ OPSCC is low, and most patients are successfully treated. Insufficient evidence currently exists to recommend routine elective tonsillectomy during surgical treatment of p16+ OPSCC.

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