scholarly journals Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 64
Author(s):  
Shinta Oktya Wardhani ◽  
Jonny Karunia Fajar ◽  
Laksmi Wulandari ◽  
Gatot Soegiarto ◽  
Yeni Purnamasari ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Infectious Diseases ◽  
Adjunctive Therapy ◽  
Standard Treatment ◽  
Meta Analysis ◽  
Group Analysis ◽  
Mortality Rates ◽  
Adjunctive Treatment ◽  
Bibliographic Databases ◽  
Risk Of Mortality

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Four bibliographic databases and a preprint database were searched for potentially relevant articles. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 1,937 patients treated with CCP and 3,405 patients without CCP retrieved from 12 studies were included. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without the CCP had a 1.32 times higher risk of mortality than those treated with the CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, reduces the mortality rate among COVID-19 patients.

scholarly journals Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 64
Author(s):  
Shinta Oktya Wardhani ◽  
Jonny Karunia Fajar ◽  
Laksmi Wulandari ◽  
Gatot Soegiarto ◽  
Yeni Purnamasari ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Group Analysis ◽  
Adjunctive Treatment ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Jadad Scale ◽  
Egger Test ◽  
Ottawa Scale

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Embase, PubMed, Web of Science, Cochrane and MedRix were searched for potentially relevant articles. All included papers were assessed for the quality using modified jadad scale and Newcaste-ottawa scale for randomized controlled trial (RCT) and non – RCT, respectively. We used a Q test and Egger test to assess the heterogeneity and publication bias among studies, respectively. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 12 papers consisting of three cross-sectional studies, one prospective study, five retrospective studies, and two RCT studies were included in our analysis. Of them, a total of 1,937 patients treated with CCP and 3,405 patients without CCP were involved.. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without the CCP had a 1.32 times higher risk of mortality than those treated with the CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, reduces the mortality rate among COVID-19 patients.

scholarly journals Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 64
Author(s):  
Shinta Oktya Wardhani ◽  
Jonny Karunia Fajar ◽  
Laksmi Wulandari ◽  
Gatot Soegiarto ◽  
Yeni Purnamasari ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Group Analysis ◽  
Adjunctive Treatment ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Jadad Scale ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Embase, PubMed, Web of Science, Cochrane and MedRix were searched for potentially relevant articles. All included papers were assessed for the quality using modified Jadad scale and Newcastle-Ottawa scale for randomized controlled trial (RCT) and non – RCT, respectively. We used a Q test and Egger test to assess the heterogeneity and publication bias among studies, respectively. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 12 papers consisting of three cross-sectional studies, one prospective study, five retrospective studies, and three RCT studies were included in our analysis. Of them, a total of 1,937 patients treated with CCP and 3,405 patients without CCP were included. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without CCP had a 1.32 times higher risk of mortality than those treated with CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, could reduce the mortality rate among COVID-19 patients.

scholarly journals The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics

2021 ◽  
Vol 5 (1) ◽  
pp. e000243
Author(s):  
Rhiannon Olivia Moody
Keyword(s):  
Mortality Rate ◽  
Klebsiella Pneumoniae ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Resistant Bacteria ◽  
Cure Rate ◽  
Treatment Regimens ◽  
Hospitalised Patients ◽  
Microbiological Cure

Introduction: Infection with the bacteria carpamenease-producing Klebsiella pneumoniae represents a significant cause of mortality in hospitalised patients. These multidrug resistant bacteria are resistant to currently used antibiotics as a result of carbapenemase production. Dual carbapenem therapy has been proposed as a valid therapeutic option, this therapy combines two carbapenem antibiotics, with one acting as a suicide inhibitor allowing the subsequent carbapenem to exert a bactericidal effect. Aim: The aim of this meta-analysis was to determine if dual carbapenem therapy had a significant effect on mortality rate and microbiological cure rate in patients diagnosed with carbapenemase-producing Klebsiella pneumoniae infections in comparison to standard antibiotic therapies. Methods: The search terms “(dual OR double) carbapenem (therapy OR treatment) AND klebsiella pneumoniae” were used to search databases and inclusion and exclusion criteria were applied to retrieved papers, a total of seven studies were identified for inclusion in the meta-analysis. The quality of included studies was assessed using the cochrane tool for risk of bias assessment and funnel plots were produced to determine the influence of publication bias. A random effects model was used to assess the outcomes; mortality rate and microbiological cure rate. Results and Conclusion: Dual carbapenem therapy had a time dependent effect on patient mortality rates. Dual carbapenem therapy significantly lowered  mortality rates in patients in comparison to standard antibiotic therapy, especially in comparison to monotherapy treatment regimens. Additionally, dual carbapenem therapy significantly improved microbiological cure rate in patients when compared to standard antibiotic treatment regimens demonstrating the possible clinical applications of a dual carbapenem antibiotic regimen in the treatment of carbapenemase-producing Klebsiella pneumoniae infections. 

scholarly journals Mortality, causes of death and influence of medication use in patients with systemic lupus erythematosus vs matched controls

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 207-216
Author(s):  
Irene E M Bultink ◽  
Frank de Vries ◽  
Ronald F van Vollenhoven ◽  
Arief Lalmohamed
Keyword(s):  
Mortality Rate ◽  
Lupus Erythematosus ◽  
Mortality Rates ◽  
Cox Proportional Hazards ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Specific Mortality ◽  
Age And Sex

Abstract Objectives We wanted to estimate the magnitude of the risk from all-cause, cause-specific and sex-specific mortality in patients with SLE and relative risks compared with matched controls and to evaluate the influence of exposure to medication on risk of mortality in SLE. Methods We conducted a population-based cohort study using the Clinical Practice Research Datalink, Hospital Episode Statistics and national death certificates (from 1987 to 2012). Each SLE patient (n = 4343) was matched with up to six controls (n = 21 780) by age and sex. Cox proportional hazards models were used to estimate overall and cause-specific mortality rate ratios. Results Patients with SLE had a 1.8-fold increased mortality rate for all-cause mortality compared with age- and sex-matched subjects [adjusted hazard ratio (HR) = 1.80, 95% CI: 1.57, 2.08]. The HR was highest in patients aged 18–39 years (adjusted HR = 4.87, 95% CI: 1.93, 12.3). Mortality rates were not significantly different between male and female patients. Cumulative glucocorticoid use raised the mortality rate, whereas the HR was reduced by 45% with cumulative low-dose HCQ use. Patients with SLE had increased cause-specific mortality rates for cardiovascular disease, infections, non-infectious respiratory disease and for death attributable to accidents or suicide, whereas the mortality rate for cancer was reduced in comparison to controls. Conclusion British patients with SLE had a 1.8-fold increased mortality rate compared with the general population. Glucocorticoid use and being diagnosed at a younger age were associated with an increased risk of mortality. HCQ use significantly reduced the mortality rate, but this association was found only in the lowest cumulative dosage exposure group.

scholarly journals Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Liwei Ni ◽  
Yuming Long ◽  
Xuya Yuan ◽  
Jianhao Xu ◽  
Jialong Tao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
High Risk ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Site Specific ◽  
Risk Of Mortality ◽  
Male Patients

Abstract Background: Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence. Method: We performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs). Results: Seven studies consisting of a total of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected. Conclusions: Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer and a high risk of mortality from prostate cancer.

scholarly journals Ketamine for the multivariate effect of PTSD: Systematic review and meta-analysis

2021 ◽  
Author(s):  
Rui Du ◽  
Kun Niu ◽  
Guofang Lu ◽  
Yulong Shang
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Group Analysis ◽  
Mean Difference ◽  
Bibliographic Databases ◽  
Post Traumatic Stress ◽  
Chronic Ptsd ◽  
Inverse Variance ◽  
Mental Illness Treatment

The aim of this systematic review and meta-analysis was to examine the efficacy, anti-effect of ketamine (intervention) for post-traumatic stress disorder (PTSD) patients during analgesia proceeding and mental illness treatment methods, in comparison with control (midazolam, opioid, saline or placebo). The bibliographic databases Cochrane, Embase, Pubmed and Web of Science were searched from inception to 23 May 2021 for randomized controlled trials, case-control and cohort studies included. For continuous and dichotomous outcomes, respectively, we calculated the mean difference using the inverse-variance method and the risk ratio with the Mantel-Haenszel method. In all, ten trials with 705 patients were included. Confirmed by meta-analysis, ketamine didn't increase the prevalence of PTSD by a risk ratio (95 % CI) of 0.86 (0.61 to 1.20), p = 0.38 in 3 trials with 503 patients. Evidence of a difference was found in the PTSD-scales taken between ketamine and control during short durations (months), with a mean difference (95 % CI) of 2.45 (1.33 to 3.58), p < 0.001 in three trials with 65 patients. Another evidence is shown in chronic PTSD (years), with a mean difference (95 % CI) of -3.66 (-7.05 to -0.27), p = 0.03 in three trials with 91 patients. Sub-group analysis underlined the increased benefit of ketamine administration for those in whom the procedure was more than one week in the chronic PTSD group. The adoption of ketamine for the short duration of PTSD is in avoidance, but for chronic PTSD is recommended and, in the opinion of the authors, should be considered as a new therapy in view of its potential to ameliorate arousal, avoidance and dissociative symptoms, neuroticism after trauma needing more animal research and clinical trials.

Etomidate, Adrenal Insufficiency and Mortality Associated With Severity of Illness: A Meta-Analysis

2020 ◽  
pp. 088506662095759
Author(s):  
Stewart G. Albert ◽  
Sujata Sitaula
Keyword(s):  
Critical Illness ◽  
Mortality Rate ◽  
Adrenal Insufficiency ◽  
Absolute Risk ◽  
Meta Analysis ◽  
Severity Of Illness ◽  
Mortality Rates ◽  
Secondary Outcome ◽  
Relative Mortality ◽  
Cochrane Reviews

Purpose: Etomidate causes adrenal insufficiency. Yet in critically ill patients, it is controversial whether it increases mortality rates above that of comparator anesthetic induction agents. We postulated that etomidate would increase relative mortality rates correspondingly to the severity of illness as defined by SAPS or APACHE scores. Materials and Methods: A literature search was performed on Pub Med, SCOPUS, and Cochrane Reviews for human studies, regardless of language, between 1983 and February 2020. The search strategy used keywords, “etomidate,” “adrenal insufficiency,” “glucocorticoid,” and “intensive care.” Both authors reviewed electronic data search titles, abstracts and extracted data, which were checked by the other reviewer. Primary outcome was 28-day survival. Secondary outcome was adrenal insufficiency. Results: There were 29 trials of etomidate versus comparators in 8584 patients. Etomidate was associated with adrenal insufficiency (risk ratio (rr) = 1·54, 95% CI; 1·42, 1·67, p < 0.001) and increased overall relative mortality rates (rr = 1.09, CI;1.04,1.16, p = 0.001). Meta-regression showed that with etomidate there was a continuous progressive relative risk of mortality associated with increasing severity of illness (predefined in each article by standard critical illness scores). In those patients who had a predicted mortality rate > the median for this analysis (predicted mortality 44%) the relative mortality rate (rr) = 1.20, Ci;1.12,1.29, p < 0.001, the absolute risk difference (rd) = 0.08, CI;0.05,0.11, p < 0.0001 and the number needed to harm (1/rd) was 12.5. In those with a calculated predicted mortality <44% there was no increase in relative mortality rate. Conclusions: Whereas etomidate causes adrenal insufficiency, it was not shown to increase mortality in many analyzed here in ICU settings. However, etomidate associated relative mortality rates increased progressively and correlated with the severity of critical illness scores. Intensivists should anticipate the need for glucocorticoid supplementation after etomidate in those with severe critical illness and in those with acute deterioration of vital signs.

scholarly journals Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

2020 ◽  
Vol 9 (9) ◽  
pp. 2685
Author(s):  
Amalia Ioanna Moula ◽  
Linda Renata Micali ◽  
Francesco Matteucci ◽  
Fabiana Lucà ◽  
Carmelo Massimiliano Rao ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Mortality Rates ◽  
Cerebrovascular Diseases ◽  
Continuous Variables ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increase Risk ◽  
Artery Disease ◽  
Dichotomous Variables ◽  
The Impact

Patients with pre-existing cardiovascular disease (CVD) might be more susceptible to infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have higher mortality rates. Nevertheless, the risk of mortality has not been previously quantified. The aim of this meta-analysis is to quantify the risk of mortality in coronavirus disease 2019 (COVID-19) patients. A meta-analysis was conducted analyzing the impact of (1) sex, (2) age, (3) CVD with coronary artery disease (CAD), (4) CAD alone, (5) CVD without CAD, (6) hypertension, (7) cerebrovascular diseases, and (8) diabetes on mortality. Relative risk was assessed for dichotomous variables, mean difference for continuous variables. Twenty-six studies were included, encompassing 8497 patients. Males had 16% higher risk of mortality than females (p < 0.05) and elderly patients had higher chance of dying than younger patients (p < 0.0001). Patients with overall CVD have a 1.96-fold higher mortality risk (p < 0.0001). CAD increases risk of mortality by 1.90-fold (p < 0.05). CVD-CAD were found to increase risk up to 2.03-fold (p < 0.05). Hypertension, cerebrovascular disease and diabetes increase the risk of death up to 1.73-fold, 1.76-fold and 1.59-fold, respectively (p < 0.0001, p < 0.0001, p < 0.05, respectively). Sex, age, presence of CAD and/or other types of CVD, hypertension, cerebrovascular diseases and diabetes mellitus increase mortality in patients with COVID-19.

scholarly journals The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis

Toxins ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 640
Author(s):  
Simone Battista ◽  
Luca Buzzatti ◽  
Marialuisa Gandolfi ◽  
Cinzia Finocchi ◽  
Luca Falsiroli Maistrello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Musculoskeletal Pain ◽  
Adjunctive Therapy ◽  
Botulinum Toxin A ◽  
Meta Analysis ◽  
Chronic Musculoskeletal Pain ◽  
Adjunctive Treatment ◽  
Cochrane Library ◽  
Toxin A

Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a multimodal approach. Hence, Medline via PubMed, EMBASE, and the Cochrane Library-CENTRAL were searched until November 2020 for randomised controlled trials (RCTs) that investigated the use of BoNT-A as an adjunctive therapy for chronic musculoskeletal pain. The risk of bias (RoB) and the overall quality of the studies were assessed through RoB 2.0 and the GRADE approach, respectively. Meta-analysis was conducted to analyse the pooled results of the six included RCTs. Four were at a low RoB, while two were at a high RoB. The meta-analysis showed that BoNT-A as an adjunctive therapy did not significantly decrease pain compared to the sole use of traditional treatment (SDM −0.89; 95% CI −1.91; 0.12; p = 0.08). Caution should be used when interpreting such results, since the studies displayed very high heterogeneity (I = 94%, p < 0.001). The overall certainty of the evidence was very low. The data retrieved from this systematic review do not support the use of BoNT-A as an adjunctive therapy in treating chronic musculoskeletal pain.

scholarly journals Timing of Renal Replacement Therapy Initiation in Patients with Septic Acute Kidney Injury; A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Hyung Jung Oh ◽  
In Kyung Min ◽  
Yun Ho Roh ◽  
Jung ho Kim ◽  
Jin Young Ahn ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Mortality Rate ◽  
Replacement Therapy ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Treated Group ◽  
Optimal Timing ◽  
Late Group

Abstract Background; Acute kidney injury (AKI) is the most frequent complication seen in patients with septic shock and is an independent risk factor for death. Although renal-replacement therapy (RRT) is standard care for patients with severe septic AKI, the optimal timing of RRT initiation remains controversial.Methods; The PubMed, Cochrane, and Embase databases were searched from their inception to June 2021 to identify the ideal timing of RRT initiation in patients with septic AKI by comparing 28- and 90-day mortality rates.Results; Among a total of six studies including 1,058 patients, the 28-day mortality rate was significantly lower in the early RRT-treated group compared to the late group [RR=0.69; 95% CI (0.51-0.94); P=0.018]. Moreover, among the five studies including 938 patients, the 90-day mortality rate was also significantly lower in the early RRT-treated group than the late group [RR=0.61; 95% CI (0.47-0.80); P=0.01]. In a subgroup analysis for continuous RRT (CRRT), we also found significantly lower 28- and 90-day mortality rates in the early CRRT-treated group compared to the late group.Conclusion; This study showed that early initiation of RRT might reduce 28- and 90-day mortality compared with late initiation in septic AKI patients.

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