Abstract P135: Covid-19 And Hypertension: Pooled Analysis Of Observational Studies

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Vikramaditya Reddy Samala Venkata ◽  
Rahul Gupta ◽  
Surya Kiran Aedma
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Outcomes ◽  
Random Effects ◽  
Observational Studies ◽  
Retrospective Studies ◽  
Pooled Analysis ◽  
Random Effects Model ◽  
Electronic Search

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 infection. Although clinical data is limited, studies published so far raise concerns about an association between hypertension and worse clinical outcomes in COVID-19. Our aim was to assess the association between hypertension and mortality in COVID-19 patients. Methods: A systematic electronic search was performed in PubMed, Embase, and Google Scholar. Retrospective studies with original COVID-19 hospitalized patient data and reporting prevalence of hypertension was included in our study. Pooled analysis using a random-effects model was performed to look at the association between hypertension and mortality. Results: 22 studies from 8 countries with over 11,000 patients were included in our analysis. Hypertension was the most prevalent comorbidity in hospitalized COVID-19 patients (42%), followed by diabetes mellitus (23%)(Figure 1). Hypertension by itself was associated with higher rates of mortality (Figure 2). Other less prevalent comorbidities include non-hypertensive cardiovascular disease (11%), CKD (6%), CVA (5%), COPD (4.3%). Conclusion: Hypertension is the most prevalent comorbidity in hospitalized COVID-19 patients, followed by diabetes mellitus and was found to be significantly associated with higher rates of mortality. Surprisingly, hypertension is significantly more common than COPD in this population. The reason for this is unclear, there is no evidence currently that hypertension is directly related to mortality in this population. More randomized studies are needed to assess the effect of hypertension on mortality in COVID-19 patients.

scholarly journals Are sniffer dogs a reliable approach for diagnosing SARS-CoV-2 infection?

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Brandon M. Henry
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Pooled Analysis ◽  
Diagnostic Efficiency ◽  
Diagnostic Specificity ◽  
Summary Receiver Operating Characteristic ◽  
Electronic Search ◽  
Individual Variations ◽  
Infected Material

Abstract Objectives Despite inter-individual variations in their diagnostic efficiency, dogs have been trained to investigate many human pathologies, especially cancer, diabetes, migraine, seizures and even infectious diseases. To this end, we performed a critical review and pooled analysis of current scientific literature on the performance of dogs trained for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive human specimens. Methods We carried out an electronic search in PubMed, Scopus and Web of Science with the keywords “dog(s)” AND “sniffer” OR “scent” OR “smell” AND “SARS-CoV-2” OR “severe acute respiratory syndrome coronavirus 2” OR “coronavirus disease 2019” OR “COVID-19” within all fields, without date or language restrictions, to identify studies describing dogs’ performance for identifying SARS-CoV-2 infected material. Results Three studies could be finally included in pooled analysis, totaling 17 dogs (47% females), aged between 0.5 and 12 years. The pooled diagnostic sensitivity was 0.88 (95% CI, 0.84–0.91; I 2, 85.3%), the diagnostic specificity 0.99 (95% CI, 0.99–0.99; I 2, 97.4%), whilst the area under the summary receiver operating characteristic curve (SROC) was 0.979 (standard error, 0.003). Conclusions The notable performance observed in this pooled analysis would persuade us to suggest that adequately trained dogs could represent an intriguing and sustainable resource for purposes of rapid SARS-CoV-2 mass screening.

The association of BMI and sarcopenia with survival in patients with glioblastoma multiforme

2021 ◽  
Author(s):  
Deniz Can Guven ◽  
Melek Seren Aksun ◽  
Ibrahim Yahya Cakir ◽  
Saadettin Kilickap ◽  
Neyran Kertmen
Keyword(s):  
Overall Survival ◽  
Body Composition ◽  
Glioblastoma Multiforme ◽  
Random Effects ◽  
Muscle Thickness ◽  
Pooled Analysis ◽  
Random Effects Model ◽  
Temporal Muscle ◽  
Inverse Variance ◽  
Meta Analyses

Background: The association between obesity and sarcopenia (via temporal muscle thickness) with overall survival (OS) has been evaluated in several glioblastoma multiforme studies, however, the data are inconclusive. Methods: The authors conducted meta-analyses via the generic inverse-variance method with a random-effects model. Results: In the pooled analysis of five studies, including 973 patients, patients with lower temporal muscle thickness had significantly decreased OS (HR: 1.62, 95% CI: 1.16–2.28, p = 0.005). The pooled analysis of five studies, including 2131 patients, demonstrated decreased OS in patients with lower BMI compared with patients with obesity (HR: 1.45, 95% CI: 1.12–1.88, p = 0.005). Conclusion: Readily available body composition parameters could be used for prognosis prediction and to aid in treatment decisions in patients with glioblastoma multiforme.

scholarly journals A systematic analysis on prevalence and sub-regional distribution of undiagnosed diabetes mellitus among adults in African countries

2020 ◽  
Author(s):  
Getenet Dessie ◽  
Henok Mulugeta ◽  
Desalegne Amare ◽  
Ayenew Negesse ◽  
Fasil Wagnew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Random Effects ◽  
Meta Analysis ◽  
Eastern Africa ◽  
Undiagnosed Diabetes ◽  
Random Effects Model ◽  
Western Africa ◽  
Pooled Prevalence ◽  
High Prevalence ◽  
Undiagnosed Diabetes Mellitus

Abstract Background Despite the high prevalence of diabetes in Africa, the extent of undiagnosed diabetes in the region is still poorly understood. This systematic review and meta-analysis was designed to determine the pooled prevalence of undiagnosed diabetes mellitus among adults in Africa. Methods We conducted a systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), identifying peer-reviewed research studies on the prevalence of undiagnosed diabetes among adult individuals using pre-defined quality and inclusion criteria. We ran our search from June 1, 2018 to Jun 14, 2020. We extracted relevant data and presented descriptive summaries of the studies in tabular form. The I2 test was used to assess heterogeneity across studies. A random effects model was used to estimate the pooled prevalence of undiagnosed diabetes mellitus at a 95% confidence interval (CI). Funnel plot asymmetry and Egger’s tests were used to check for publication bias. The final effect size was determined by applying a trim and fill analysis in a random-effects model. Results Our search identified 1442 studies amongst which 23 articles were eligible for inclusion in the final meta-analysis. The average pooled prevalence of undiagnosed diabetes mellitus among adults was 3.85 (95% CI: 3.10–4.60). The pooled prevalence of undiagnosed diabetes mellitus based on geographic location was 4.43 (95% CI: 3.12–5.74) in Eastern Africa; 4.72 (95% CI: 2.64–6.80) in Western Africa; 4.27 (95% CI: 1.77–6.76) in Northern Africa and 1.46 (95%CI: 0.57–2.34) in southern Africa respectively. Conclusion Our findings indicate a high prevalence of undiagnosed diabetes in Africa and suggest that it may be more prevalent in Western Africa than the rest of the regions. Given the high levels of undiagnosed diabetes in the Africa region, more attention should be paid to incorporating diabetes screening and treatment services into existing diabetes related programs to reduce the prevalence of undiagnosed cases.

scholarly journals Radiotherapy protocol deviations and clinical outcomes: A meta-analysis of cooperative group clinical trials.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 181-181 ◽  
Author(s):  
Nitin Ohri ◽  
Xinglei Shen ◽  
Adam Dicker ◽  
Laura Doyle ◽  
Amy Harrison ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Quality Assurance ◽  
Clinical Outcomes ◽  
Random Effects ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Cooperative Group ◽  
Secondary Endpoints ◽  
The Impact

181 Background: Several reports have linked noncompliance with radiotherapy (RT) protocol guidelines with inferior clinical outcomes. Here we perform a meta-analysis of prospective cooperative group trials to determine the impact of RT quality assurance (QA) deviations on disease control and overall survival (OS). Methods: We searched MEDLINE and the Cochrane Central Register of Controlled Trials for multi-institutional trials that reported clinical outcomes in relation to RT quality assurance (QA) results. Hazard ratios (HRs) describing the impact of RT protocol noncompliance on outcomes were extracted directly from the original studies or calculated from survival curves. Analyses were performed to assess the impact of RT QA deviations on OS and secondary outcomes (local/locoregional control, event-free survival, relapse), which were grouped together. Pooled estimates were obtained using the inverse variance method. A random effects model was used in cases of significant effect heterogeneity (p<0.10 using Q test). Results: Eight studies met all inclusion criteria and were incorporated into this analysis. Four were pediatric trials (POG 8346, SFOP.TC 94, POG 9031, SIOP/UKCC PNET-3), and four studied adult patients (RTOG 73-01, SWOG 7628, TROG 02.02, RTOG 97-04). Six of these trials reported the impact of RT QA deviations on overall survival, and six described the effects of RT QA deviations on secondary endpoints. The frequency of RT QA deviations ranged from 8% to 71% (median: 40%). Using a random effects model, RT deviations were associated with a significant decrease in OS (HR = 1.74, 95% CI: 1.28 to 2.35, p<0.001). A similar effect was seen for secondary endpoints (HR = 1.79, 95% CI: 1.15 to 2.78, p=0.009). No evidence of publication bias was detected using the Egger test (p=0.361 for OS, p=0.468 for secondary endpoints). Conclusions: In clinical trials, RT protocol deviations are associated with increased risk of treatment failure and overall mortality. The magnitude of these effects demonstrates that RT QA results should be considered in the interpretation of clinical trial results. More importantly, the delivery of high-quality RT is critical for the successful treatment of cancer patients.

scholarly journals Rationale and methodology for a European pooled analysis of postmarketing interventional and observational studies of insulin glargine 300 U/mL in diabetes: protocol of REALI project

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033659 ◽  
Author(s):  
Nick Freemantle ◽  
Riccardo C Bonadonna ◽  
Pierre Gourdy ◽  
Didac Mauricio ◽  
Dirk Mueller-Wieland ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Glargine ◽  
Plasma Glucose ◽  
Real World ◽  
Observational Studies ◽  
Pooled Analysis ◽  
Primary Data ◽  
Subgroup Discovery ◽  
Nocturnal Hypoglycaemia ◽  
Study Protocols

IntroductionType 2 diabetes mellitus (T2DM) is a common and heterogeneous disease. Using advanced analytic approaches to explore real-world data may identify different disease characteristics, responses to treatment and progression patterns. Insulin glargine 300 units/mL (Gla-300) is a second-generation basal insulin analogue with preserved glucose-lowering efficacy but reduced risk of hypoglycaemia. The purpose of the REALI pooled analysis described in this paper is to advance the understanding of the effectiveness and real-world safety of Gla-300 based on a large European patient database of postmarketing interventional and observational studies.Methods and analysisIn the current round of pooling, REALI will include data from up to 10 000 subjects with diabetes mellitus (mostly T2DM) from 20 European countries. Outcomes of interest include change from baseline to week 24 in haemoglobin A1c, fasting plasma glucose, self-measured plasma glucose, body weight, insulin dose, incidence and rate of any-time-of-the-day and nocturnal hypoglycaemia. The data pool is being investigated using two complementary methodologies: a conventional descriptive, univariate and multivariable prognostic analysis; and a data-mining approach using subgroup discovery to identify phenotypic clusters of patients who are highly associated with the outcome of interest. By mid-2019, deidentified data of 7584 patients were included in the REALI database, with a further expected increase in patient number in 2020 as a result of pooling additional studies.Ethics and disseminationThe proposed study does not involve collection of primary data. Moreover, all individual study protocols were approved by independent local ethics committees, and all study participants provided written informed consent. Furthermore, patient data is deidentified before inclusion in the REALI database. Hence, there is no requirement for ethical approval. Results will be disseminated via peer-reviewed publications and presentations at international congresses as data are analysed.

scholarly journals Impact of type 2 diabetes mellitus on clinical outcomes in patients with COVID-19 and cardiovascular disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K G Lobanova ◽  
T Y U Demidova ◽  
V M Plakhotnyaya
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Antihypertensive Therapy ◽  
Ace Inhibitors ◽  
Beta Blockers

Abstract Introduction Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the severe course of COVID-19. Thus, all patients with COVID-19, T2DM and CVD should be constant medical control and receive adequate therapy for concomitant diseases. Purpose To study the effect of T2DM on the clinical outcomes of patients with COVID-19 and CVD. Methods Retrospective analysis of clinical outcomes of 1665 patients with a confirmed diagnosis of COVID-19, depending on the presence of CVD, T2DM and received therapy. Results The study included 866 men and 799 women; 299 patients (17.96%) had T2DM. The average age of the patients was 57.56±15.04 years. We noted a high prevalence of CVD: 747 patients (44.9%) had hypertension, 362 patients (21.7%) – coronary heart disease (CHD): 109 (6.5%) – myocardial infarction, 23 (1.4%) – exertional angina, 106 (6.4%) – atrial fibrillation, 98 (5.9%) – chronic heart failure. The patients with T2DM had hypertension in 80% of cases and CHD in 42%. Overall, 65.2% of patients had at least 1 concomitant CVD. Mortality of patients with COVID-19 without concomitant pathology was 0.5%, and in the patients with CHD – 20.7%, with hypertension – 12.9%. Mortality in the patients without T2DM was 7.4%, in the patients with T2DM – 14.0%. Hyperglycemia was associated with a higher mortality rate: the median of glycemia was 5.7 mmol/L in discharged patients and 7.2 mmol/L in deceased patients, regardless of the presence of T2DM (p&lt;0.001). The deceased patients had a higher level of HbA1c compared to those discharged (7.8% vs 8.1%). 24.6% of patients received antihypertensive therapy: 15.5% of patients received ACE inhibitors or ARBs, 11.9% – beta-blockers, 7.1% – thiazide and thiazide-like diuretics, 3.1% – calcium channel blockers. Statins were received by 2.4% of patients, antiplatelet drugs – 2.1%. The mortality rate of patients with COVID-19 and hypertension who received antihypertensive therapy was comparable to the mortality rate of the patients without hypertension: 8.8% and 9.0%, respectively. A significant decrease in mortality was observed during therapy with ACE inhibitors/ARBs (OR 0.39, 95% CI 0.21–0.72, p&lt;0.05), beta-blockers (OR 0.53, 95% CI 0.28–1, p&lt;0.05). This decrease was more significant among patients with T2DM compared with patients without T2DM: a 2.27-fold decrease in mortality due to ACE inhibitors/ARBs in the group without T2DM (OR 0.44, 95% CI 0.2–0.96, p&lt;0.05), in the T2DM group – 4.76 times (OR 0.21, 95% CI 0.07–0.6, p&lt;0.05); decrease in mortality against the background of beta-AB in the group without T2DM – by 1.72 times (OR 0.58, 95% CI 0.26–1.37), in the group with T2DM – by 3 times (OR 0.33, 95% CI 0.12–0.97, p&lt;0.05). Conclusion The presence of CVD and T2DM in the patients with COVID-19 worsens the prognosis of COVID-19. But the adequate therapy for concomitant diseases can have a positive effect on this group of patients. FUNDunding Acknowledgement Type of funding sources: None.

Sign in / Sign up

Export Citation Format

Share Document