Association between glucocorticoids treatment and viral clearance delay in patients with COVID-19: a systematic review and meta-analysis

Abstract Background Evidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. Methods In this systematic review and meta-analysis, we searched for studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2019 to April 20, 2021. We mainly pooled the risk ratios (RRs) and mean difference (MD) for viral clearance delay and did subgroup analyses by the severity of illness and doses of glucocorticoids. Results 38 studies with a total of 9572 patients were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 patients (adjusted RR 1.52, 95% CI 1.29 to 1.80, I2 = 52%), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significant both for COVID-19 patients being mild or moderate ill (adjusted RR 1.86, 95% CI 1.35 to 2.57, I2 = 48%), and for patients of being severe or critical ill (adjusted RR 1.59, 95% CI 1.23 to 2.07, I2 = 0%); however, this risk significantly increased for patients taking high doses (unadjusted RR 1.85, 95% CI 1.08 to 3.18; MD 7.19, 95% CI 2.78 to 11.61) or medium doses (adjusted RR 1.86, 95% CI 0.96 to 3.62, I2 = 45%; MD 3.98, 95% CI 3.07 to 4.88, I2 = 4%), rather those taking low doses (adjusted RR 1.38, 95% CI 0.94 to 2.02, I2 = 59%; MD 1.46, 95% CI −0.79 to 3.70, I2 = 82%). Conclusions Glucocorticoids treatment delayed viral clearance in COVID-19 patients of taking high doses or medium doses, rather in those of taking low doses of glucocorticoids.

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Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-138544/v1 ◽

2021 ◽

Author(s):

Jianbo Li ◽

Xuelian Liao ◽

Yue Zhou ◽

Luping Wang ◽

Hang Yang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Severity Of Illness ◽

Viral Clearance ◽

Cochrane Library ◽

High Dose ◽

Hazard Ratios ◽

Subgroup Analyses ◽

High Doses ◽

Critical Ill

Abstract BackgroundEvidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. MethodsIn this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.ResultsOne trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).ConclusionsGlucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

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Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-138544/v2 ◽

2021 ◽

Author(s):

Jianbo Li ◽

Xuelian Liao ◽

Yue Zhou ◽

Luping Wang ◽

Hang Yang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Severity Of Illness ◽

Viral Clearance ◽

Cochrane Library ◽

High Dose ◽

Hazard Ratios ◽

Subgroup Analyses ◽

High Doses ◽

Critical Ill

Abstract Background Evidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. Methods In this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.Results One trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).Conclusions Glucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

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The effect of soya consumption on inflammatory biomarkers: a systematic review and meta-analysis of clinical trials

British Journal Of Nutrition ◽

10.1017/s0007114520003268 ◽

2020 ◽

pp. 1-12

Author(s):

Mahsa Rezazadegan ◽

Fatemeh Mirjalili ◽

Cain C. T. Clark ◽

Mohammad Hossein Rouhani

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Web Of Science ◽

Meta Analysis ◽

Inflammatory Biomarkers ◽

Beneficial Effects ◽

Isi Web Of Science ◽

Subgroup Analyses ◽

Study Heterogeneity ◽

High Doses

Abstract Inflammation is a major cause of chronic diseases. Several studies have investigated the effects of soya intake on inflammatory biomarkers; however, the results are equivocal. The aim of this study was to conduct a systematic review and meta-analysis of clinical trials that evaluated the effect of soya consumption on inflammatory biomarkers. Medline, Scopus, ISI Web of Science and Google Scholar were systematically searched, up to and including May 2020, for clinical trials that evaluated the effects of soya and soya products on TNF-α, IL-6, IL-2, IL-1β and interferon γ (IFN-γ) in adults. A random effects method was used to calculate overall effects, and subgroup analyses were performed to discern probable sources of inter-study heterogeneity. A total of twenty-eight clinical trials were included. Although soya consumption reduced TNF-α (Hedges’ g = –0·28; 95 % CI –0·49, –0·07), it had no significant effect on IL-6 (Hedges’ g = 0·07, 95 % CI –0·14, 0·28), IL-2 (mean difference (MD) = –1·38 pg/ml; 95 % CI –3·07, 0·31), IL-1β (MD = –0·02 pg/ml; 95 % CI –0·08, 0·03) and IFN-γ (MD = 1685·82 pg/ml; 95 % CI –1604·86, 4976·50). Subgroup analysis illustrated a reduction in TNF-α in parallel designed studies, at dosages ≥100 mg of isoflavones, and in unhealthy subjects. The present study showed that high doses of isoflavones in unhealthy subjects may yield beneficial effects on TNF-α.

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Association of Estrogen Receptor Genes Polymorphisms With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis Based on Observational Studies

Frontiers in Endocrinology ◽

10.3389/fendo.2021.726184 ◽

2021 ◽

Vol 12 ◽

Author(s):

Siyu Zhou ◽

Shu Wen ◽

Yongcheng Sheng ◽

Meina Yang ◽

Xiaoyang Shen ◽

...

Keyword(s):

Systematic Review ◽

Estrogen Receptor ◽

Polycystic Ovary Syndrome ◽

Publication Bias ◽

Polycystic Ovary ◽

Meta Analysis ◽

Genetic Models ◽

Cochrane Library ◽

Ovary Syndrome ◽

Subgroup Analyses

PurposeControversial results existed in amounts of studies investigating the authentic association of estrogen receptor genes (ESR1 and ESR2) polymorphisms with the occurrence and progression of polycystic ovary syndrome (PCOS). The inconsistency might result from different loci, sample sizes, and ethnicities. To find the potential correlations between ESR1/ESR2 polymorphisms and PCOS risk, we conducted the first systematic review and meta-analysis to comprehensively summarize current studies in a large combined population.MethodsEligible studies were retrieved from PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP up to February 28, 2021. The quality of studies was assessed using the Newcastle–Ottawa Scale (NOS) scoring system. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to synthesize data in five genetic models. Subgroup analyses were conducted by ethnicity. Heterogeneity and publication bias were also assessed. The protocol was registered in PROSPERO under the number CRD42021239200.ResultsA total of 8 studies involving 1,522 PCOS patients and 4,198 controls were included. No evidence demonstrated the association of ESR1 rs2234693 (OR=1.07 95%CI 0.98–1.18), ESR1 rs9340799 (OR=0.99 95%CI 0.69–1.43), or ESR2 rs4986938 (OR=1.06 95%CI 0.81–1.38) polymorphisms and PCOS risk in five genetic models. According to stratified subgroup analyses, ethnicity was considered the major source of heterogeneity. No publication bias was found in eligible studies.ConclusionThe present meta-analysis found no significant associations between the variants of ESR1 rs2234693, ESR1 rs9340799, ESR2 rs4936938, and individual PCOS susceptibility, even if ethnicity was taken into account.Systematic Review RegistrationThe protocol was registered in PROSPERO (available from https://www.crd.york.ac.uk/PROSPERO) with the ID number CRD42021239200.

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Cytomegalovirus seroprevalence among blood donors: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211034656 ◽

2021 ◽

Vol 49 (8) ◽

pp. 030006052110346

Author(s):

Tiruneh Adane ◽

Solomon Getawa

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Blood Donors ◽

Web Of Science ◽

Meta Analysis ◽

Google Scholar ◽

Cochrane Library ◽

Blood Products ◽

Specific Antibodies

Background Screening for cytomegalovirus (CMV)-specific antibodies is not routine in some settings. Thus, transfusion of blood products poses risks for susceptible individuals. Objectives To investigate the global pooled CMV seroprevalence among volunteer blood donors. Methods This systematic review and meta-analysis was performed according to PRISMA guidelines. The databases searched included Embase, Google Scholar, Medline, PubMed, Web of Science, and Cochrane Library. Data were extracted independently and analyzed using STATA version 11. Results The global seroprevalence of CMV IgG, CMV IgM, and both CMV IgM and IgG was 83.16% (95% confidence interval [CI]: 78.55–87.77%, I2 = 99.5%), 13.77% (95% CI: 11.59–15.95%, I2 = 98.8%), and 23.78% (95% CI: 10.50–37.06%, I2 = 98.7), respectively. Conclusion The global seroprevalence of CMV was high among blood donors. Therefore, regular CMV screening should be conducted to identify CMV-seronegative blood donors.

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Nasal Decolonization of Staphylococcus Aureus and the Risk of Surgical Site Infection After Surgery: A Meta-Analysis

10.21203/rs.3.rs-30729/v1 ◽

2020 ◽

Author(s):

Jia Tang ◽

Jiangjin Hui ◽

Jing Ma ◽

Mingquan Chen

Keyword(s):

Staphylococcus Aureus ◽

Web Of Science ◽

Meta Analysis ◽

Surgical Site Infections ◽

Cochrane Library ◽

Randomized Controlled ◽

Pulmonary Surgery ◽

Different Types ◽

The Cochrane Library ◽

Risk Ratios

Abstract Aim: To assess the effects of nasal decontamination on preventing surgical site infections (SSIs) in people who are S aureus carriers undergoing different types of surgeries. Methods: Relevant randomized controlled trials (RCTs) were identified through systematic searches of the PubMed, Embase, Web of science, and the Cochrane Library databases. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and the effects model was chosen according to the heterogeneity. Subgroup analyses were performed according to different types of surgeries that S aureus carriers were applied.Results: Twenty RCTs published between 1996 and 2019 involving 10526 patients were included. Pooled results showed that the overall SSIs and pulmonary surgery SSIs presented with a statistical difference in measures of nasal decontamination (RR=0.59 and 0.47, respectively, both p<0.01). However, the associations between nasal decolonization and increased risks of SSIs in orthopedics surgery or cardiovascular surgery remained insignificant in studies.Conclusion: It seems that nasal decolonization of Staphylococcus aureus may be associated with a reduction of SSI in these patients, especially in patients receiving pulmonary surgeries.

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Lower Income Levels Correlate With Increased Prevalence of Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

10.21203/rs.3.rs-139122/v1 ◽

2021 ◽

Author(s):

Qiong He ◽

Mengyuan Zhang ◽

Yongle Wang ◽

Jin Zhang ◽

Yi Zhang ◽

...

Keyword(s):

Systematic Review ◽

Gestational Diabetes ◽

Low Income ◽

Web Of Science ◽

Meta Analysis ◽

Income Level ◽

Cochrane Library ◽

Lower Income ◽

Middle Income ◽

Income Levels

Abstract BackgroundIncome level is an important factor that influences the occurrence of gestational diabetes. Thus, this systematic review and network meta-analysis aimed at evaluating the correlation between income levels and the prevalence of gestational diabetes. MethodsRelevant published studies were searched in Pubmed, Web of Science, Cochrane library, and Ovid from the establishment time of database to January 3, 2020. Finally, 13 eligible clinical studies involving 1,817,801 women were selected from a total of 3776 studies and included in this study. The statistical softwares Revman5.3 and Stata14.0 were used to compare the prevalence of gestational diabetes in five different income levels; low, lower middle, medium, upper middle, and high. ResultsThe incidences of gestational diabetes in people with different economic income levels were: high income <middle income <upper middle income <lower middle income <low income. ConclusionThere is no linear correlation between income levels and incidences of gestational diabetes. However, the overall prevalence of gestational diabetes is inversely proportional to income level, that is, the higher the income level, the lower the prevalence of gestational diabetes.

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Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11060777 ◽

2021 ◽

Vol 11 (6) ◽

pp. 777

Author(s):

Woon-Man Kung ◽

Sheng-Po Yuan ◽

Muh-Shi Lin ◽

Chieh-Chen Wu ◽

Md. Mohaimenul Islam ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Observational Studies ◽

Web Of Science ◽

Meta Analysis ◽

The Elderly ◽

Previous Evidence ◽

Increased Risk ◽

Meta Analyses ◽

Risk Ratios

Background: Cognitive impairment is one of the most common, burdensome, and costly disorders in the elderly worldwide. The magnitude of the association between anemia and overall cognitive impairment (OCI) has not been established. Objective: We aimed to update and expand previous evidence of the association between anemia and the risk of OCI. Methods: We conducted an updated systematic review and meta-analysis. We searched electronic databases, including EMBASE, PubMed, and Web of Science for published observational studies and clinical trials between 1 January 1990 and 1 June 2020. We excluded articles that were in the form of a review, letter to editors, short reports, and studies with less than 50 participants. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We estimated summary risk ratios (RRs) with random effects. Results: A total of 20 studies, involving 6558 OCI patients were included. Anemia was significantly associated with an increased risk of OCI (adjusted RR (aRR) 1.39 (95% CI, 1.25–1.55; p < 0.001)). In subgroup analysis, anemia was also associated with an increased risk of all-cause dementia (adjusted RR (aRR), 1.39 (95% CI, 1.23–1.56; p < 0.001)), Alzheimer’s disease [aRR, 1.59 (95% CI, 1.18–2.13; p = 0.002)], and mild cognitive impairment (aRR, 1.36 (95% CI, 1.04–1.78; p = 0.02)). Conclusion: This updated meta-analysis shows that patients with anemia appear to have a nearly 1.39-fold risk of developing OCI than those without anemia. The magnitude of this risk underscores the importance of improving anemia patients’ health outcomes, particularly in elderly patients.

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Oral Complications of Chemotherapy on Paediatric Patients with Cancer: A Systematic Review and Meta-Analysis

Medical Sciences Forum ◽

10.3390/msf2021005025 ◽

2021 ◽

Vol 5 (1) ◽

pp. 25

Author(s):

Ana Sofia Alves ◽

Gunel Kizi ◽

Ana Raquel Barata ◽

Paulo Mascarenhas ◽

Irene Ventura

Keyword(s):

Systematic Review ◽

Incidence Rate ◽

Web Of Science ◽

Meta Analysis ◽

Paediatric Oncology ◽

Cochrane Library ◽

Patients With Cancer ◽

Search Results ◽

Oral Complications ◽

Paediatric Patients

The goal of cancer treatment is to fight and/or control cancer. The aim of this study was to review and meta-analyse the incidence of main oral complications in paediatric oncology during chemotherapy. The search results were obtained from B-on, Web of Science, Scopus, Cochrane Library and PubMed databases. Of 1032 articles potentially relevant, 13 were included in this review. The overall incidence of caries, gingivitis, ulcers, mucositis, and candidiasis was 67.8%, 55.6%, 44.2%, 41.6%, and, 29.5%, respectively. During chemotherapy, paediatric patients with cancer present higher incidence of caries and gingivitis. Incidence rate meta-analysis show high heterogeneity. More studies should be done to reduce uncertainty.

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Outcomes of Macrosurgical Versus Microsurgical Vasovasostomy in Vasectomized Men: a Systematic Review and Meta-analysis

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-021-01011-1 ◽

2021 ◽

Author(s):

M. Duijn ◽

J. A. van der Zee ◽

Y. Bachour

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Descriptive Analysis ◽

Pregnancy Rates ◽

Primary Data ◽

Cochrane Library ◽

Microscopical Technique ◽

Vasectomy Reversal ◽

The Cochrane Library

AbstractIn order to restore fertility by vasectomy reversal, vasovasostomy (VV) is one of the most chosen options. During this procedure, the vas deferens is anastomosed either by a macro- or microscopical technique. Up to date, it is unknown which of these techniques shows best overall post-procedure patency and pregnancy rates. The purpose of this systematic review and meta-analysis is to reach a consensus on which technique is best for vasovasostomy and thereby better counsel patients and practitioners. A systematic review and meta-analysis on macroscopic and microscopic VV for vasectomy reversal was performed. PubMed, The Cochrane Library, Embase, and Web of Science were systematically searched from inception until 2019. Studies and associated data were evaluated by two reviewers. Primary, data on post-operative patency and pregnancy rates, interval to reversal, and post-operative complications were extracted. Proportions (95% CI) and heterogeneity scores (I2) were calculated, using a random effects model. A total of 8305 patients were included by 25 studies. Descriptive analysis showed higher post-operative patency (80.5% vs 91.4%) and pregnancy rates (47.7% vs 73.3%) after microscopic vasovasostomy. Meta-analysis produced post-operative patency proportions of 0.80 (95% CI, 0.76–0.84) and 0.88 (95% CI, 0.83–0.92) after macro- and microscopic VV respectively. Proportions of post-operative pregnancy were 0.43 (95% CI, 0.35–0.50) after macroscopic VV and 0.47 (95% CI, 0.31–0.62) after microsurgical VV. Microscopic VV is associated with higher post-operative patency and pregnancy rates compared to macroscopic vasovasostomy. However, further research is needed because of shortage in high methodological quality and variety.

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