Effectiveness of Pharmacological Pain Relief Methods on Birth Experience: A Systematic Review and Meta-Analysis

Background:: The use of pharmacological pain relief methods during labour is increasing, however there is no clear evidence that pharmacological interventions can also improve women’s satisfaction with birth experience. Objective:: To assess the effectiveness of pharmacological interventions on women's satisfaction with birth experience (primary outcome) and satisfaction with the received method (secondary outcome). Methods:: We searched databases in English (MEDLINE, Cochrane Library, Embase, ProQuest, Scopus and Web of Science) and Persian languages (SID and Magiran) from inception until April 30, 2018 for clinical trials that pharmacological pain relief methods were compared with standard or routine cares, or non-pharmacological methods. The evaluation of studies in term of risk of bias was conducted using the Cochrane Handbook. Meta-analysis results were reported as OR and 95% confidence interval. In meta-analysis, subgroup analysis was performed based on the type of intervention. Due to the heterogeneity of over 30%, random effect was reported instead of the fixed effect. The heterogeneity was evaluated using I2, T2 and Chi2. The evaluation of the quality of the studies was also examined using the Grading of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach. Results:: The results of 7 studies with low-quality in meta-analysis, showed that pharmacological methods significantly improved satisfaction with birth experience (OR = 2.99; 95% CI: 1.37 to 6.52; P = 0.006). However, meta-analysis of subgroups showed that only inhalation of Entonox gas (OR = 6.51; 95% CI: 3.47 to 12.22; P < 0.001), in contrast to epidural analgesia (OR = 1.19; 95% CI: 0.62 to 2.27; P = 0.60) and Hyoscine injection (OR = 2.58; 95% CI: 0.93 to 7.20; P = 0.07) significantly improved satisfaction with birth experience. Conclusion:: Pharmacological interventions such as epidural, although introduced as one of the effective methods for pain relief, may not provide women with satisfaction with birth. However, more studies with precise methodology, high sample size, and standard tools should be performed to more accurately investigate the effect of pharmacological interventions on birth experience.

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Novel oral anticoagulats for the treatment of left ventricle thrombosis: a systematic review and meta-analysis

EP Europace ◽

10.1093/europace/euab116.532 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

M Serenelli ◽

F Vitali ◽

R Pavasini ◽

E Tonet ◽

G Pompei ◽

...

Keyword(s):

Primary Outcome ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Left Ventricular ◽

Left Ventricular Thrombus ◽

Cochrane Library ◽

Secondary Outcome ◽

Ventricular Thrombus

Abstract Funding Acknowledgements Type of funding sources: None. Background novel oral anticoagulants (NOACs) are not guideline-recommanded treatment for left ventricular thrombus. Purpose: the aim of this meta-analysis is to compare NOACs versus vitamin-K atagonsits (VKAs) efficacy in treating left ventricular thrombus (LVT). Methods: we systematically searched MEDLINE, Cochrane Library, Biomed Central, and Web of Science for trials comparing NOACs versus VKAs in the setting of LVT. Five studies, out of the 74 initially selected after first screening, were included in the meta-analysis. For the development of this meta-analysis, the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. The shortlisted studies were retrieved as full articles and appraised independently by two unblinded reviewers. The Mantel-Haensel method with a random effect model was used for the pooled analysis. The primary outcome was the occurrence of stroke and systemic embolism. Secondary outcome was occurrence of left ventricular thrombosis resolution during treatment. Results: 707 patients were included in the analysis for the primary outcome. Of these, 230 were treated with NOACs and 477 with VKAs. The pooled OR for the primary outcome was 0.71 (95% CI 0.18-2.86, I2 67%), thus showing similar effect in term of ischaemic protection. A total of 698 patients, 228 on NOACs and 470 on VKAs were included in the analysis of the secondary outcome. The pooled OR for the secondary outcome pooled OR 0.97, 95% CI 0.56-1.68, I2 46%. Conclusions and Relevance: NOACs seem to have a similar efficacy profile compare to VKAs and so they should be considered as an alternative treatment for left ventricular thrombosis. Large prospective randomized clinical trials are needed to confirm this exploratory finding. Abstract Figure 1

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Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression

BMC Psychiatry ◽

10.1186/s12888-019-2302-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Xiaofen Wang ◽

Sixiang Cheng ◽

Huilan Xu

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Sleep Disorders ◽

Suicidal Behaviour ◽

Meta Analysis ◽

Cochrane Library ◽

Assessment Development ◽

Depressed Patients ◽

Completed Suicide

Abstract Background The potential link between sleep disorders and suicidal behaviour has been the subject of several reviews. We performed this meta-analysis to estimate the overall association between sleep disorders and suicidal behaviour and to identify a more specific relationship in patients with depression. Methods A systematic search strategy was developed across the electronic databases PubMed, EMBASE and the Cochrane Library from inception to January 1, 2019 for studies that reported a relationship between sleep disorders and suicidal behaviour in depressed patients. The odds ratio (OR) and corresponding 95% confidence interval (CI) were used to measure the outcomes. Heterogeneity was evaluated by Cochran’s Q test and the I2 statistic. The Newcastle-Ottawa Scale (NOS) was adopted to evaluate the methodological quality of each of the included studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of the evidence. We calculated the overall association between sleep disorders and suicidal behaviour and estimated more specific categories, including insomnia, nightmares, hypersomnia, suicidal ideation, suicide attempt, and completed suicide. Results A total of 18 studies were included in this study. Overall, sleep disorders were closely related to suicidal behaviour in patients with depression (OR = 2.45 95% CI: 1.33 4.52). The relatively increased risks of sleep disorders with suicidal ideation, suicide attempt and completed suicide ranged from 1.24 (95% CI: 1.00 1.53) to 2.41 (95% CI: 1.45 4.02). Nightmares were found to be highly correlated with the risk of suicidal behaviour (OR = 4.47 95% CI: 2.00 9.97), followed by insomnia (OR = 2.29 95% CI: 1.69 3.10). The certainty of the evidence was rated as very low for the overall outcome and the major depression subgroup and was rated as low for the depression subgroup. Conclusions This meta-analysis supports the finding that sleep disorders, particularly nightmares and insomnia, increase the risk of suicidal behaviour in depressed patients. Considering that all included studies were observational, the quality of the evidence is rated as very low. More well-designed studies are needed to confirm our findings and to better explain the mechanisms by which sleep disorders aggravate suicidal behaviour in depressed patients.

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Ziprasidone, haloperidol and clonazepam intramuscular administration in the treatment of agitation symptoms in Chinese patients with schizophrenia: A network meta-analysis

General Psychiatry ◽

10.1136/gpsych-2018-000016 ◽

2018 ◽

Vol 31 (2) ◽

pp. e000016

Author(s):

Liang Su ◽

Zheng Lu ◽

Shenxun Shi ◽

Yifeng Xu

Keyword(s):

Primary Outcome ◽

Meta Analysis ◽

Cochrane Review ◽

Acute Stage ◽

Chinese Patients ◽

Cochrane Library ◽

Assessment Development ◽

Excessive Sedation ◽

Made In

BackgroundAgitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.AimTo compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.MethodsSearches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation (GRADE) was used to assess the strength of evidence.ResultsA total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam (sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size (standardised mean difference (SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam (sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system (EPS) (z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG (z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘medium’.ConclusionOur results suggested that ziprasidone was more suitable than haloperidol and clonazepam in the treatment of agitation symptoms in Chinese patients with schizophrenia, according to the efficacy and acceptability of these three intramuscular injection medications.

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Acupuncture for post-stroke cognitive impairment: a systematic review and meta-analysis

Acupuncture in Medicine ◽

10.1177/09645284211009542 ◽

2021 ◽

pp. 096452842110095

Author(s):

Xu Kuang ◽

Wenjuan Fan ◽

Jiawei Hu ◽

Liqun Wu ◽

Wei Yi ◽

...

Keyword(s):

Cognitive Impairment ◽

Subgroup Analysis ◽

Meta Analysis ◽

Cochrane Library ◽

Qualitative Synthesis ◽

China National Knowledge Infrastructure ◽

Quality Of Evidence ◽

Post Stroke ◽

Assessment Development

Objectives: The aim of this study was to evaluate the effectiveness and safety of acupuncture for the treatment of post-stroke cognitive impairment (PSCI). Methods: The Cochrane Library, Embase, Medline, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical (VIP), Wanfang, and Chinese Biological Medicine (CBM) databases were electronically searched from their inception to 10 April 2019. The Montreal Cognitive Assessment (MoCA) scale and Mini-Mental State Examination (MMSE) scale were used as outcomes to assess effectiveness with respect to cognitive function. Assessment of risk of bias (ROB) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment were performed by two reviewers independently. Data were analyzed using Review Manager (RevMan) 5.3. Results: A total of 28 trials with 2144 participants were included in the qualitative synthesis and meta-analysis. Four of the 28 trials (14%) were assessed as being at overall low ROB, 24 of the 28 trials (86%) were assessed as having overall high ROB. The quality of evidence for both MoCA and MMSE were deemed to be very low by the GRADE criteria. Results indicated that acupuncture groups may be benefiting more than non-acupuncture groups with respect to variation of MoCA scores (merged mean difference (MMD): 2.66, 95% confidence interval (CI): 2.18 to 3.13, p < 0.00001; heterogeneity: χ2 = 35.52, p = 0.0007, I2 = 63%), and the heterogeneity decreased in both subgroup analysis and sensitivity analysis. In addition, acupuncture groups might be benefiting more than non-acupuncture groups in terms of changes in MMSE score (MMD = 2.97, 95% CI = 2.13 to 3.80, p < 0.00001; heterogeneity: χ2 = 269.75; p < 0.00001; I2 = 92%), and the heterogeneity decreased in subgroup analysis. Only one RCT addressed adverse events, and the symptoms were mild and did not affect treatment and evaluation. Conclusion: Acupuncture could be effective and safe for PSCI. Nevertheless, the results should be interpreted cautiously due to the high ROB of included trials and very low quality of evidence for assessed outcomes.

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Wrist-ankle acupuncture has a positive effect on cancer pain: a meta-analysis

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03193-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bei Dong ◽

Lu Lin ◽

Qiuyun Chen ◽

Yishu Qi ◽

Fen Wang ◽

...

Keyword(s):

Pain Relief ◽

Cancer Pain ◽

Meta Analysis ◽

Cochrane Library ◽

Secondary Outcome ◽

Pharmacological Intervention ◽

Control Group ◽

Drug Intervention ◽

Relief Rate ◽

Better Than

Abstract Background Wrist-ankle acupuncture (WAA) as a kind of micro acupuncture therapy has been used to management cancer pain, however, the effects of WAA on cancer pain were controversial in the current studies. Therefore, the purpose of this meta-analysis was to critically evaluate the effect of wrist-ankle acupuncture (WAA) on cancer pain. Methods Seven digital databases were searched from the inception of databases to July 2020, including CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed and Embase. Randomized controlled trials conforming to the inclusion and exclusion criteria were screened and extracted; the risk of bias was evaluated using the Cochrane Collaboration criteria. The primary outcome indicators included pain relief rate and pain score, and the secondary outcome was adverse reaction incidence. All analyses were performed with Review Manager 5.3. Results A total of 13 studies with 1005 cancer patients (intervention group: 568, control group: 437) were included in this meta-analysis. The results demonstrated that the pain relief rate of experimental group (WAA / WAA + drug intervention) was better than that of control group (analgesic drug intervention), and the difference was statistically significant [RR = 1.31, 95%CI: 1.15 ~ 1.49, P < 0.01]. Conclusions WAA has certain effect on cancer pain, and the effect of WAA combined with pharmacological intervention is better than that of drug therapy alone.

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Comparative Effectiveness and Safety of 32 Pharmacological Interventions Recommended by Guidelines for COVID-19: A Systematic Review and Network Meta-Analysis Combining 66 Trials

10.21203/rs.3.rs-104497/v1 ◽

2020 ◽

Author(s):

Shanshan Wu ◽

Qingxin Zhou ◽

Xueyang Zeng ◽

Jingxue Zhang ◽

Zhirong Yang ◽

...

Keyword(s):

Standard Care ◽

Meta Analysis ◽

Antiviral Agents ◽

Current Evidence ◽

Cochrane Library ◽

Cure Rate ◽

Pharmacological Interventions ◽

Assessment Development ◽

Risk Of Mortality ◽

Increased Risk

Abstract Background: To evaluate comparative efficacy and safety of pharmacological interventions in patients with coronavirus disease 2019. Methods: Medline, Embase, the Cochrane Library and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with SARS-COV-2/SARS-COV. Random-effects network meta-analysis within Bayesian framework was performed, followed by Grading of Recommendations Assessment, Development and Evaluation (GRADE) system assessing quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion (VNC) and overall adverse events (OAE). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.Results: 66 RCTs with 19,095 patients were included, involving standard care (SOC), 8 different antiviral agents, 6 different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids and other treatments. Compared with SOC, significant reduction of mortality was observed for TCM (OR=0.34, 95%CI: 0.20-0.56, moderate quality) and corticosteroids (OR=0.84, 0.75-0.96, low quality) with improved cure rate (OR=2.16, 1.60-2.91, low quality for TCM; OR=1.17, 1.05-1.30, low quality for corticosteroids). However, increased risk of mortality was found for CQ_HD versus SOC (OR=3.20, 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR=0.52, 0.38-0.70, very low quality) but CQ_HD (OR=2.51, 1.20-5.24) and IFN (OR=2.69, 1.02-7.08) versus SOC with very low quality) were associated with an increased risk. Conclusions: Corticosteroids and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low quality and further high-quality trials are needed.

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Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

Frontiers in Immunology ◽

10.3389/fimmu.2021.709155 ◽

2021 ◽

Vol 12 ◽

Author(s):

Huoyan Liang ◽

Heng Song ◽

Ruiqing Zhai ◽

Gaofei Song ◽

Hongyi Li ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Evaluation Methodology ◽

Cochrane Library ◽

Assessment Development ◽

Short Time ◽

Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

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Effect of garlic (Allium sativum) extract on salivary streptococcus mutans: a systematic review and meta-analysis

Pharmaceutical Sciences ◽

10.34172/ps.2021.37 ◽

2021 ◽

Author(s):

Mostafa Torbati ◽

Parya Emamverdizadeh ◽

Mohammadalili Torbati ◽

Mahsa Maghalian ◽

Mojgan Mirghafourvand

Keyword(s):

Systematic Review ◽

Streptococcus Mutans ◽

Allium Sativum ◽

Meta Analysis ◽

Garlic Extract ◽

Cochrane Library ◽

Secondary Outcome ◽

Control Group ◽

Dental Diseases

Background: Oral and dental diseases are among the common health conditions which can have different effects on the individuals’ health and quality of life. The objective of this study was to examine the effect of garlic (Allium sativum) extract on saliva Streptococcus mutans (primary outcome) and its side effects (secondary outcome). Methods: In the present systematic review and meta-analysis, English and Persian databases (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, SID, and Magiran) were systematically searched until February 25, 2021. The quality of the included studies was examined using Cochrane handbook, and the meta-analysis was carried out using RevMan 5.3. Heterogeneity of the studies was analyzed by index I2. Moreover, the quality of the evidence was assessed through GRADE approach. Results: A total of 93 studies were found on the databases; 89 articles were screened by title and abstract review and were removed as 19 studies were repetitive and 70 studies were unrelated to the subject under study. Ultimately, 4 articles with a sample size of 171 participants were included in this study, and two of the four studies were meta-analyzed. In all the 4 studies, garlic extract was effective in reducing the number of saliva Streptococcus mutans colonies compared to the control group. The results of the meta-analysis showed that using garlic extract mouthwash significantly decreased the average number of saliva Streptococcus mutans colonies (Mean Difference: -3.32; 95%CI: -4.39 to -2.26; P<0.00001). Conclusion: Although this review study indicated the significant effect of garlic extract in reducing saliva Streptococcus mutans, the evidence is not sufficient enough to recommend garlic extract to fight saliva Streptococcus mutans, and more clinical trials with stronger designs and larger sample sizes are needed.

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Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-040129 ◽

2020 ◽

Vol 10 (10) ◽

pp. e040129 ◽

Cited By ~ 3

Author(s):

Biruk Beletew Abate ◽

Ayelign Mengesha Kassie ◽

Mesfin Wudu Kassaw ◽

Teshome Gebremeskel Aragie ◽

Setamlak Adane Masresha

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Sex Difference ◽

Meta Analysis ◽

Random Effect ◽

Sensitivity Analyses ◽

Cochrane Library ◽

Secondary Outcome ◽

Men And Women ◽

High Prevalence

ObjectiveTo assess the sex difference in the prevalence of COVID-19 confirmed cases.DesignSystematic review and meta-analysis.SettingPubMed, Cochrane Library and Google Scholar were searched for related information. The authors developed a data extraction form on an Excel sheet and the following data from eligible studies were extracted: author, country, sample size, number of female patients and number of male patients. Using STATA V.14 for analysis, the authors pooled the overall prevalence of men and/or women using a random-effect meta-analysis model. The authors examined the heterogeneity in effect size using Q statistics and I2 statistics. Subgroup and sensitivity analyses were performed. Publication bias was also checked.ParticipantsStudies on COVID-19 confirmed cases were included.InterventionSex (male/female) of COVID-19 confirmed cases was considered.Primary and secondary outcome measuresThe primary outcome was prevalence of COVID-19 among men and women.ResultsA total of 57 studies with 221 195 participants were used in the analysis. The pooled prevalence of COVID-19 among men was found to be 55.00 (51.43–56.58, I2=99.5%, p<0.001). Sensitivity analysis showed the findings were not dependent on a single study. Moreover, a funnel plot showed symmetrical distribution. Egger’s regression test p value was not significant, which indicates absence of publication bias in both outcomes.ConclusionsThe prevalence of symptomatic COVID-19 was found to be higher in men than in women. The high prevalence of smoking and alcohol consumption contributed to the high prevalence of COVID-19 among men. Additional studies on the discrepancies in severity and mortality rate due to COVID-19 among men and women and the associated factors are recommended.

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Serial interval and incubation period of COVID-19: a systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-021-05950-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Muluneh Alene ◽

Leltework Yismaw ◽

Moges Agazhe Assemie ◽

Daniel Bekele Ketema ◽

Wodaje Gietaneh ◽

...

Keyword(s):

Systematic Review ◽

Incubation Period ◽

Meta Analysis ◽

Random Effect ◽

Public Health Intervention ◽

Cochrane Library ◽

Cross Sectional ◽

Serial Interval ◽

The Mean

Abstract Background Understanding the epidemiological parameters that determine the transmission dynamics of COVID-19 is essential for public health intervention. Globally, a number of studies were conducted to estimate the average serial interval and incubation period of COVID-19. Combining findings of existing studies that estimate the average serial interval and incubation period of COVID-19 significantly improves the quality of evidence. Hence, this study aimed to determine the overall average serial interval and incubation period of COVID-19. Methods We followed the PRISMA checklist to present this study. A comprehensive search strategy was carried out from international electronic databases (Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library) by two experienced reviewers (MAA and DBK) authors between the 1st of June and the 31st of July 2020. All observational studies either reporting the serial interval or incubation period in persons diagnosed with COVID-19 were included in this study. Heterogeneity across studies was assessed using the I2 and Higgins test. The NOS adapted for cross-sectional studies was used to evaluate the quality of studies. A random effect Meta-analysis was employed to determine the pooled estimate with 95% (CI). Microsoft Excel was used for data extraction and R software was used for analysis. Results We combined a total of 23 studies to estimate the overall mean serial interval of COVID-19. The mean serial interval of COVID-19 ranged from 4. 2 to 7.5 days. Our meta-analysis showed that the weighted pooled mean serial interval of COVID-19 was 5.2 (95%CI: 4.9–5.5) days. Additionally, to pool the mean incubation period of COVID-19, we included 14 articles. The mean incubation period of COVID-19 also ranged from 4.8 to 9 days. Accordingly, the weighted pooled mean incubation period of COVID-19 was 6.5 (95%CI: 5.9–7.1) days. Conclusions This systematic review and meta-analysis showed that the weighted pooled mean serial interval and incubation period of COVID-19 were 5.2, and 6.5 days, respectively. In this study, the average serial interval of COVID-19 is shorter than the average incubation period, which suggests that substantial numbers of COVID-19 cases will be attributed to presymptomatic transmission.

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