Comparison of clinical manifestations, pre-existing comorbidities, complications and treatment modalities in severe and non-severe COVID-19 patients: A systemic review and meta-analysis

The global pandemic of novel coronavirus disease 2019 (COVID-19) has become an emergency of major international concern. We aim to assess the prevalence of clinical manifestations, pre-existing comorbidities, complications and treatment modalities in COVID-19 patients and compare incidence of these clinical data of severe patients with non-severe patients. An electronic search was performed in four databases to identify studies reporting clinical data of severe and non-severe COVID-19 patients. We calculated the odds ratio (OR) using fixed or random effect model. The analysis included 41 studies with 16,495 patients. The most prevalent clinical manifestations were fever 78.1%, cough 64.6%, fatigue 40.8%, and dyspnea 38.6%. Dyspnea (OR: 4.20, 95% CI: 3.09–5.72), cough (OR: 1.45, 95% CI: 1.18–1.78), and fatigue (OR: 1.40, 95% CI: 1.14–1.72) were found to be statistically significant higher in severe COVID-19 patients. We found that the most prevalent comorbidities were hypertension 32.2%, diabetes 17.1%, and cardiovascular disease 15.3%. Compared with non-severe group, proportion of hypertension (OR: 1.98, 95% CI: 1.62–2.42), diabetes (OR: 2.04, 95% CI: 1.67–2.50), cardiovascular disease (OR: 2.78, 95% CI: 2.00–3.86), and cancer (OR: 1.75, 95% CI: 1.40–2.18) were statistically significant higher in severe group. 24.7% patients presented with ARDS. The pooled effect of ARDS in severe and non-severe cases was 42.69 (OR: 42.69, 95% CI: 21.62–84.31). There was significant higher incidence of antiviral drugs, antibiotics, and glucocorticoids use in severe patients. Compared with non-severe patients, symptoms such as fever, cough, dyspnea, existing comorbidities, and complications are prevalent in severe COVID-19 patients.

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Association Between Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Concentrations and Cardiovascular Events in Cardiovascular Disease: A Systemic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.758956 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jiahui Liu ◽

Fangfang Fan ◽

Xingyu Luo ◽

Wenjun Ji ◽

Yaokun Liu ◽

...

Keyword(s):

Cardiovascular Disease ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Positive Association ◽

Systemic Review ◽

Proprotein Convertase ◽

Pcsk9 Inhibitors ◽

Clinical Role ◽

Increased Risk

Background: A large amount of evidence suggests that proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors have clinical benefits in patients with cardiovascular disease (CVD). However, whether PCSK9 concentrations predict future cardiovascular (CV) events remains unclear.Methods: We conducted a meta-analysis to investigate the ability of PCSK9 concentrations to predict future CV events in patients with established CVD. A comprehensive search of electronic databases was conducted in June 2021. We included relative risk (RR) estimates with 95% CI or events of interest.Results: Eleven cohort studies including 8,471 patients with CVD were enrolled. The pooled RR of CV events for the increase in the circulating baseline PCSK9 concentrations by 1 SD showed a positive association in a random-effect model (RR 1.226, 95% CI: 1.055–1.423, P = 0.008). Similarly, the risk of the total CV events increased by 52% in the patients in the highest tertile compared with those in the lowest tertile of circulating PCSK9 concentrations (RR 1.523, 95% CI: 1.098–2.112, P = 0.012). The association between PCSK9 and CV events was stronger in stable patients with CVD, patients treated with statins, and Asian patients.Conclusions: High PCSK9 concentrations are significantly related to the increased risk of future CV events. These results enrich the knowledge of PCSK9 function and suggest the further possible clinical role of PCSK9 inhibitors.

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Regional and chronological differences in prevalences of olfactory and gustatory dysfunction in coronavirus disease (COVID-19): a systemic review and meta-analysis

10.21203/rs.3.rs-58460/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jeong-Whun Kim ◽

Seung Cheol Han ◽

Hyung Dong Jo ◽

Sung-Woo Cho ◽

Jin Youp Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Olfactory Dysfunction ◽

Systemic Review ◽

Effect Model ◽

Geographical Regions ◽

Significant Difference ◽

Subgroup Analyses

Abstract Olfactory and gustatory dysfunction are frequently reported in patients with coronavirus disease (COVID-19). However, the reported prevalence of olfactory and/or gustatory dysfunction varies widely, and the reason for the inter-study differences is unclear. Hence, in this meta-analysis, we performed subgroup analyses to investigate the factors that contribute to the inter-study variability in the prevalence of olfactory and gustatory dysfunction. Out of 943 citations, we included 55 eligible studies with 13,527 patients with COVID-19 for a systematic review. The overall pooled prevalences of olfactory and gustatory dysfunction were 51.4% and 47.5%, respectively, in the random-effect model. In subgroup analyses, the prevalences of olfactory and gustatory dysfunction were significantly different among four geographical regions (both P < 0.001, respectively). Although the prevalences of olfactory and gustatory dysfunction did not significantly differ according to the time of enrollment, the subgroup analyses including only studies from the same geographical region (Europe) revealed a significant difference in olfactory dysfunction according to the time of enrollment. The regional and chronological differences in the prevalences of olfactory and gustatory dysfunctions partly explain the wide inter-study variability.

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Post-operative day 3 Procalcitonin predicts post-operative infectious complications in pancreatic surgery A systemic review and updated meta-analysis.

10.1101/2020.09.21.20198994 ◽

2020 ◽

Author(s):

BHAVIN VASAVADA ◽

hardik patel

Keyword(s):

Odds Ratio ◽

Pancreatic Surgery ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diagnostic Odds Ratio ◽

Infectious Complications ◽

Systemic Review ◽

Geometric Means ◽

Sensitivity Specificity

Aim of study: Aim of this meta-analysis is to evaluate post-operative procalcitonin as a marker to predict post- operative infectious complications after pancreatic surgeries. Material and Methods: Systemic literature search was performed using MEDLINE, EMBASE and to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) as a predictor for detecting infectious complications on postoperative days (POD) 3 and 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters for POD 3 and 5 were derived. Geometric means were calculated for PCT cut offs. Results: 6 studies included day 3 PCT analysis, 2 studies included both day 3 and day 5 analysis. Total data of 471 patients were derived. 161 patients developed infectious complications. Pooled sensitivity, specificity, pooled area under curve, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 3 PCT were 74%,79%,0.8453, 11.03,3.17 and 0.31 respectively. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 5 PCT were 83%,70%,12.91,2.91 and 0.25 respectively. Geometric means for PCT cut off for day 3 and 5 were 0.80 and 0.43. Conclusion: Postoperative procalcitonin particularly day 3 procalcitonin levels predict post-operative infectious complications following pancreatic surgeries.

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Association Between Ambient Air Pollution and Multiple Sclerosis: a Systemic Review and Meta-Analysis

10.21203/rs.3.rs-212139/v1 ◽

2021 ◽

Author(s):

Chao Tang ◽

Qing-Ru Li ◽

Yan-Mei Mao ◽

Yuan-Rui Xia ◽

Heng-Sheng Guo ◽

...

Keyword(s):

Multiple Sclerosis ◽

Air Pollution ◽

Air Pollutants ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Ambient Air ◽

Ambient Air Pollution ◽

Systemic Review ◽

Cochrane Library

Abstract The effects of air pollutants on autoimmune diseases are gaining increasing attention. At present, no studies have conducted systemic review and meta-analysis on ambient air pollution and multiple sclerosis (MS). In this paper, literature was collected in order to explore whether there was a connection between air pollutants and MS or not. Through electronic literature search, literature related to our research topic was collected in Cochrane Library, Embase and Pubmed till August 18, 2020 according to certain criteria. Pooled risk estimate and 95% confidence intervals (95%CI) were calculated by random-effect model analysis. After removing copies, browsing titles and abstracts and reading full text, 6 studies were finally included. The results showed that only particulate matter (PM) with aerodynamic diameter ≤10 (PM10) was related to MS (pooled HR=1.058, 95% CI=1.050-1.066), and no correlation was found between other pollutants and MS. There was no publication bias, and the heterogeneity analysis results were stable. PM is correlated with the disease MS, while other pollution is not connected with MS. More literature results need to be included to meta-analysis results for further study.

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Was Antiphospholipid Syndrome a Risk Factor of Stroke? A Systemic Review and Meta-Analysis of Cohort Studies

Disease Markers ◽

10.1155/2021/4431907 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Kai Zhao ◽

Ping Zhou ◽

Ling Xu ◽

Ruili Li ◽

Jincai Yang ◽

...

Keyword(s):

Risk Factor ◽

Autoimmune Diseases ◽

Cohort Studies ◽

Publication Bias ◽

Antiphospholipid Syndrome ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Systemic Review ◽

Effect Model

Antiphospholipid syndrome (APS) is characterized by thrombosis. This systemic review and meta-analysis was to verify the hypothesis that APS might increase the risk of stroke. Studies were identified after literature searching of PubMed, Embase, and Cochrane. Newcastle-Ottawa Quality Assessment Scale Cohort Studies (NOQAS-C) was used to assess the quality of studies. The pooled effect with 95% confidence interval (95% CI) was calculated by random-effect model. I -square ( I 2 ) was used to test heterogeneity. Funnel plot was used to evaluate publication bias. A total of 17 cohort studies with overall high quality were included. There was no publication bias. Pooled hazard ratio of stroke occurrence in APS patients was 1.76 (1.39-2.21) with low heterogenicity and stable result from sensitivity analysis. In the analysis of subgroups, pooled risk ratios of stroke occurrence in patients with only positive antibodies of APS diagnosis were 1.75 (0.99-3.09), which for the APS patients with other autoimmune diseases were 14.70 (7.56-28.56). APS might be a risk factor of stroke, especially in patients with other autoimmune diseases.

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Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina58010130 ◽

2022 ◽

Vol 58 (1) ◽

pp. 130

Author(s):

Galvin Sim Siang Lin ◽

Sze Hui Koh ◽

Karyn Zuhuan Ter ◽

Chia Wei Lim ◽

Sharmin Sultana ◽

...

Keyword(s):

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Systemic Review ◽

Level Of Evidence ◽

Cross Sectional ◽

Attitude And Practice ◽

Dental Practitioners ◽

Knowledge Attitude And Practice ◽

Poor Practice

Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners’ perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian–Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners’ knowledge and practice of teledentistry interventions.

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Post-Operative Infectious Complications in Pancreatic Surgery – A Systemic Review and Updated Meta-analysis

10.20944/preprints202009.0545.v1 ◽

2020 ◽

Author(s):

BHAVIN Vasavada ◽

hardik patel

Keyword(s):

Odds Ratio ◽

Pancreatic Surgery ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diagnostic Odds Ratio ◽

Infectious Complications ◽

Systemic Review ◽

Geometric Means ◽

Sensitivity Specificity

Aim of study:Aim of this meta-analysis is to evaluate post-operative procalcitonin as a marker to predict post- operative infectious complications after pancreatic surgeries.Material and Methods:Systemic literature search was performed using MEDLINE, EMBASE and to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) as a predictor for detecting infectious complications on postoperative days (POD) 3 and 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters for POD 3 and 5 were derived. Geometric means were calculated for PCT cut offs. Results:6 studies included day 3 PCT analysis, 2 studies included both day 3 and day 5 analysis. Total data of 471 patients were derived. 161 patients developed infectious complications. Pooled sensitivity, specificity, pooled area under curve, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 3 PCT were 74%,79%,0.8453, 11.03,3.17 and 0.31 respectively. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 5 PCT were 83%,70%,12.91,2.91 and 0.25 respectively. Geometric means for PCT cut off for day 3 and 5 were 0.80 and 0.43. Conclusion:Postoperative procalcitonin particularly day 3 procalcitonin levels predict post-operative infectious complications following pancreatic surgeries.

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Comparison of effectiveness of interventions in reducing mortality in patients of toxic epidermal necrolysis: A network meta-analysis

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_605_19 ◽

2021 ◽

Vol 0 ◽

pp. 1-17

Author(s):

Tejas K. Patel ◽

Parvati B. Patel ◽

Sejal Thakkar

Keyword(s):

Supportive Care ◽

Toxic Epidermal Necrolysis ◽

Intravenous Immunoglobulin ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Indirect Evidence ◽

Treatment Modalities ◽

Mortality Data ◽

Randomized Controlled Studies

Background: Limited evidence is available about effectiveness and choice of immunomodulating treatment modalities for toxic epidermal necrolysis (TEN). Aims: To compare the effectiveness of interventions to reduce mortality in patients of toxic epidermal necrolysis through network meta-analysis. Methods: Studies were retrieved using PubMed, Google Scholar and Cochrane Database of Systematic Reviews from inception to September 18, 2018. Only English language articles were considered. Observational and randomized controlled studies having ≥ 5 TEN patients in each intervention arm were included. Two investigators independently extracted study characteristics, intervention details and mortality data. Bayesian network meta-analysis was performed using the Markov chain Monte Carlo (MCMC) approach through the random effect model. The ranking analysis was done to provide a hierarchy of interventions. The consistency between direct and indirect evidence was assessed through node spit analysis. The primary outcome was to compare the mortality [Odds ratio OR (95% credibility interval CrI)] among all treatment modalities of TEN. Results: Twenty-four studies satisfying the selection criteria were included. The network analysis showed improved survival with cyclosporine as compared to supportive care [OR- 0.19 (95% CrI: 0.05, 0.59)] and intravenous immunoglobulin [OR- 0.21 (95% CrI: 0.05, 0.76)]. The hierarchy of treatments based on “surface under the cumulative ranking curves” (SUCRA) value were cyclosporine (0.93), steroid+intravenous immunoglobulin (0.76), etanercept (0.59), steroids (0.46), intravenous immunoglobulin (0.40), supportive care (0.34) and thalidomide (0.02). No inconsistencies between direct and indirect estimates were observed for any of the treatment pairs. Limitations: Evidence is mainly based on retrospective studies. Conclusion: The use of cyclosporine can reduce mortality in TEN patients. Other promising immunomodulators could be steroid+intravenous immunoglobulin combination and etanercept.

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Cardiac Arrhythmias and COVID-19 – a Meta-analysis of Recent Reports

10.21203/rs.3.rs-37700/v1 ◽

2020 ◽

Author(s):

Husam M. I. Salah ◽

Jawahar L. Mehta

Keyword(s):

Cardiac Arrhythmias ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Series ◽

Severe Illness ◽

Inclusion Criteria ◽

Effect Model ◽

Study Population ◽

Novel Coronavirus

Abstract Introduction: The 2019 novel coronavirus disease (COVID-19) is a current pandemic. Cardiovascular manifestations of COVID-19 have been described in many studies; however, no studies have examined the prevalence and characterizations of cardiac arrhythmias among patients with COVID-19 infection. The aim of this meta-analysis was to examine the prevalence of cardiac arrhythmias among patients with COVID-19 infection.Method: PubMed, Google Scholar, and ResearchGate databases were searched for relevant articles from inception until June 14, 2020. Inclusion criteria were: 1) Cohort studies or case series studies; 2) Study population included individuals with confirmed COVID-19 infection; 3) Arrhythmic events were reported in the study. All other studies were excluded. MedCalc software was used to analyze the pooled data. The random-effect model was utilized to obtain the prevalence of arrhythmia among the included patients and its 95% confidence interval. Cohran's Q and I2 index were used for heterogeneity measurements. The main planned outcome was the prevalence of arrhythmia among patients with COVID-19 infection.Results: Thirteen studies with a total of 2861 patients met our inclusion criteria. The prevalence of arrhythmia among patients with COVID-19 infection was 8.1% (95% CI [6.10, 10.37]). 82.8% of the patients who had arrhythmia has severe illness (95% CI [70.916, 92.124]).Conclusion: The prevalence of arrhythmias among patients with COVID-19 infection is 8.1%, which is much higher than in the general population (2.35%).

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E-Cigarettes and myocardial Infarction: a systemic review and meta-analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.071 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

A Sharma ◽

I Gupta ◽

V U ◽

R Golamari

Keyword(s):

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Systemic Review ◽

Major Adverse Cardiovascular Events ◽

Forest Plot ◽

P Value ◽

Funding Sources ◽

Effect Model ◽

Harmful Effects

Abstract Funding Acknowledgements Type of funding sources: None. Introduction With widespread awareness about the harmful effects of traditional smoking, many people are considering the use of an e-cigarette. However, there are many studies which have shown e-cigarettes is not entirely harmless and it’s use has been implication in causing major adverse cardiovascular events. Methodology This systemic review strictly adhered to the PRISMA checklist. An electronic search was conducted comprehensively through five databases to find the relevant articles. The odds ratio (OR) was used for comparing groups. Meta-analysis was conducted using R statistical software version 3.4.3. A random-effect model was used. Results A total of 4 studies were included in the analysis incorporating data on 585,306 subjects. In these, 19,435 were e-cigarettes users, while 1693 used only traditional cigarette users, and 553,095 were non-e-cigarette users. A total of 7.0% of e-cigarette users suffered an MI in their lifetime, while only 6.5% of non-e-cigarette users have had MI. The OR of getting an MI in e-cigarettes users was 1.30 (95% CI = 1.23-1.38, p-value < 0.01) in comparison to non e-cigarette users. While it is 0.61 (95% CI = 0.40 – 0.93, p-value 0.02) when compared with traditional smoking. Conclusion Those using e-cigarettes have a higher odds of suffering from an MI in comparison to not using e-cigarettes. However, using e-cigarettes reduces the risk of MI by half in comparison to traditional smoking. Abstract Figure. Forest plot

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