scholarly journals Rapid systematic review of neonatal COVID-19 including a case of presumed vertical transmission

2020 ◽  
Vol 4 (1) ◽  
pp. e000718 ◽  
Author(s):  
Morris Gordon ◽  
Taher Kagalwala ◽  
Karim Rezk ◽  
Chris Rawlingson ◽  
M Idris Ahmed ◽  
...  

ObjectiveTo carry out a systematic review of the available studies on COVID-19 (coronavirus disease 2019) in neonates seen globally since the onset of the COVID-19 global pandemic in 2020. The paper also describes a premature baby with reverse transcription (RT)-PCR-positive COVID-19 seen at the Blackpool Teaching Hospitals NHS Foundation Trust, UK.DesignWe conducted a multifaceted search of the Cumulative Index to Nursing and Allied Health Literature, Embase, Medline and PubMed from 1 December 2019 to 12 May 2020 to harvest articles from medical journals and publications reporting cases of COVID-19 in neonates from anywhere in the world. Additional searches were also done so as not to miss any important publications. Write-up was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the protocol for the review was registered with International Prospective Register of Systematic Reviews (PROSPERO), and risk of bias was analysed with the Newcastle-Ottawa tool. Additionally, the preterm neonate with COVID-19 from our hospital is also reported.ResultsThe systematic review has revealed eight studies where neonates have been described to have confirmed COVID-19, with low risk of bias. Of the 10 reported cases elsewhere, only three are likely to be vertically transmitted, while seven occurred in the postperinatal period and are likely to have been postnatally acquired. All neonates had a mild course, recovered fully and were negative on retesting. Our case of COVID-19 in a 32-week premature baby from the UK was delivered by emergency caesarean section, with the mother wearing a face mask and the family having no contact with the neonate, suggesting vertical transmission. On day 33, the neonate was asymptomatic but was still RT-PCR-positive on nasopharyngeal airway swab.ConclusionsNeonatal infection is uncommon, with only two previously reported cases likely to be of vertical transmission. The case we report is still RT-PCR-positive on day 28 and is asymptomatic. Ongoing research is needed to ascertain the epidemiology of COVID-19 in neonates.

2018 ◽  
Vol 39 (12) ◽  
pp. 1449-1456 ◽  
Author(s):  
Lesley Price ◽  
Jennifer MacDonald ◽  
Lucyna Gozdzielewska ◽  
Tracey Howe ◽  
Paul Flowers ◽  
...  

AbstractObjectiveTo synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).MethodsPRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.ResultsOverall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.ConclusionsThis is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.


2015 ◽  
Vol 10 (2) ◽  
pp. 150
Author(s):  
Joanne L. Jordan

A Review of: Westphal, A., Kriston, L., Hölzel, L.P., Härter, M., & von Wolff, A. (2014). Efficiency and contribution of strategies for finding randomized controlled trials: a case study from a systematic review on therapeutic interventions of chronic depression. Journal of Public Health Research, 3(2), 177. doi: 10.4081/jphr.2014.177 Abstract Objective – To evaluate the efficiency and contribution of additional searching strategies for finding randomized controlled trials (RCTs) in a systematic review. Design – A methodological case study. Setting – Biomedical literature. Methods – A sensitive search (defined as “the ratio of the number of relevant reports identified to the total number of relevant reports in existence”) was conducted of electronic databases, Cochrane CENTRAL database, MEDLINE, EMBASE, PsycInfo, CINAHL, BIOSIS, and Web of Science databases (Science and Social Science Citation Indexes). The following additional searching strategies were conducted: hand-searching contents of relevant journals (Archives of General Psychiatry, Journal of Consulting and Clinical Psychology, and Journal of Affective Disorders), citation tracking (forwards tracking using Social Science and Science Citation Index and backwards tracking by looking through reference lists of included studies), screening reference lists of relevant systematic reviews, searching clinical trials registers (ClinicalTrials.gov and ICTRP registers), and contacting first authors of included studies to find any similar unpublished studies. The number of articles identified by each of these methods was recorded and screened for inclusion in the systematic review. The authors calculated what they labelled as the ‘efficiency’ of each searching strategy (the number of included studies identified by the search method as a proportion of the full text articles screened) and the ‘contribution’ of the search strategies (the ratio of included studies identified by that method to the final number of included studies in the systematic review). The methodological quality of each included study was assessed using the Cochrane Risk of Bias Tool, which is a critical appraisal checklist used to judge the study’s value in the systematic review. The meta-analysis in the systematic review was conducted with and without the studies identified by the additional searching strategies to assess their impact on the review’s findings. Main Results – In total 50 studies were identified, 42 from electronic database searches and 8 from additional search strategies. As illustrated by the results in Table 1, the most useful additional search strategy was screening reference lists of relevant systematic reviews. Journal hand-searching and contacting authors also contributed to the review. Of the eight studies identified by the additional search strategies none were judged to have a low risk of bias (four had high risk of bias and four were unclear). Of the 42 included studies from electronic searches only 11 were judged to have a low risk of bias, whereas 9 studies had a high risk of bias and 22 were unclear. Excluding the eight studies retrieved from additional search strategies in the systematic review meta-analysis did not influence the results on the effectiveness of the different interventions for chronic depression. These studies were found to be indexed correctly on the electronic databases, but were not identified in the initial search. Conclusion – Additional search strategies, especially screening reference lists of systematic reviews and hand-searching relevant journals, retrieved a substantial number of relevant studies for a systematic review of interventions for treating chronic depression. However, results of the review’s meta-analysis did not differ when these additional studies (rated as either high or unclear risk of bias) were not included and search methods were time consuming. It might be reasonable to rely on electronic searching strategies when resources for conducting a systematic review are limited or when doing a “rapid review.” The benefits and limitations of additional search strategies should be considered particularly when resources or time for conducting a systematic review are limited. If the electronic database search is sensitive and includes the Cochrane CENTRAL database additional search strategies may not be necessary, but these findings should be tested in other research areas.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050453
Author(s):  
Alessia D'Elia ◽  
Olivia Orsini ◽  
Stephanie Sanger ◽  
Alannah Hillmer ◽  
Nitika Sanger ◽  
...  

IntroductionTreatment of bipolar disorder is the focus of several clinical trials, however the understanding of the outcomes for establishing treatment effectiveness within these trials is limited. Further, there is limited literature which reports on the outcomes considered to be important to patients, indicating that patient perspectives are often not considered when selecting outcomes of effectiveness within trials. This protocol describes a systematic review which aims to describe the outcomes being used within trials to measure treatment effectiveness, commenting on the inclusion of patient-important outcomes within previous trials.Methods and analysisThis protocol is reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols statement. OVID MEDLINE, OVID Embase, OVID APA PsycINFO, Web of Science, the Wiley Cochrane Library, ClinicalTrials.gov and the International Clinical Trials Registry Platform databases will be searched for eligible studies. Screening, full-text and data extraction stages will be completed in duplicate using the Covidence platform for systematic reviews. Eligible studies will include clinical trials of interventions in bipolar disorder, in order to identify outcomes used to assess treatment effectiveness, and qualitative studies, to determine which outcomes have been reported as important by patients. Risk of bias for included studies will be assessed using the Cochrane Risk of Bias Tool for randomised controlled trials, and the Newcastle-Ottawa Scale for observational research.Ethics and disseminationThis review will involve dissemination to key stakeholders, including primary end users such as patients, clinicians and trialists. Knowledge translation tools will be generated to share the relevant conclusions of this review. Results will be communicated to the scientific community through peer-reviewed publications, conferences and workshops. No ethics approval will be sought as this study is based on literature.PROSPERO registration numberCRD42021214435.


Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1877
Author(s):  
Salihu S. Musa ◽  
Umar M. Bello ◽  
Shi Zhao ◽  
Zainab U. Abdullahi ◽  
Muhammad A. Lawan ◽  
...  

The COVID-19 pandemic has hugely impacted global public health and economy. The COVID-19 has also shown potential impacts on maternal perinatal and neonatal outcomes. This systematic review aimed to summarize the evidence from existing systematic reviews about the effects of SARS-CoV-2 infections on maternal perinatal and neonatal outcomes. We searched PubMed, MEDLINE, Embase, and Web of Science in accordance with PRISMA guidelines, from 1 December 2019 to 7 July 2021, for published review studies that included case reports, primary studies, clinical practice guidelines, overviews, case-control studies, and observational studies. Systematic reviews that reported the plausibility of mother-to-child transmission of COVID-19 (also known as vertical transmission), maternal perinatal and neonatal outcomes, and review studies that addressed the effect of SARS-CoV-2 infection during pregnancy were also included. We identified 947 citations, of which 69 studies were included for further analysis. Most (>70%) of the mother-to-child infection was likely due to environmental exposure, although a significant proportion (about 20%) was attributable to potential vertical transmission of SARS-CoV-2. Further results of the review indicated that the mode of delivery of pregnant women infected with SARS-CoV-2 could not increase or decrease the risk of infection for the newborns (outcomes), thereby emphasizing the significance of breastfeeding. The issue of maternal perinatal and neonatal outcomes with SARS-CoV-2 infection continues to worsen during the ongoing COVID-19 pandemic, increasing maternal and neonatal mortality, stillbirth, ruptured ectopic pregnancies, and maternal depression. Based on this study, we observed increasing rates of cesarean delivery from mothers with SARS-CoV-2 infection. We also found that SARS-CoV-2 could be potentially transmitted vertically during the gestation period. However, more data are needed to further investigate and follow-up, especially with reports of newborns infected with SARS-CoV-2, in order to examine a possible long-term adverse effect.


2020 ◽  
Author(s):  
Melanie Karrer ◽  
Angela Schnelli ◽  
Adelheid Zeller ◽  
Hanna Mayer

Abstract Background People with dementia are confronted with negative consequences due to hospital stays. When developing new interventions to improve the care of people with dementia in acute care hospitals, it is crucial to have a comprehensive overview of the previous interventions tested in this field and to know the investigated outcomes and effects. Methods We conducted a systematic review of interventional studies to provide an overview of interventions targeting the care situation of patients with dementia in acute care hospitals. We included trials with interventional study designs and systematic reviews of interventional studies with no restrictions regarding the outcomes. We searched five electronic databases, conducted a hand search of journals and performed forward and backward citation tracking of the included studies. For risk of bias assessment, we used the Cochrane Collaboration’s tool for assessing risk of bias in randomised trials, ROBANS (for non-randomised controlled trials) and AMSTAR (for systematic reviews). We provide tabular and narrative summaries of the findings. Results Nineteen studies met the inclusion criteria. he findings indicated a broad range of interventions and outcomes. We categorised the interventions into nine intervention types: educational programmes, family-/person-centred programmes, use of specially trained nurses, volunteer programmes, delirium management programmes, special care units and inpatient rehabilitation interventions. Staff outcomes were primarily investigated, followed by patient outcomes. Outcomes for relatives were only reported in three of the included studies. Educational programmes were the most commonly reported intervention type and showed improvements in staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were able to improve patient-related outcomes, e.g. delirium severity, functional performance and rehospitalisation rates. Rehabilitation interventions after hip fractures and special care units for people with dementia showed hardly significant effects. Conclusions Although the included interventional studies were able to show improved outcomes for staff, relatives and patients, the evidence is insufficient to declare which interventions are effective in improving care for people with dementia in acute care hospitals. Future research should focus on patient and family caregiver outcomes. Furthermore, interventions addressing relatives, interprofessional collaboration and the entire practice culture are needed.


2020 ◽  
Author(s):  
Melanie Karrer ◽  
Angela Schnelli ◽  
Adelheid Zeller ◽  
Hanna Mayer

Abstract Background: People with dementia are confronted with negative consequences due to hospital stays. When developing new interventions to improve care for people with dementia in acute care hospitals (by intervention we understand organisational strategies, programmes, and/or treatments and actions performed by healthcare professionals), it is crucial to have a comprehensive overview of previous interventions tested in this field and to know the outcomes.Methods: We conducted a systematic review to provide an overview of interventions targeting the care situation of patients with dementia in acute care hospitals. We included trials with interventional study designs and systematic reviews without restrictions regarding the outcomes. We searched five electronic databases, conducted a hand search of journals and performed forward and backward citation tracking of included studies. For risk of bias assessment, we used the Cochrane Collaboration’s tool for assessing risk of bias in randomised trials, ROBANS (for non-randomised controlled trials) and AMSTAR (for systematic reviews). We provide tabular and narrative summaries of the findings. Results: Twenty studies met the inclusion criteria. The findings indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types: educational programmes, special non-pharmacological interventions, delirium management programmes, inpatient rehabilitation interventions, family-/person-centred programmes, use of specially trained nurses, volunteer programmes and special care units. Staff outcomes were investigated in most of the studies, followed by patient outcomes. Outcomes concerning relatives were reported in four studies. Educational programmes were the most commonly reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving patient-related outcomes, e.g. delirium severity and functional performance. Rehabilitation interventions after hip fractures and special care units for people with dementia hardly showed any significant effects. Conclusions: Although the included interventional studies reported improved outcomes concerning patients, relatives and staff, the evidence is insufficient to declare which interventions are effective in improving care for people with dementia in acute care hospitals. Future research should focus on relevant patient and family caregiver outcomes. Thereby, it is necessary to consider the complexity of the interventions. Interventions addressing relatives, interprofessional collaboration and the entire practice culture are needed. Trial registration: PROSPERO: CRD42018111032.


BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sue Mallett ◽  
A. Joy Allen ◽  
Sara Graziadio ◽  
Stuart A. Taylor ◽  
Naomi S. Sakai ◽  
...  

Abstract Background Tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral ribonucleic acid (RNA) using reverse transcription polymerase chain reaction (RT-PCR) are pivotal to detecting current coronavirus disease (COVID-19) and duration of detectable virus indicating potential for infectivity. Methods We conducted an individual participant data (IPD) systematic review of longitudinal studies of RT-PCR test results in symptomatic SARS-CoV-2. We searched PubMed, LitCOVID, medRxiv, and COVID-19 Living Evidence databases. We assessed risk of bias using a QUADAS-2 adaptation. Outcomes were the percentage of positive test results by time and the duration of detectable virus, by anatomical sampling sites. Results Of 5078 studies screened, we included 32 studies with 1023 SARS-CoV-2 infected participants and 1619 test results, from − 6 to 66 days post-symptom onset and hospitalisation. The highest percentage virus detection was from nasopharyngeal sampling between 0 and 4 days post-symptom onset at 89% (95% confidence interval (CI) 83 to 93) dropping to 54% (95% CI 47 to 61) after 10 to 14 days. On average, duration of detectable virus was longer with lower respiratory tract (LRT) sampling than upper respiratory tract (URT). Duration of faecal and respiratory tract virus detection varied greatly within individual participants. In some participants, virus was still detectable at 46 days post-symptom onset. Conclusions RT-PCR misses detection of people with SARS-CoV-2 infection; early sampling minimises false negative diagnoses. Beyond 10 days post-symptom onset, lower RT or faecal testing may be preferred sampling sites. The included studies are open to substantial risk of bias, so the positivity rates are probably overestimated.


2020 ◽  
Author(s):  
Ting Wan Tan ◽  
Han Ling Tan ◽  
Chih Ming Chang

BACKGROUND Urinary tract infection (UTI) is one of common illness in newborn and infants. An accurate urine sample to diagnosis of UTI is crucial to ensure appropriate treatment to avoid delayed and false-treatment. However, data to assess the effectiveness and safety of non-invasive stimulation technique of collecting urine in newborn and infants are yet to be critically evaluated. OBJECTIVE This protocol aimed to conduct a systematic review and meta-analysis to evaluate the evidences related to the effectiveness and safety of non-invasive stimulation technique of collecting urine in newborn and infants. METHODS This protocol follows guideline according to Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocol and registered on the International Prospective Register of Systematic Reviews. Seven databases will be searched from their inception to March 2020: PubMed, EBSCO, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and cumulative index to nursing and allied health literature database. RESULTS This Systemic review will include randomized controlled clinical trials (RCTs) including quasi-randomized controlled trials (quasi-RCTs), observational studies (prospective cohort or retrospective cohort studies). We will perform data extraction, study selection, assessment with risk of bias and data analysis. Primary outcomes measure success in obtaining a urine sample. Secondary outcome measures included gender, age group, weight analysis, contamination rate and adverse effects. Study methodological appraisal of the studies will be assessed by the Cochrane Risk of Bias Tools. For sufficient data are available, a meta-analysis will be conducted. I2 statistics will be used to assess heterogeneity and identify potential sources. CONCLUSIONS This systematic review wills no requirement for ethical approval, without human beings involvement. This systematic review will be published electronically in a peer-reviewed journal, and will give healthcare practitioners good practical guide and information for the evidences related to the effectiveness of non-invasive stimulation techniques to collect urine in newborn and infants, aims to improve clinical outcomes.


2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.


2018 ◽  
Vol 120 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Olavo B. de Oliveira-Neto ◽  
Fabiano Timbo Barbosa ◽  
Celio Fernando de Sousa-Rodrigues ◽  
Fernando Jose Camello de Lima

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