Olfactory recovery following infection with COVID-19: A systematic review

Olfactory loss has been identified as one of the common symptoms related to COVID-19 infection. Although olfactory loss is recognized, our understanding of both the extent of loss and time to olfactory recovery following infection is less well known. Similarly, knowledge of potential impactful patient factors and therapies that influence olfactory recovery is desirable but is not overtly clear in the literature. Our systematic review sought to fill this knowledge gap. We included studies that: involved either an observational or an interventional design that reported data on patients with olfactory dysfunction due to Reverse Transcription Polymerase Chain Reaction (RT-PCR) diagnosed COVID-19 infection; and reported data regarding olfactory recovery measured by an objective olfactory test, Likert scale and/or visual analog scale (VAS). The study methods were determined a priori and registered in PROSPERO (Registration Number CRD42020204354). An information specialist searched Medline, Embase, LitCovid and the Cochrane Register of Controlled Trials up to March 2021, and two reviewers were involved in all aspects of study selection and data collection. After screening 2788 citations, a total of 44 studies of assorted observational designs were included. Patients had undergone objective COVID-19 testing, and most were adult patients with mild to moderate COVID-19. Olfactory recovery was found to occur as early as 7 days, with most patients recovering olfaction within 30 days. Few studies included prolonged follow-up to 6 months or longer duration. Poor olfaction at initial presentation was associated with poor recovery rates. Only a small number of studies assessed olfactory retraining and steroid therapy. Additional trials are underway.

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Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10081740 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1740

Author(s):

Marion Bareille ◽

Michaël Hardy ◽

Jonathan Douxfils ◽

Stéphanie Roullet ◽

Dominique Lasne ◽

...

Keyword(s):

Systematic Review ◽

Mechanical Strength ◽

Small Sample ◽

The Common ◽

Small Sample Sizes ◽

Definition Of ◽

Reported Data ◽

Prophylactic Anticoagulation ◽

The Impact ◽

Heparin Neutralization

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until December 31st, 2020. VET methods and parameters, and patients’ features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.

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A call to action for delirium research: Meta-analysis and regression of delirium associated mortality

BMC Geriatrics ◽

10.1186/s12877-020-01723-4 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

May Zin Aung Thein ◽

Jarett V. Pereira ◽

Anita Nitchingham ◽

Gideon A. Caplan

Keyword(s):

English Language ◽

Meta Analysis ◽

A Priori ◽

Group Analysis ◽

Hospital Setting ◽

Mortality Data ◽

Mixed Effect ◽

Elderly Inpatients ◽

Registration Number

Abstract Background Delirium is an extremely common hospital complication. No study to date has assessed whether a priori defined covariates; type of hospital setting and year of study publication, influence the relationship between delirium and mortality. This is also the first study to examine the longitudinal trend of delirium-associated mortality over recent decades, to analyse the trajectory of our efforts in combating this disease. Methods MEDLINE, EMBASE and PsycINFO, were searched from January 1981 to May 2018 for English-language primary articles. Rigorous title and abstract screen and full-text screen were conducted independently by two reviewers. This paper adhered to MOOSE guidelines. Data was extracted independently by one reviewer using standardised data-collection sheets, with a separate reviewer verifying for accuracy. The quality of included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Unadjusted effect sizes and event counts were analysed with a random effects model in primary meta-analysis and meta-regression, whereas a mixed effect model was used in secondary sub-group analysis. Mortality data at longest follow-up and cumulative mortality (hospital mortality combined with mortality at longest follow-up) data were analysed. Results As part of a larger project, 446 of 6790 articles were retrieved, including 71 studies that measured mortality. Our results demonstrate that elderly inpatients with delirium had significantly greater odds of mortality (OR 3.18 [95%CI: 2.73, 3.70]) compared to non-delirious controls. Patients with delirium in the ICU had the highest odds for mortality (OR: 7.09 [95%CI: 3.60, 14.0]); double the risk compared to the average. Curiously, despite advancements in delirium research, delirium associated in-hospital odds of mortality has not changed in 30 years. Conclusion This is the largest meta-analysis to confirm the association between delirium and mortality, in older (age ≥ 65) hospital inpatients. The current meta-analysis highlights the significant odds of mortality after an episode of delirium, and these odds are much higher for ICU patients. However, in contrast to other medical conditions that have seen a decrease in associated mortality over the past few decades, delirium associated mortality remains unchanged. These findings underscore the urgent need for better delirium treatments. PROSPERO Registration Number: CRD42018098627, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=98627

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Hospitalization at the end of life among nursing home residents with dementia: a systematic review

BMC Palliative Care ◽

10.1186/s12904-019-0462-1 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Falk Hoffmann ◽

Anke Strautmann ◽

Katharina Allers

Keyword(s):

Systematic Review ◽

Nursing Home ◽

End Of Life ◽

Age Groups ◽

Nursing Home Residents ◽

Hospital Death ◽

Registration Number ◽

Hospital Deaths ◽

Reported Data ◽

The Uk

Abstract Background Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. Methods A systematic literature search in MEDLINE, CINAHL and Scopus was conducted in May 2018. Studies were included if they reported proportions of in-hospital deaths or hospitalizations of NHR with dementia in the last month of life. Two authors independently selected studies, extracted data, and assessed quality of studies. Results Nine hundred forty-five citations were retrieved; 13 studies were included. Overall, 7 studies reported data on in-hospital death with proportions ranging between 0% in Canada and 53.3% in the UK. Studies reporting on the last 30 days of life (n = 8) varied between 8.0% in the Netherlands and 51.3% in Germany. Two studies each assessed the influence of age and sex. There seem to be fewer end-of-life hospitalizations in older age groups. The influence of sex is inconclusive. All but one study found that at the end of life residents with dementia were hospitalized less often than those without (n = 6). Conclusions We found large variations in end-of-life hospitalizations of NHR with dementia, probably being explained by differences between countries. The influence of sex and age might differ when compared to residents without dementia. More studies should compare NHR with dementia to those without and assess the influence of sex and age. Trial registration PROSPERO registration number CRD42018104263.

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Recurrent TB: a systematic review and meta-analysis of the incidence rates and the proportions of relapses and reinfections

Thorax ◽

10.1136/thoraxjnl-2020-215449 ◽

2021 ◽

pp. thoraxjnl-2020-215449

Author(s):

Victor Vega ◽

Sharon Rodríguez ◽

Patrick Van der Stuyft ◽

Carlos Seas ◽

Larissa Otero

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Treatment Success ◽

Drug Regimen ◽

Incidence Rates ◽

Recurrence Rates ◽

Tb Treatment ◽

Registration Number ◽

Study Characteristics

BackgroundA recurrent tuberculosis (TB) episode results from exogenous reinfection or relapse after cure. The use of genotyping allows the distinction between both.MethodsWe did a systematic review and meta-analysis, using four databases to search for studies in English, French and Spanish published between 1 January 1980 and 30 September 2020 that assessed recurrences after TB treatment success and/or differentiated relapses from reinfections using genotyping. We calculated person years of follow-up and performed random-effects model meta-analysis for estimating pooled recurrent TB incidence rates and proportions of relapses and reinfections. We performed subgroup analyses by clinical–epidemiological factors and by methodological study characteristics.FindingsThe pooled recurrent TB incidence rate was 2.26 per 100 person years at risk (95% CI 1.87 to 2.73; 145 studies). Heterogeneity was high (I2=98%). Stratified pooled recurrence rates increased from 1.47 (95% CI 0.87 to 2.46) to 4.10 (95% CI 2.67 to 6.28) per 100 person years for studies conducted in low versus high TB incidence settings. Background HIV prevalence, treatment drug regimen, sample size and duration of follow-up contributed too. The pooled proportion of relapses was 70% (95% CI 63% to 77%; I²=85%; 48 studies). Heterogeneity was determined by background TB incidence, as demonstrated by pooled proportions of 83% (95% CI 75% to 89%) versus 59% (95% CI 42% to 74%) relapse for studies from settings with low versus high TB incidence, respectively.InterpretationThe risk of recurrent TB is substantial and relapse is consistently the most frequent form of recurrence. Notwithstanding, with increasing background TB incidence the proportion of reinfections increases and the predominance of relapses among recurrences decreases.PROSPERO registration numberCRD42018077867

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Effect of treatments on skin microbiota in patients with atopic dermatitis: a protocol for systematic review

BMJ Open ◽

10.1136/bmjopen-2021-053488 ◽

2022 ◽

Vol 12 (1) ◽

pp. e053488

Author(s):

Yang Guo ◽

Xia Dou ◽

Xing-ling Jian ◽

Kao-yuan Zhang ◽

Ying-jie Zheng ◽

...

Keyword(s):

Systematic Review ◽

Atopic Dermatitis ◽

Data Extraction ◽

Risk Of Bias ◽

Microbial Interactions ◽

Skin Microbiota ◽

Clinical Trial Registry ◽

Bias Assessment ◽

Study Selection ◽

Registration Number

IntroductionAtopic dermatitis (AD) is a chronic inflammatory skin disease and skin microbiota dysbiosis shows an important role in the pathogenesis of AD. Effects of treatment on skin microbiota for patients with AD have been evaluated in recent years; however, the results remained controversial across studies. This systematic review will summarise studies evaluating the effect of treatments on skin microbiota among patients with AD.Methods and analysisWe will search PubMed, EMBASE, Web of Science, ClinicalTrials.gov and Chinese Clinical Trial Registry in November 2021; other data sources will also be considered, including searching specific authors and screening references cited in the enrolled articles. Interventional studies, which enrolled patients with AD receiving treatments and reported treatment-related skin microbiota changes, will be included. Our primary outcomes include skin microbiota diversity and treatment-related differential microbes; the secondary outcomes include microbiota functions and microbial interactions. Risk of bias assessment will be performed using Cochrane risk-of-bias tool for randomised trials, risk of bias in non-randomised studies of interventions and methodological index for non-randomised studies. Two researchers will independently perform study selection, data extraction and risk of bias assessment, with disagreements resolved by group discussions. Subgroup analyses will be performed according to different types of treatment for AD.Ethics and disseminationEthics approval is not required for this systematic review. Findings will be disseminated via peer-reviewed publication or conference proceedings.PROSPERO registration numberCRD42021246566.

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Is Dental Amalgam a Higher Risk Factor rather than Resin-Based Restorations for Systemic Conditions? A Systematic Review

Materials ◽

10.3390/ma14081980 ◽

2021 ◽

Vol 14 (8) ◽

pp. 1980

Author(s):

Gianni Gallusi ◽

Antonio Libonati ◽

Mario Piro ◽

Virginia Di Taranto ◽

Edoardo Montemurro ◽

...

Keyword(s):

Systematic Review ◽

Dental Amalgam ◽

Systemic Effects ◽

Systemic Diseases ◽

Manual Search ◽

Dental Restorations ◽

Study Selection ◽

Increased Risk ◽

Amalgam Restorations

Objective: The aim of this study was to confirm the hypothesis that patients with one or more amalgam restorations have an increased risk for systemic diseases rather than patients with resin-based restorations. Data: The data search produced an initial 3568 total number of records. All titles and abstract were reviewed by five independent examiners, and only 36 records were selected for full text in depth examination. Out of these, only nine publications matched the inclusion criteria and were included in this systematic review. Sources: Electronic databases (MEDLINE, Scopus, Embase, and Web of Knowledge) were searched up to June 2019. In addition, a manual search was carried out on journals related to this topic. Study selection: All selected human clinical studies compared patients with dental amalgam restorations to patients with non-amalgam restorations on restorative material related diseases/health conditions with at least 50 patients and a reasonable follow up. The systemic effects of dental restorations were analyzed. As for any systemic effects, there was no difference between amalgam and composite restoration. Conclusions: With the limitations of the few available randomized controlled trials (RCTs) on the matter, amalgam restorations, similarly to other modern resin-based materials, were not related to an increased risk of systemic diseases or conditions. Clinical significance: On the basis of the available RCTs, amalgam restorations, if compared with resin-based fillings, do not show an increased risk for systemic diseases. There is still insufficient evidence to exclude or demonstrate any direct influence on general health. The removal of old amalgam restorations and their substitution with more modern adhesive restorations should be performed only when clinically necessary and not just for material concerns. In order to better evaluate the safety of dental amalgam compared to other more modern restorative materials, further RCTs that consider important parameters such as long and uniform follow up periods, number of restorations per patient, and sample populations representative of chronic or degenerative diseases are needed.

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Prospective association between use of electronic cigarettes and use of conventional cigarettes - a systematic review and meta-analysis

ERJ Open Research ◽

10.1183/23120541.00976-2020 ◽

2021 ◽

pp. 00976-2020

Author(s):

Louise Adermark ◽

Maria Rosaria Galanti ◽

Charlotta Ryk ◽

Hans Gilljam ◽

Linnea Hedman

Keyword(s):

Systematic Review ◽

Cigarette Smoking ◽

Electronic Cigarettes ◽

Meta Analysis ◽

Cochrane Library ◽

Cigarette Use ◽

Study Selection ◽

Prospective Association ◽

Never Smokers

ObjectiveThe aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking.Data sourcesA systematic literature search was finalised November 11, 2019 using PubMed incl. Medline, EMBASE, Cochrane Library, Scopus, PubMed Health, NICE evidence search, PROSPERO, CRD, and PsycInfo.Study selectionStudies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and non-users of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE.Data synthesisThirty longitudinal studies from 22 different cohorts assessing e-cigarette use among non- or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline non-smokers e-cigarette users compared with non-users of 4.68 (CI 3.64–6.02), while the adjusted OR was 3.37 (CI 2.68–4.24). These results were consistent irrespective of whether the outcome was measured as ever smoking or as past 30-day smoking. The evidence was graded as moderate.ConclusionsUse of e-cigarettes may predict the initiation or recurrence of cigarette smoking.

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The prevalence, mortality, and associated risk factors for developing COVID-19 in hip fracture patients: a systematic review and meta-analysis

Bone and Joint Research ◽

10.1302/2046-3758.912.bjr-2020-0473.r1 ◽

2020 ◽

Vol 9 (12) ◽

pp. 873-883

Author(s):

Nicholas D. Clement ◽

Nathan Ng ◽

Cameron J. Simpson ◽

Robyn F. L. Patton ◽

Andrew James Hall ◽

...

Keyword(s):

Systematic Review ◽

Hip Fracture ◽

Mortality Rate ◽

Meta Analysis ◽

Crude Mortality Rate ◽

Crude Mortality ◽

Increased Risk ◽

Associated Risk Factors ◽

Reported Data

Aims The aims of this meta-analysis were to assess: 1) the prevalence of coronavirus disease 2019 (COVID-19) in hip fracture patients; 2) the associated mortality rate and risk associated with COVID-19; 3) the patient demographics associated with COVID-19; 4) time of diagnosis; and 5) length of follow-up after diagnosis of COVID-19. Methods Searches of PubMed, Medline, and Google Scholar were performed in October 2020 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Search terms included “hip”, “fracture”, and “COVID-19”. The criteria for inclusion were published clinical articles reporting the mortality rate associated with COVID-19 in hip fracture patients. In total, 53 articles were identified and following full text screening 28 articles satisfied the inclusion criteria. Results A total of 28 studies reported the mortality of COVID-19-positive patients, of which 21 studies reported the prevalence of COVID-19-positive patients and compared the mortality rate to COVID-19-negative patients. The prevalence of COVID-19 was 13% (95% confidence interval (CI) 11% to 16%) and was associated with a crude mortality rate of 35% (95% CI 32% to 39%), which was a significantly increased risk compared to those patients without COVID-19 (odds ratio (OR) 7.11, 95% CI 5.04 to 10.04; p < 0.001). COVID-19-positive patients were more likely to be male (OR 1.51, 95% CI 1.16 to 1.96; p = 0.002). The duration of follow-up was reported in 20 (71.4%) studies. A total of 17 studies reported whether a patient presented with COVID-19 (n = 108 patients, 35.1%) or developed COVID-19 following admission (n = 200, 64.9%), of which six studies reported a mean time to diagnosis of post-admission COVID-19 at 15 days (2 to 25). Conclusion The prevalence of COVID-19 was 13%, of which approximately one-third of patients were diagnosed on admission, and was associated with male sex. COVID-19-positive patients had a crude mortality rate of 35%, being seven times greater than those without COVID-19. Due to the heterogenicity of the reported data minimum reporting standards of outcomes associated with COVID-19 are suggested. Cite this article: Bone Joint Res 2020;9(12):873–883.

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Midterm Outcomes of Bone Marrow Stimulation for Primary Osteochondral Lesions of the Talus: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119879127 ◽

2019 ◽

Vol 7 (10) ◽

pp. 232596711987912 ◽

Cited By ~ 5

Author(s):

James Toale ◽

Yoshiharu Shimozono ◽

Conor Mulvin ◽

Jari Dahmen ◽

Gino M.M.J. Kerkhoffs ◽

...

Keyword(s):

Systematic Review ◽

Surface Damage ◽

Osteochondral Lesions ◽

Weighted Mean ◽

Bone Marrow Stimulation ◽

Repair Tissue ◽

Long Term Follow Up ◽

Reported Data

Background: Bone marrow stimulation (BMS) is a common surgical intervention in the treatment of small osteochondral lesions of the talus (OLTs). Evidence has shown good clinical outcomes after BMS in the short term, but several studies have shown less favorable results at midterm and long-term follow-up because of fibrocartilaginous repair tissue degeneration. Purpose: To evaluate the clinical and radiological outcomes of BMS in the treatment of primary OLTs at midterm and long-term follow-up and to investigate reported data in these studies. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical and radiological outcomes as well as reported data were evaluated. Results: A total of 15 studies comprising 853 patients (858 ankles) were included at a weighted mean follow-up time of 71.9 months. There were 9 studies that used the American Orthopaedic Foot & Ankle Society (AOFAS) score, with a weighted mean postoperative score of 89.9. There were 3 studies that measured postoperative magnetic resonance imaging results in the midterm using the MOCART (magnetic resonance observation of cartilage repair tissue) scoring system and showed 48% of patients with complete filling, 74% with complete integration, and 76% with surface damage. There was a complication rate of 3.4% and a reoperation rate of 6.0% after BMS in the midterm. Conclusion: This systematic review found good clinical outcomes after BMS at midterm follow-up for primary OLTs. Radiological outcomes showed repair tissue surface damage in the majority of patients, which may be a harbinger for long-term problems. Data were variable, and numerous data were underreported. Further high-quality studies, a validated outcome scoring system, and further radiological reports at midterm follow-up are required to accurately assess the success of BMS in the midterm.

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Effects of neurofeedback versus methylphenidate for the treatment of ADHD: systematic review and meta-analysis of head-to-head trials

Evidence-Based Mental Health ◽

10.1136/ebmental-2019-300088 ◽

2019 ◽

Vol 22 (3) ◽

pp. 111-117 ◽

Cited By ~ 3

Author(s):

Lixia Yan ◽

Siyuan Wang ◽

Yang Yuan ◽

Junhua Zhang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Comparative Efficacy ◽

Chinese Studies ◽

Registration Number ◽

Mean Differences ◽

Randomised Controlled ◽

Core Symptoms

BackgroundThe comparative efficacy and tolerability of methylphenidate (MPH) and neurofeedback (NF) in individuals with attention-deficit/hyperactivity disorder (ADHD) remains uncertain. This study aimed to fill this gap by means of a systematic review/meta-analysis.MethodsPubMed, OVID, ERIC, Web of Science, ClinialTrials.gov and a set of Chinese databases were searched until 22 August 2018. Standardised mean differences (SMD) were pooled using comprehensive meta-analysis software.Results18 randomised controlled trials (RCTs) were included (778 individuals with ADHD in the NF arm and 757 in the MPH group, respectively; 13 studies in Chinese, five in English). At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=−0.578, 95% CI (−1.063 to –0.092)) and on two neuropsychological parameters (inattention:−0.959 (-1.711 to –0.208); inhibition:−0.469 (-0.872 to –0.066)). Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913). Results were robust to sensitivity analyses, with two important exceptions: removing Chinese studies and non-funded studies, no differences emerged between MPH and NF, although the number of studies was small. At the study follow-up, MPH was superior to NF in some outcomes, but results were inconsistent across raters.ConclusionsDue to the risk of bias of included studies, the results of the sensitivity analysis excluding Chinese and non-funded studies, and the mixed findings on at the follow-up endpoint, further high quality studies are needed to assess the comparative efficacy and acceptability of NF and MPH in individuals with ADHD.Trial registration numberCRD42018090256.

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