scholarly journals Cardio-Cerebrovascular Disease is Associated With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 109980042095198 ◽  
Author(s):  
Jia-Ning Yu ◽  
Bing-Bing Wu ◽  
Jie Yang ◽  
Xiao-Ling Lei ◽  
Wang-Qin Shen

At present, COVID-19 is raging all over the world. Many comorbidities, such as diabetes mellitus (OR = 2.67, 95% CI = 1.91–3.74) and hypertension (OR = 2.3, 95% CI = 1.76–3.00), have been shown to worsen the patient’s condition. However, whether cardio-cerebrovascular disease will affect COVID-19 remains unclear. In this meta-analysis, we collected studies from PubMed, Wed of Science and CNKI (Chinese) to July 25, which reported COVID-19 patients with and without cardio-cerebrovascular disease as well as their severity and mortality. The random-effect model meta-analysis was used to analyze them and get overall odds ratios (OR) with 95% CIs. Funnel plots and the Begg’s and Egger’s test were used to assess publication bias. Thirty-one studies with 23,632 patients were finally included in the meta-analysis. The results showed an OR of 3.004 (95% CI = 2.097–4.303) for COVID-19 severity and an OR of 5.587 (95% CI = 2.810–11.112) for COVID-19 mortality. Compared with cardiovascular disease, the subgroup analysis indicated that cerebrovascular disease was more likely to increase the severity (OR = 3.400, 95% CI = 1.569–7.368) and mortality (OR = 23.477, 95% CI = 3.050–180.735) of COVID-19. Therefore, it can be inferred that cardio-cerebrovascular disease is associated with an increase in the risk of severe illness and death among COVID-19 patients. This meta-analysis showed that cardio-cerebrovascular disease has a significant relation with severe and death outcomes of COVID-19. Nurses should pay special attention to COVID-19 patients with the cardio-cerebrovascular disease.

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Song Yue ◽  
Jingyang Wu ◽  
Jiahua Zhang ◽  
Lei Liu ◽  
Lei Chen

Background. In order to clarify previous ambiguous research conclusions, a meta-analysis was made to investigate the relationship between betatrophin levels in blood and type 2 diabetes mellitus (T2DM).Methods. We have searched all the English and Chinese references regarding the relationship between betatrophin and diabetes in database both manually and online. Strict criteria have been established to include and exclude articles, with Mean and Standard Deviation as statistics to evaluate strength of association. We have chosen either fixed- or random effect model according to heterogeneity inspection results and used Begg’s test and Egger’s test to analyze publication bias.Results. A total of 11 studies were included in this meta-analysis. Meta-analysis indicated a significant association between betatrophin and T2DM (Mean: 329.46; 95% confidence interval: 182.51 to 476.42,P<0.0001). However, in the subgroup analysis, there was no significant statistic between betatrophin concentration and T2DM within Caucasian population (Mean: 98.40; 95% confidence interval: −1585.08 to 1781.88,P=0.91).Conclusions. Such relationship may suggest preference for association between betatrophin and T2DM in different population.


Author(s):  
Utin Ilma Agni Kun’ain ◽  
◽  
Setyo Sri Rahardjo ◽  
Didik Gunawan Tamtomo ◽  
◽  
...  

Background: Previous studies reported that adults with certain comorbid conditions are at increased risk for severe illness of Covid-19. The purpose of this meta-analysis study was to assess the effect of diabetes mellitus comorbidity on the severity in patients with Covid-19 infection. Subjects and Method: Meta-analysis and systematic review was conducted by collecting articles from Pubmed, Google Scholar, and Springer Link online databases, from 2019 to 2020. Keywords used “COVID-19 and comorbidity”, “COVID-19 and severity and diabetes”, “comorbidity or severity or diabetes or adjusted odd ratio”. The inclusion criteria were full text, using English and Indonesian language, using observational study, primary study in hospital. The study population (P) was COVID-19 patients. Intervention (I) was diabetes mellitus with comparison (C) without diabetes mellitus. The study outcome (O) was risk of severity. The data were analyzed using random effect model in Revman 5.3. Results: There were 6 studies from South Korea, United States, and China. This study had high heterogeneity (I2= 65%, p= 0.01). DM comorbidity increased the risk of severity 2.74 times in patients with comorbidity than those without DM comorbidity (aOR=2.74; 95% CI= 1.37 to 5.48; p=0.004). Conclusion: Diabetes mellitus comorbidity increases the risk of severity in patients with COVID-19. Keywords: COVID-19, severity, diabetes mellitus, comorbidity Correspondence: Utin Ilma Agni Kun’ain. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected] Mobile: +628111044542. DOI: https://doi.org/10.26911/the7thicph.05.57


2020 ◽  
Author(s):  
Husam M. I. Salah ◽  
Jawahar L. Mehta

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%).


2021 ◽  
Vol 12 ◽  
Author(s):  
Xingyun Zhu ◽  
Lina Zhao ◽  
Jing Chen ◽  
Chu Lin ◽  
Fang Lv ◽  
...  

PurposeThe effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes.MethodsPubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly.ResultsIn total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P&lt;0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P&lt;0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P&lt;0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255).ConclusionPhysical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control.Systematic Review RegistrationPROSPERO [CRD42021259807].


2021 ◽  
Vol 50 (8) ◽  
pp. 2367-2377
Author(s):  
Lieng Teng Cheong ◽  
Ken Yong Foo ◽  
Mun Lum Ka ◽  
Yung Toh Shen ◽  
Xuan Hii Chan ◽  
...  

Gestational diabetes mellitus (GDM) is glucose intolerance first diagnosed during pregnancy. In Malaysia, the prevalence, risk factors, and maternal/foetal outcomes vary somewhat among the local studies. In this systematic review of Malaysian studies, we synthesise relevant data from 13 journal articles (including 10,285 women with gestational diabetes). A meta-analysis of twelve datasets showed a prevalence of 21.5% (95% CI 17.3 to 25.9%, random effect model). Clinical factors in the mother found to increase her risk of GDM were consistent with international data. A meta-analysis of complications showed statistically significant increase for macrosomia (OR 3.08, 95% CI 1.77 to 5.36) but not for pre-eclampsia (OR 1.44, 95% CI 0.52 to 4.00) and caesarean delivery (OR 1.31, 95% CI 0.98 to 1.75). The high prevalence of gestational diabetes mellitus and documented adverse consequences support the need for universal screening of this condition in all pregnant women in Malaysia.


2021 ◽  
pp. 105566562110464
Author(s):  
Manas R. Purohit ◽  
Lakkakula Saikrishna ◽  
Henu Verma ◽  
L.V.K.S. Bhaskar ◽  
Syed A. Hussain

Introduction Non-syndromic cleft lip and palate (NSCLP) is one of the most common and challenging congenital deformities worldwide. Previous research has linked the methylenetetrahydrofolate dehydrogenase1 (MTHFD1) gene to orofacial cleft (OFC) susceptibility via a complex metabolism. Studies analyzing the MTHFD1 1958G > A variant and NSCLP are contradictory. This study aims to evaluate the association between the MTHFD1 1958G > A variant and NSCLP by meta-analysis. Methods PubMed, Web of Science, MEDLINE, and Google Scholar databases were searched to retrieve the eligible studies. A fixed- or random-effect model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI). All analyses were calculated by Metagenyo software. To detect heterogeneity, the Cochrane Q and I2 statistics were used. The publication bias was estimated using funnel plots and Egger’s test. Results Our study suggested that the MTHFD1 1958G > A variant allele “A” does not appear to increase the risk of NSCLP (A vs G random effect model: Overall P  = .501, OR  =  1.07, CI  =  0.88–1.31; Asians P  = .245, OR  =  1.29, CI  =  0.84–1.97; Caucasians P  = .658, OR  =  0.95, CI  =  0.76–1.19). Similarly, mutant genotypes also did not exhibit increased risk for NSCLP in the overall populations as well in subgroup analysis by ethnicity (AA  +  AG vs GG: Overall P  = .684, OR  =  1.06, CI  =  0.80–1.39; Asians P  = .240, OR  =  1.47, CI  =  0.77–2.78; Caucasians P  = .923, OR  =  0.99, CI  =  0.85–1.16). Conclusions Our data suggest no association between the MTHFD1 1958G > A variant and NSCLP. Additional well-designed studies are needed to better understand the role of MTHFD1 polymorphisms in the etiopathogenesis of NSCLP.


Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 127
Author(s):  
David Núñez-Fuentes ◽  
Esteban Obrero-Gaitán ◽  
Noelia Zagalaz-Anula ◽  
Alfonso Javier Ibáñez-Vera ◽  
Alexander Achalandabaso-Ochoa ◽  
...  

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Atlaw ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Kenbon Seyoum ◽  
Damtew Solomon ◽  
...  

Abstract Background Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs. Conclusions The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.


Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001687
Author(s):  
Aliya Amirova ◽  
Theodora Fteropoulli ◽  
Paul Williams ◽  
Mark Haddad

ObjectivesThis meta-analysis aims to (1) evaluate the efficacy of physical activity interventions in heart failure and (2) to identify intervention characteristics significantly associated with the interventions’ efficacy.MethodsRandomised controlled trials reporting intervention effects on physical activity in heart failure were combined in a meta-analysis using a random-effect model. Exploratory meta-analysis was performed by specifying the general approach (eg, cardiac rehabilitation), strategies used (eg, action planning), setting (eg, centre based), mode of delivery (eg, face to face or online), facilitator (eg, nurse), contact time and behavioural change theory use as predictors in the random-effect model.ResultsInterventions (n=21) had a significant overall effect (SMD=0.54, 95% CI (0.13 to 0.95), p<0.0005). Combining an exercise programme with behavioural change intervention was found efficacious (SMD=1.26, 95% CI (0.26 to 2.26), p<0.05). Centre-based (SMD=0.98, 95% CI (0.35 to 1.62), and group-based (SMD=0.89, 95% CI (0.29 to 1.50),) delivery by a physiotherapist (SMD=0.84, 95% CI (0.03 to 1.65),) were significantly associated with efficacy. The following strategies were identified efficacious: prompts/cues (SMD=3.29, 95% CI (1.97 to 4.62)), credible source (standardised mean difference, SMD=2.08, 95% CI (0.95;3.22)), adding objects to the environment (SMD=1.47, 95% CI (0.41 to 2.53)), generalisation of the target behaviour SMD=1.32, 95% CI (0.22 to 2.41)), monitoring of behaviour by others without feedback (SMD=1.02, 95% CI (0.05 to 1.98)), self-monitoring of outcome(s) of behaviour (SMD=0.79, 95% CI (0.06 to 1.52), graded tasks (SMD=0.73, 95% CI (0.22 to 1.24)), behavioural practice/rehearsal (SMD=0.72, 95% CI (0.26 to 1.18)), action planning (SMD=0.62, 95% CI (0.03 to 1.21)) and goal setting (behaviour) (SMD=0.56, 95% CI (0.03 to 1.08)).ConclusionThe meta-analysis suggests intervention characteristics that may be suitable for promoting physical activity in heart failure. There is moderate evidence in support of an exercise programme combined with a behavioural change intervention delivered by a physiotherapist in a group-based and centre-based settings.PROSPERO registerationCRD42015015280.


2018 ◽  
Vol 94 (1111) ◽  
pp. 278-283 ◽  
Author(s):  
Xue-Feng Xie ◽  
Xiao-Hui Huang ◽  
Ai-Zong Shen ◽  
Jun Li ◽  
Ye-Huan Sun

AimLeptin, synthesised by adipocytes, has been identified as a hormone that can influence inflammatory activity. Several studies have investigated leptin levels in patients with multiple sclerosis (MS), but the results are not consistent. This study aims to derive a more precise evaluation on the relationship between circulating leptin levels and MS.DesignA comprehensive literature searched up to July 2017 was conducted to evaluate the association of circulating leptin levels and MS. The random-effect model was applied to calculate pooled standardised mean difference (SMD) and its 95% CI.Main outcome measuresCirculating leptin levels of patients with MS and healthy controls.ResultsOf 2155 studies identified, 33 met eligibility criteria and 9 studies with 645 patients with MS and 586 controls were finally included in the meta-analysis. Meta-analysis revealed that, compared with the healthy control group, the MS group had significantly higher plasma/serum leptin levels, with the SMD of 0.70% and 95% CI (0.24 to 1.15). Subgroup analyses suggested that the leptin levels of patients with MS were associated with region, age, study sample size, measurement type, gender and blood sample type.ConclusionOverall, our study suggests that patients with MS have a significantly higher leptin level than in healthy controls. Further mechanism studies and longitudinal large cohort studies are still needed to further reveal the role of leptin in the pathogenesis of MS.


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