scholarly journals Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

scholarly journals Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients.Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support.Result 46 studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2- 95%) patients while 22% (95% CI– 16-28%, I2- 88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2- 98%) patients died. The common comorbidities were hypertension (48%, 95% CI– 36-60% I2- 92%), diabetes mellitus (22%, 95% CI– 13-32%, I2- 86%) and cardiovascular disease (19%, 95% CI – 11-28%, I2- 85%). Common symptoms were fever (83%, 95% CI– 66-97%, I2-91%), cough (60%, 95% CI– 50-70%, I2- 71%) and dyspnoea (42%, 95% CI– 19-67%, I2- 94%). Overall, 84% (95% CI– 60-100%, I2- 81%) required oxygen support and 21% (95% CI– 0-49%, I2- 91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes.Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

scholarly journals Global prevalence of classic phenylketonuria based on Neonatal Screening Program Data: systematic review and meta-analysis

2020 ◽  
Vol 63 (2) ◽  
pp. 34-43 ◽  
Author(s):  
Hamid Reza Shoraka ◽  
Ali Akbar Haghdoost ◽  
Mohammad Reza Baneshi ◽  
Zohre Bagherinezhad ◽  
Farzaneh Zolala
Keyword(s):  
Systematic Review ◽  
Neonatal Screening ◽  
Screening Program ◽  
Cell Damage ◽  
Meta Analysis ◽  
Random Effect ◽  
Congenital Defects ◽  
Factors Affecting ◽  
Screening Programs ◽  
Pooled Prevalence

Phenylketonuria is a disease caused by congenital defects in phenylalanine metabolism that leads to irreversible nerve cell damage. However, its detection in the early days of life can reduce its severity. Thus, many countries have started disease screening programs for neonates. The present study aimed to determine the worldwide prevalence of classic phenylketonuria using the data of neonatal screening studies. The PubMed, Web of Sciences, Sciences Direct, ProQuest, and Scopus databases were searched for related articles. Article quality was evaluated using the Joanna Briggs Institute Critical Appraisal Evaluation Checklist. A random effect was used to calculate the pooled prevalence, and a phenylketonuria prevalence per 100,000 neonates was reported. A total of 53 studies with 119,152,905 participants conducted in 1964–2017 were included in this systematic review. The highest prevalence (38.13) was reported in Turkey, while the lowest (0.3) in Thailand. A total of 46 studies were entered into the meta-analysis for pooled prevalence estimation. The overall worldwide prevalence of the disease is 6.002 per 100,000 neonates (95% confidence interval, 5.07–6.93). The metaregression test showed high heterogeneity in the worldwide disease prevalence (<i>I</i><sup>2</sup>=99%). Heterogeneity in the worldwide prevalence of phenylketonuria is high, possibly due to differences in factors affecting the disease, such as consanguineous marriages and genetic reserves in different countries, study performance, diagnostic tests, cutoff points, and sample size.

scholarly journals Clinical features of ProMisE groups identify different phenotypes of patients with endometrial cancer

2021 ◽  
Author(s):  
Antonio Raffone ◽  
Antonio Travaglino ◽  
Olimpia Gabrielli ◽  
Mariacarolina Micheli ◽  
Valeria Zuccalà ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Clinical Features ◽  
Adjuvant Treatment ◽  
Meta Analysis ◽  
Figo Stage ◽  
Stage I ◽  
Pooled Prevalence ◽  
Prognostic Groups

Abstract Background The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) groups has identified four molecular prognostic groups of endometrial cancer (EC): POLE-mutated (POLE-mt), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), p53-wild-type (p53-wt). These groups might have different pathogenesis and risk factors, and might occur in different phenotypes of patients. However, these data are still lacking. Objective To provide a clinical characterization of the ProMisE groups of EC. Methods A systematic review and meta-analysis was performed by searching seven electronic databases from their inception to December 2020, for all studies reporting clinical characteristics of EC patients in each ProMisE group. Pooled means of age and BMI and pooled prevalence of FIGO stage I and adjuvant treatment in each ProMisE group were calculated. Results Six studies with 1, 879 women were included in the systematic review. Pooled means (with standard error) and prevalence values were: in the MMR-d group, age = 66.5 ± 0.6; BMI = 30.6 ± 1.2; stage I = 72.6%; adjuvant treatment = 47.3%; in the POLE-mt group, age = 58.6 ± 2.7; BMI = 27.2 ± 0.9; stage I = 93.7%; adjuvant treatment = 53.6%; in the p53-wt group, age = 64.2 ± 1.9; BMI = 32.3 ± 1.4; stage I = 80.5%; adjuvant treatment = 45.3%; in the p53-abn group, age = 71.1 ± 0.5; BMI = 29.1 ± 0.5; stage I = 50.8%; adjuvant treatment = 64.4%. Conclusion The ProMisE groups identify different phenotypes of patients. The POLE-mt group included the youngest women, with the lower BMI and the highest prevalence of stage I. The p53-wt group included patients with the highest BMI. The p53-abn group included the oldest women, with the highest prevalence of adjuvant treatment and the lowest prevalence of stage I. The MMR-d group showed intermediate values among the ProMisE groups for all clinical features.

scholarly journals Sarcopenia in Patients With Parkinson's Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Cai ◽  
Fei Feng ◽  
Qianqian Wei ◽  
Zheng Jiang ◽  
Ruwei Ou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Features ◽  
Random Effects ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cross Sectional ◽  
Pooled Prevalence ◽  
Cross Sectional Studies

Background: Parkinson's disease (PD) and sarcopenia are two common diseases in aging people. To date, the prevalence of sarcopenia in PD patients and the relationship between clinical features and sarcopenia in PD patients are not clear. The aim of the study was to (1) assess the prevalence of sarcopenia in PD patients and (2) reveal the clinical features between PD patients with and without sarcopenia.Method: A systematic review was carried out through screening PubMed, EMBASE, and Cochrane database in May 2020. All study designs (case–control, cohort, and cross-sectional studies) were eligible for meta-analysis. Data of patients' characteristics, sarcopenia criteria, sarcopenia prevalence, and sarcopenia measures were retrieved. The primary outcome was estimated prevalence of sarcopenia by a pooled prevalence (%) and its 95% confidence interval (CI), using a random-effects model. The secondary outcome was the differences in clinical features between PD patients with and without sarcopenia by meta-analysis. Included articles were assessed for risk of bias. Potential sources of variation were investigated by using subgroup analyses and meta-regression.Result: Ten studies were included in the review. Among them, nine were cross-sectional studies, and one was a prospective cohort study. Age of participants with PD in the studies ranged from 51.1 to 80.7 years. The estimated prevalence of sarcopenia ranged from 6 to 55.5%. The random-effects pooled prevalence was 29% (95% CIs: 0.18–0.40). When only studies at low risk of bias were considered, pooled prevalence decreased to 17% (95% CIs: 0.02–0.33), with still high heterogeneity. The incidence of falls in PD patients with sarcopenia was higher than that in PD patients without sarcopenia. There was no difference in sex ratio between PD patients with and without sarcopenia.Conclusion: Sarcopenia seems to be common in patients with PD. Early assessment of sarcopenia should be implemented in PD to avoid fall and disability.

Distinct Clinical Features and Prognostic Factors in Hepatitis C Virus-Associated Non-Hodgkin’s Lymphoma: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Minyue Zhang ◽  
Fei Gao ◽  
Ling Peng ◽  
Lijing Shen ◽  
Peng Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
Free Survival

Abstract Background: Increasing evidence suggested that hepatitis C virus (HCV) infection was associated with non-Hodgkin’s lymphoma (NHL). However, no clear consensus has been reached about the clinical features and the effective treatment in HCV-associated NHL patients. We therefore performed a systematic review and meta-analysis to explore the clinical characteristics and effect of antiviral treatment or rituximab administration in NHL patients with HCV infection.Methods: PubMed, Embase, Web of Science, and OVID database were searched for eligible studies up to Feb 28, 2021. Hazard ratio (HR) or odds ratio (OR) corresponding to 95% confidence interval (CI) were calculated to estimate outcomes. Publication biases were assessed by Egger's test and Begg's test. Statistical analysis was performed by software RevMan 5.4 and Stata version 15.Results: There were 27 shortlisted articles out of a total of 13368 NHL patients included in the current meta-analysis. Our results demonstrated that NHL patients with HCV infection showed significantly shorter overall survival (OS: HR 1.89; 95% CI 1.42-2.51, P<0.0001) and progress-free survival (PFS: HR 1.58; 95% CI 1.26-1.98, P<0.0001), lower overall response rate (ORR: OR 0.58, 95% CI 0.46-0.73, P<0.00001) and higher incidence of hepatic dysfunction during chemotherapy (OR 5.96; 95% CI 2.61-13.62, P<0.0001) compared with NHL patients without HCV infection. HCV-positive NHL patients exhibited advanced disease stage, elevated level of LDH, high-intermediate and high IPI/FLIPI risk as well as higher incidence of spleen and liver involvement. Moreover, antiviral treatment could prolong survivals (OS: HR 0.38; 95% CI 0.24-0.60, P<0.0001), reduce disease progression [PFS/DFS (disease-free survival): HR 0.63; 95% CI 0.46-0.86, P=0.003] and reinforce treatment response (ORR: OR 2.62; 95% CI 1.34-5.11, P=0.005) in HCV-infected NHL patients. Finally, rituximab administration was associated with a favorable OS while liver cirrhosis and low levels of albumin were inferior prognostic factors of OS for HCV-positive NHL patients. Conclusions: The current study provided the compelling evidence about an inferior prognosis and distinct clinical characteristics in HCV-associated NHL patients. Antiviral treatment and rituximab-containing regimes were shown to be efficacious to improve clinical outcomes of NHL patients with HCV infection.

scholarly journals Effects of Exercise Interventions on Inflammatory Parameters in Acutely Hospitalized Older Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (2) ◽  
pp. 290
Author(s):  
Robinson Ramírez-Vélez ◽  
Antonio García-Hermoso ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
Mikel L. Sáez de Asteasu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Usual Care ◽  
Older Patients ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled ◽  
Inflammatory Parameters ◽  
Hospitalized Older Adults

The purpose of this systematic review and meta-analysis was to appraise the acute effects of exercise training on inflammatory parameters in hospitalized older adults. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, Medline and PubMed were searched for studies published until August 2020. The review included all randomized controlled trials (RCTs) that evaluated and compared the effect of exercise versus usual care on inflammatory parameters in acutely hospitalized older adults. Two reviewers independently assessed the studies. The quality of all the included studies was assessed using the DerSimonian–Laird random-effects inverse-variance model. Five studies (275 participants) met the inclusion criteria. The exercise interventions included resistance or multicomponent intervention programs. The results indicate that, compared with usual care, exercise interventions have a positive impact on overall inflammatory parameters, including C-reactive protein (CRP) and insulin-like growth factor-I (IGF-1) (Hedge’s g = −0.19, 95% confidence interval [CI] −0.33 to −0.04, p = 0.011, I2 = 0%). However, analyses of individual inflammatory parameters revealed a non-significant trend for reductions in CRP (Hedge’s g = −0.20, 95% CI −0.47 to 0.07, p = 0.151, I2 = 31.2%) and IGF-I (Hedge’s g = −0.34, 95% CI −0.79 to 0.11, p = 0.138, I2 = 0%). On the basis of this review, we conclude that exercise during acute hospitalization offers a mild improvement in the inflammatory profile over usual care in older patients. Nevertheless, due to limited number of RCTs, our findings must be interpreted with caution and confirmed in future studies.

scholarly journals Distinct clinical features and prognostic factors of hepatitis C virus-associated non-Hodgkin’s lymphoma: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minyue Zhang ◽  
Fei Gao ◽  
Ling Peng ◽  
Lijing Shen ◽  
Peng Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
Hodgkin's Lymphoma ◽  
Free Survival

Abstract Background Increasing evidence suggests that hepatitis C virus (HCV) infection is associated with non-Hodgkin’s lymphoma (NHL). However, no clear consensus has been reached about the clinical features and effective treatment of HCV-associated NHL patients. We therefore performed a systematic review and meta-analysis to explore the clinical characteristics and effectiveness of antiviral treatment or rituximab administration among NHL patients with HCV infection. Methods Eight electronic databases, including PubMed, OVID, EMBASE, Cochrane Library, ClinicalTrials, WANFANG, CNKI, and VIP, were searched for eligible studies up to July 31, 2021. The hazard ratio (HR) or odds ratio (OR) corresponding to the 95% confidence interval (CI) was calculated to estimate the outcomes. Publication bias was assessed by Egger’s and Begg’s tests. Statistical analysis was performed with RevMan 5.4 software and Stata version 15. Results There were 27 shortlisted articles out of a total of 13,368 NHL patients included in the current meta-analysis. Our results demonstrated that NHL patients with HCV infection had a significantly shorter overall survival (OS: HR 1.89; 95% CI 1.42–2.51, P < 0.0001) and progression-free survival (PFS: HR 1.58; 95% CI 1.26–1.98, P < 0.0001), a lower overall response rate (ORR: OR 0.58, 95% CI 0.46–0.73, P < 0.00001) and a higher incidence of hepatic dysfunction during chemotherapy (OR 5.96; 95% CI 2.61–13.62, P < 0.0001) than NHL patients without HCV infection. HCV-positive NHL patients exhibited an advanced disease stage, an elevated level of LDH, a high-intermediate and high IPI/FLIPI risk as well as a higher incidence of spleen and liver involvement. Moreover, antiviral treatment prolonged survival (OS: HR 0.38; 95% CI 0.24–0.60, P < 0.0001), reduced disease progression [PFS/DFS (disease-free survival): HR 0.63; 95% CI 0.46–0.86, P = 0.003] and reinforced the treatment response (ORR: OR 2.62; 95% CI 1.34–5.11, P = 0.005) among the HCV-infected NHL patients. Finally, rituximab administration was associated with a favourable OS, while liver cirrhosis and low levels of albumin predicted a poor OS for HCV-positive NHL patients. Conclusions The current study provided compelling evidence about an inferior prognosis and distinct clinical characteristics among HCV-associated NHL patients. Antiviral treatment and rituximab-containing regimens were shown to be efficacious in improving the clinical outcomes of NHL patients with HCV infection.

scholarly journals Review of clinical characteristics and laboratory findings of COVID-19 in children-Systematic review and Meta-analysis

2020 ◽  
Author(s):  
Harmeet K Kharoud ◽  
Rizwana Asim ◽  
Lianne Siegel ◽  
Lovepreet Chahal ◽  
Gagan Deep Singh
Keyword(s):  
Systematic Review ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Laboratory Findings ◽  
Asymptomatic Children ◽  
Pooled Prevalence ◽  
Reported Data

OBJECTIVE: To conduct a systematic review and meta-analysis to assess the prevalence of various clinical symptoms and laboratory findings of COVID-19 in children. METHODS: PubMed, MEDLINE, and SCOPUS databases were searched to include studies conducted between January 1, 2020, and July 15, 2020 which reported data about clinical characteristics and laboratory findings in laboratory-confirmed diagnosis of COVID-19 in pediatric patients. Random effects meta-analysis using generalized linear mixed models was used to estimate the pooled prevalence. RESULTS: The most prevalent symptom of COVID-19 in children was 46.17% (95%CI 39.18-53.33%), followed by cough (40.15%, 95%CI 34.56-46.02%). Less common symptoms were found to be dyspnea, vomiting, nasal congestion/rhinorrhea, diarrhea, sore throat/pharyngeal congestion, headache, and fatigue. The prevalence of asymptomatic children was 17.19% (95%CI 11.02-25.82%). The most prevalent laboratory findings in COVID-19 children were elevated Creatinine Kinase (26.86%, 95%CI 16.15-41.19%) and neutropenia (25.76%, 95%CI 13.96-42.58%). These were followed by elevated LDH, thrombocytosis, lymphocytosis, neutrophilia, elevated D Dimer, Elevated CRP, elevated ESR, leukocytosis, elevated AST and leukopenia. There was a low prevalence of elevated ALT and lymphopenia in children with COVID- 19. CONCLUSIONS AND RELEVANCE: This study provides estimates of the pooled prevalence of various symptoms and laboratory findings of COVID-19 in the pediatric population.

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