scholarly journals Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression

2021 ◽  
Vol 14 ◽  
pp. 117955142199067
Author(s):  
Indriwanto Sakidjan Atmosudigdo ◽  
Michael Anthonius Lim ◽  
Basuni Radi ◽  
Joshua Henrina ◽  
Emir Yonas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Male Gender ◽  
Composite Outcome ◽  
Funnel Plot ◽  
Poor Outcome ◽  
Registration Number ◽  
Meta Regression

Objective: This systematic review and meta-analysis aimed to evaluate whether dyslipidemia affects the mortality and severity of COVID-19, we also aimed to evaluate whether other comorbidities influence the association. Methods: A systematic literature search using PubMed, Embase, and EuropePMC was performed on 8 October 2020. This study’s main outcome is a poor composite outcome, comprising of mortality and severe COVID-19. Results: There were 9 studies with 3663 patients. The prevalence of dyslipidemia in this pooled analysis was 18% (4%-32%). Dyslipidemia was associated with increased composite poor outcome (RR 1.39 [1.02, 1.88], P = .010; I2: 56.7%, P = .018). Subgroup analysis showed that dyslipidemia was associated with severe COVID-19 (RR 1.39 [1.03, 1.87], P = .008; I2: 57.4%, P = .029). Meta-regression showed that the association between dyslipidemia and poor outcome varies by age (coefficient: −0.04, P = .033), male gender (coefficient: −0.03, P = .042), and hypertension (coefficient: −0.02, P = .033), but not diabetes (coefficient: −0.24, P = .135) and cardiovascular diseases (coefficient: −0.01, P = .506). Inverted funnel-plot was relatively symmetrical. Egger’s test indicates that the pooled analysis was not statistically significant for small-study effects ( P = .206). Conclusion: Dyslipidemia potentially increases mortality and severity of COVID-19. The association was stronger in patients with older age, male, and hypertension. PROSPERO Registration Number: CRD42020213491

scholarly journals Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032092689 ◽  
Author(s):  
Raymond Pranata ◽  
Michael Anthonius Lim ◽  
Ian Huang ◽  
Sunu Budhi Raharjo ◽  
Antonia Anna Lukito
Keyword(s):  
Systematic Review ◽  
Disease Progression ◽  
Literature Search ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Systematic Literature Search ◽  
Severity Of Disease ◽  
Poor Outcome ◽  
Meta Regression ◽  
Meta Regression Analysis

Objective: To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Methods: We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest. Results: A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), p < 0.001; I2, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), p < 0.001; I2, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), p < 0.001; I2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I2,0%, p = 0.35), ICU care (RR 2.11 (1.34, 3.33), p = 0.001; I2 18%, p = 0.30), and disease progression (RR 3.01 (1.51, 5.99), p = 0.002; I2 0%, p = 0.55). Meta-regression analysis showed that gender ( p = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79). Conclusion: Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.

Insulin therapy and outcome from coronavirus disease 2019 (COVID-19): A Systematic Review, Meta-Analysis, and Meta-Regression

2021 ◽  
Vol 21 ◽  
Author(s):  
Timotius Ivan Hariyanto ◽  
Nata Pratama Hardjo Lugito ◽  
Theo Audi Yanto ◽  
Jeremia Immanuel Siregar ◽  
Andree Kurniawan
Keyword(s):  
Systematic Review ◽  
Insulin Therapy ◽  
Meta Analysis ◽  
Random Effect ◽  
Pooled Analysis ◽  
The Poor ◽  
Meta Regression ◽  
Insulin Use ◽  
The Relationship ◽  
Review Manager

Background: Currently, the relationship between insulin therapy and COVID-19 outcome is not yet established. Our study aims to evaluate the possible association between insulin and the poor composite development of COVID-19. Methods: We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until December 12th, 2020. All articles published on COVID-19 and insulin were retrieved. Statistical analysis was done using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. Results: Our pooled analysis showed that insulin use was associated with poor composite development of COVID-19 [OR 2.06 (95% CI 1.70 – 2.48), p < 0.00001, I2 = 83%, random-effect modelling], and its subgroup which comprised of risk of COVID-19 [OR 1.70 (95% CI 1.40 – 2.08), p < 0.00001, I2 = 34%, random-effect modelling], severe COVID-19 [OR 2.30 (95% CI 1.60 – 3.30), p < 0.00001, I2 = 88%, random-effect modelling], and mortality [OR 2.14 (95% CI 1.47 – 3.10), p < 0.0001, I2 = 85%, random-effect modelling]. Meta-regression showed that the association was influenced by age (p = 0.008), but not by diabetes (p = 0.423), and cardiovascular disease (p = 0.086). Conclusion: Physicians should be more aware and take extra precautions with diabetes patients who use insulin therapy.

scholarly journals The Association Between ABO Blood Group and Preeclampsia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ting Li ◽  
Yixiao Wang ◽  
Lan Wu ◽  
Zhonghui Ling ◽  
Chanjuan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Blood Group ◽  
Meta Analysis ◽  
Blood Groups ◽  
Abo Blood Group ◽  
Linear Regression Equation ◽  
Funnel Plot ◽  
Meta Regression ◽  
Meta Regression Analysis

Objective: This meta-analysis comprehensively evaluated the association between ABO blood group and the risk of preeclampsia (PE).Design: Systematic review and meta-analysis.Data sources: PubMed, Web of Science, and ScienceDirect databases from their inception to September 23, 2020.Methods: Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained through random-effects and fixed-effects models according to heterogeneity. Meta-regression analysis was applied to explore the source of heterogeneity. We conducted a subgroup analysis by the publication year, study design, state, and Newcastle-Ottawa Scale (NOS) score. In addition, we calculated the rate of each ABO blood group in PE by total pooled effects.Results: A total of 12 articles with 714,153 patients were included in our analysis. Compared with people without PE (control group), the O blood group presented a lower risk of PE (OR 0.95, 95% CI 0.93–0.97). The AB (OR 1.46, 95% CI 1.12–1.91) blood group presented a higher risk. However, the total pooled OR and 95% CI for the A (OR 1.02, 95% CI 0.90–1.16) and B (OR 1.02, 95% CI 0.98–1.05) blood groups were not significant. The funnel plot and linear regression equation showed that there was no publication bias for the O, A, or B blood groups (all P &gt; 0.05). However, the funnel plot and linear regression equation for the AB blood group were obviously asymmetric (P &lt; 0.05), and the publication bias persisted even after the trim-and-fill method was applied (P &lt; 0.05). Multivariable meta-regression analysis did not find a specific source of heterogeneity. The A blood group showed an association with early-onset PE (OR 0.53, 95% CI 0.33–0.83), and the other blood groups showed no significant differences. In PE, the rates of the O, A, B, and AB blood groups decreased gradually (0.39, 0.33, 0.19, 0.07).Conclusion: These findings suggest that pregnant women with AB blood group are more likely to develop PE, and more attention should be paid to AB blood group whose blood pressure is high but not sufficient to diagnose PE.Systematic Review Registration: Prospero CRD42021227930.

scholarly journals Vancomycin-Resistant Enterococci (VRE) in Nigeria: The First Systematic Review and Meta-Analysis

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 565
Author(s):  
Yusuf Wada ◽  
Azian Binti Harun ◽  
Chan Yean Yean ◽  
Abdul Rahman Zaidah
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Forest Plot ◽  
Funnel Plot ◽  
Vancomycin Resistant Enterococci ◽  
Pooled Prevalence ◽  
Vancomycin Resistant ◽  
Meta Regression ◽  
Leave One Out

Vancomycin-Resistant Enterococci (VRE) are on the rise worldwide. Here, we report the first prevalence of VRE in Nigeria using systematic review and meta-analysis. International databases MedLib, PubMed, International Scientific Indexing (ISI), Web of Science, Scopus, Google Scholar, and African journals online (AJOL) were searched. Information was extracted by two independent reviewers, and results were reviewed by the third. Two reviewers independently assessed the study quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. OpenMeta analyst was used. The random effect was used, and publication bias was assessed using a funnel plot. Between-study heterogeneity was assessed, and the sources were analysed using the leave-one-out meta-analysis, subgroup analysis, and meta-regression. Nineteen studies met the eligibility criteria and were added to the final meta-analysis, and the study period was from 2009–2018. Of the 2552 isolates tested, 349 were VRE, and E. faecalis was reported the most. The pooled prevalence of VRE in Nigeria was estimated at 25.3% (95% CI; 19.8–30.8%; I2 = 96.26%; p < 0.001). Between-study variability was high (t2 = 0.011; heterogeneity I2 = 96.26% with heterogeneity chi-square (Q) = 480.667, degrees of freedom (df) = 18, and p = 0.001). The funnel plot showed no publication bias, and the leave-one-out forest plot did not affect the pooled prevalence. The South-East region had a moderate heterogeneity though not significant (I2 = 51.15%, p = 0.129). Meta-regression showed that all the variables listed contributed to the heterogeneity except for the animal isolate source (p = 0.188) and studies that were done in 2013 (p = 0.219). Adherence to proper and accurate antimicrobial usage, comprehensive testing, and continuous surveillance of VRE are required.

scholarly journals Transcranial magnetic stimulation for posttraumatic stress disorder: an updated systematic review and meta-analysis

2016 ◽  
Vol 38 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Alisson Paulino Trevizol ◽  
Mirna Duarte Barros ◽  
Paula Oliveira Silva ◽  
Elizabeth Osuch ◽  
Quirino Cordeiro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Ptsd Symptoms ◽  
Funnel Plot ◽  
Meta Regression

Introduction Transcranial magnetic stimulation (TMS) is a promising non-pharmacological intervention for posttraumatic stress disorder (PTSD). However, randomized controlled trials (RCTs) and meta-analyses have reported mixed results. Objective To review articles that assess the efficacy of TMS in PTSD treatment. Methods A systematic review using MEDLINE and other databases to identify studies from the first RCT available up to September 2015. The primary outcome was based on PTSD scores (continuous variable). The main outcome was Hedges' g. We used a random-effects model using the statistical packages for meta-analysis available in Stata 13 for Mac OSX. Heterogeneity was evaluated with I2 (> 35% for heterogeneity) and the χ2 test (p < 0.10 for heterogeneity). Publication bias was evaluated using a funnel plot. Meta-regression was performed using the random-effects model. Results Five RCTs (n = 118) were included. Active TMS was significantly superior to sham TMS for PTSD symptoms (Hedges' g = 0.74; 95% confidence interval = 0.06-1.42). Heterogeneity was significant in our analysis (I2 = 71.4% and p = 0.01 for the χ2 test). The funnel plot shows that studies were evenly distributed, with just one study located marginally at the edge of the funnel and one study located out of the funnel. We found that exclusion of either study did not have a significant impact on the results. Meta-regression found no particular influence of any variable on the results. Conclusion Active TMS was superior to sham stimulation for amelioration of PTSD symptoms. Further RCTs with larger sample sizes are fundamental to clarify the precise impact of TMS in PTSD.

scholarly journals Cholesterol and Triglyceride Concentrations, COVID-19 Severity, and Mortality: A Systematic Review and Meta-Analysis With Meta-Regression

2021 ◽  
Vol 9 ◽  
Author(s):  
Angelo Zinellu ◽  
Panagiotis Paliogiannis ◽  
Alessandro G. Fois ◽  
Paolo Solidoro ◽  
Ciriaco Carru ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Severe Disease ◽  
Hdl Cholesterol ◽  
Hospitalized Patients ◽  
Study Endpoint ◽  
Survival Status ◽  
Registration Number ◽  
Meta Regression

Lipid profile alterations have been observed in patients with coronavirus disease 2019 (COVID-19) in relation to disease severity and mortality. We conducted a systematic review and meta-analysis with meta-regression of studies reporting total, HDL, and LDL-cholesterol, and triglyceride concentrations in hospitalized patients with COVID-19. We searched PubMed, Web of Science and Scopus, between January 2020 and January 2021, for studies describing lipid concentrations, COVID-19 severity, and survival status (PROSPERO registration number: CRD42021253401). Twenty-two studies in 10,122 COVID-19 patients were included in the meta-analysis. Pooled results showed that hospitalized patients with severe disease or non-survivor status had significantly lower total cholesterol (standardized mean difference, SMD = −0.29, 95% CI −0.41 to −0.16, p &lt; 0.001), LDL-cholesterol (SMD = −0.30, 95% CI −0.41 to −0.18, p &lt; 0.001), and HDL-cholesterol (SMD = −0.44, 95% CI −0.62 to −0.26, p &lt; 0.001), but not triglyceride (SMD = 0.04, 95% CI −0.10 to −0.19, p = 0.57), concentrations compared to patients with milder disease or survivor status during follow up. Between-study heterogeneity was large-to-extreme. In sensitivity analysis, the effect size of different lipid fractions was not affected when each study was in turn removed. The Begg's and Egger's t-tests did not show evidence of publication bias, except for studies investigating LDL-cholesterol. In meta-regression, significant associations were observed between the SMD of LDL-cholesterol and age and hypertension, and between the SMD of triglycerides and study endpoint and aspartate aminotransferase. In our systematic review and meta-analysis, lower total, HDL, and LDL-cholesterol, but not triglyceride, concentrations were significantly associated with COVID-19 severity and mortality. Cholesterol concentrations might be useful, in combination with other clinical and demographic variables, for risk stratification and monitoring in this group.Systematic Review Registration: PROSPERO registration number: CRD42021253401.

scholarly journals Statin and mortality in COVID-19: a systematic review and meta-analysis of pooled adjusted effect estimates from propensity-matched cohorts

2021 ◽  
pp. postgradmedj-2021-140409
Author(s):  
Ahmad Fariz Malvi Zamzam Zein ◽  
Catur Setiya Sulistiyana ◽  
Uswatun Khasanah ◽  
Arief Wibowo ◽  
Michael Anthonius Lim ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Male Gender ◽  
Effect Estimate ◽  
Inverse Probability ◽  
Risk Of Mortality ◽  
Registration Number ◽  
Multivariable Regression ◽  
Randomised Controlled

PurposeStatin potentially improved outcome in patients with COVID-19. Patients who receive statin generally have a higher proportion of comorbidities than those who did not, which may introduce bias. In this meta-analysis, we aimed to investigate the association between statin use and mortality in patients with COVID-19 by pooling the adjusted effect estimates from propensity-score matching (PSM) matched studies or randomised controlled trials to reduce bias.MethodsA systematic literature search using the PubMed, Scopus and Embase databases were performed up until 1 March 2021. Studies that were designed the study to assess statin and mortality using PSM with the addition of Inverse Probability Treatment Weighting or multivariable regression analysis on top of PSM-matched cohorts were included. The effect estimate was reported in term of relative risk (RR).Results14 446 patients were included in the eight PSM-matched studies. Statin was associated with decreased mortality in patients with COVID-19 (RR 0.72 (0.55, 0.95), p=0.018; I2: 84.3%, p<0.001). Subgroup analysis in patients receiving statin in-hospital showed that it was associated with lower mortality (RR 0.71 (0.54, 0.94), p=0.030; I2: 64.1%, p<0.025). The association of statin and mortality was not significantly affected by age (coefficient: −0.04, p=0.382), male gender (RR 0.96 (0.95, 1.02), p=0.456), diabetes (RR 1.02 (0.99, 1.04), p=0.271) and hypertension (RR 1.01 (0.97, 1.04), p=0.732) in this pooled analysis.ConclusionIn this meta-analysis of PSM-matched cohorts with adjusted analysis, statin was shown to decrease the risk of mortality in patients with COVID-19.PROSPERO registration numberCRD42021240137.

scholarly journals The Prognostic Value of Hyponatremia for Predicting Poor Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohammad Rizki Akbar ◽  
Raymond Pranata ◽  
Arief Wibowo ◽  
Irvan ◽  
Teddy Arnold Sihite ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
Pooled Analysis ◽  
Reference Level ◽  
Effect Estimate ◽  
Poor Outcome ◽  
Meta Regression Analysis ◽  
Posttest Probability

Background: This meta-analysis aimed to assess the prognostic value of hyponatremia in patients with COVID-19.Methods: We performed a systematic literature search on PubMed, Scopus, ScienceDirect, and Wiley up until January 26, 2021. The key exposure was hyponatremia, defined as sodium level below the reference level. The outcome of interest was poor outcome, which was a composite of mortality, severe COVID-19, and prolonged hospitalization. Severe COVID-19 was defined severe CAP or needing ICU care or IMV. The pooled effect estimate was odds ratio (OR). Sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic OR (DOR), and area under curve (AUC) were generated.Results: There were 11,493 patients from eight studies included in this systematic review and meta-analysis. The incidence of hyponatremia was 24%, and incidence of poor outcome was 20%. Hyponatremia was associated with poor outcome in COVID-19 (OR 2.65 [1.89, 3.72], p &lt; 0.001; I2: 67.2%). Meta-regression analysis showed that the association between hyponatremia and poor outcome was reduced by age (OR 0.94 [0.90, 0.98], p = 0.006) and hypertension (OR 0.96 [0.93, 0.94], p &lt; 0.001). Hyponatremia has a sensitivity of 0.37 [0.27, 0.48], specificity of 0.82 [0.72, 0.88], PLR of 2.0 [1.5, 2.7], NLR of 0.77 [0.69, 0.87], DOR of 3 [2, 4], and AUC of 0.62 [0.58, 0.66] for predicting poor outcome. In this pooled analysis, hyponatremia has a 33% posttest probability for poor outcome, and absence of hyponatremia confers to a 16% posttest probability.Conclusion: Hyponatremia was associated with poor outcome in patients with COVID-19.Systematic Review Registration: PROSPERO, CRD42021233592.

scholarly journals Association between retirement and mortality: working longer, living longer? A systematic review and meta-analysis

2020 ◽  
Vol 74 (5) ◽  
pp. 473-480
Author(s):  
Ranu Sewdas ◽  
Astrid de Wind ◽  
Sari Stenholm ◽  
Pieter Coenen ◽  
Ilse Louwerse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Early Retirement ◽  
Literature Search ◽  
Meta Analysis ◽  
Systematic Literature Search ◽  
Random Effects Models ◽  
Risk Of Mortality ◽  
Meta Regression ◽  
Meta Regression Analysis

AimThis study summarised available evidence on the association between early and on-time retirement, compared with continued working, and mortality. Moreover, this study investigated whether and to what extent gender, adjustment for demographics and prior health status influence this association.MethodsA systematic literature search of longitudinal studies was conducted. A qualitative analysis of the included studies was performed, followed by a meta-regression analysis to assess the influence of gender, prior health and demographics. Random-effects models were used in a meta-analysis to estimate the pooled effects for relevant subgroups identified in the meta-regression.ResultsIn total, 25 studies were included. Adjustment for prior health and demographics influenced the association between retirement and mortality (p<0.05). The results of the meta-analysis of 12 studies are presented for ‘insufficiently adjusted’ and ‘fully adjusted’ subgroups. There was no association between early retirement and mortality compared with working until retirement (fully adjusted subgroup: HR 1.05, 95% CI 0.87 to 1.28). On-time retirement was associated with a higher risk of mortality compared with working beyond retirement (insufficiently adjusted subgroup: HR 1.56, 95% CI 1.41 to 1.73). However, in the subgroup that adjusted for prior health, on-time retirement was not associated with mortality (HR 1.12, 95% CI 0.98 to 1.28).ConclusionEarly retirement was not associated with a higher risk of mortality. On-time retirement was associated with a higher risk of mortality, which might reflect the healthy worker effect. It is important to consider information on prior health and demographics when studying the association between retirement and mortality to avoid biased findings.

Systematic review and meta-analysis of Altruistic and Game-playing Love

2020 ◽  
Author(s):  
Hossein Dabiriyan Tehrani ◽  
Sara Yamini
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Game Playing ◽  
Love Styles ◽  
Collectivistic Culture ◽  
Meta Regression ◽  
Collectivistic Cultures ◽  
The Relationship

This systematic review aimed to find attitudes toward Altruistic and Game-playing love styles across individualistic and collectivistic cultures. Addressing major moderators concerning Altruistic and Game-playing love styles are the secondary objectives of this review. This review included 102 articles comprising samples from 37 countries (N = 41997). The findings of this meta-analysis show that there is a collectivistic and individualistic difference in Game-playing but not in the Altruistic love style. Collectivistic and individualistic cultures, on average, demonstrate the same perception concerning the Altruistic love style, whereas collectivistic culture shows the Game-playing love style more strongly. To explain the role of moderators in key measures, the subgroup analysis and meta-regression show that both Game-playing and Altruistic love styles decline by increasing the length of the relationship. Likewise, having children affects these love styles such that the Altruistic love style is improved, and the Game-playing love style is reduced by the presence of children in families.

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