Effect of Vitamin C supplements on respiratory tract infections: A systematic review and meta-analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Tahmina Afrose Keya ◽  
Anthony Leela ◽  
Kevin Fernandez ◽  
Nasrin Habib ◽  
Mumunur Rashid
Keyword(s):  
Vitamin C ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Respiratory Illness ◽  
Inclusion Criteria ◽  
Vitamin C Supplementation ◽  
Respiratory Tract Illness ◽  
Meta Analyses ◽  
Tract Infections

Background: Respiratory tract infections are a primary cause of illness and mortality over the world. Objective: This study was aimed to investigate the effectiveness of vitamin C supplementation in preventing and treating respiratory tract infections. Methods: We used the Cochrane, PubMed, and MEDLINE Ovid databases to conduct our search. The inclusion criteria were placebo-controlled trials. Random effects meta-analyses were performed to measure the pooled effects of vitamin C supplementation on the incidence, severity, and duration of respiratory illness. Results: found ten studies that met our inclusion criteria out of a total of 2758.The pooled risk ratio (RR) of developing respiratory illness when taking vitamin C regularly across the study period was 0⸳94 (with a 95% confidence interval of 0⸳87 to 1⸳01) which found that supplementing with vitamin C lowers the occurrence of illness. This effect, however, was statistically insignificant (P= 0⸳09). This study showed that vitamin C supplementation had no consistent effect on the severity of respiratory illness (SMD 0⸳14, 95% CI -0⸳02 to 0⸳30: I2 = 22%, P=0⸳09). However, our study revealed that vitamin C group had a considerably shorter duration of respiratory infection (SMD -0⸳36, 95% CI -0⸳62 to -0⸳09, P = 0⸳01). Conclusion: Benefits of normal vitamin C supplementation for reducing the duration of respiratory tract illness were supported by our meta-analysis findings. Since few trials have examined the effects of therapeutic supplementation, further research is needed in this area.

Home environmental interventions for prevention of respiratory tract infections: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kok Pim Kua ◽  
Dr. Shaun Wen Huey Lee
Keyword(s):  
Systematic Review ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Severe Pneumonia ◽  
Environmental Interventions ◽  
Home Heating ◽  
Meta Analyses ◽  
Tract Infections

Abstract Objectives Poor housing conditions have been associated with increased risks of respiratory infections. This review aims to determine whether modifying the physical environment of the home has benefits in reducing respiratory infections. Content We performed a systematic review and meta-analysis of the effectiveness of home environmental interventions for preventing respiratory tract infections. Ten electronic databases were searched to identify randomized controlled trials published from inception to July 31, 2020. Random-effects meta-analyses were used to assess the study outcomes. Our search identified 14 eligible studies across 12 countries, which comprised 87,428 households in total. The type of interventions on home environment included kitchen appliance and design, water supply and sanitation, house insulation, and home heating. Meta-analysis indicated a potential benefit of home environmental interventions in preventing overall respiratory tract infections (Absolute RR=0.89, 95% CI=0.78–1.01, p=0.07; Pooled adjusted RR=0.72, 95% CI=0.63–0.84, p<0.0001). Subgroup analyses depicted that home environmental interventions had no significant impact on lower respiratory tract infections, pneumonia, and severe pneumonia. A protective effect against respiratory infections was observed in high income country setting (RR=0.82, 95% CI=0.78–0.87, p<0.00001). Summary and outlook Home environmental interventions have the potential to reduce morbidity of respiratory tract infections. The lack of significant impact from stand-alone housing interventions suggests that multicomponent interventions should be implemented in tandem with high-quality health systems.

scholarly journals Effect of probiotic fermented dairy products on incidence of respiratory tract infections: a systematic review and meta-analysis of randomized clinical trials

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kamil Rashidi ◽  
Bahman Razi ◽  
Mina Darand ◽  
Azadeh Dehghani ◽  
Parisa Janmohammadi ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Protective Effect ◽  
Dairy Products ◽  
Respiratory Tract Infections ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Total Sample ◽  
Fermented Dairy Products ◽  
Tract Infections ◽  
Fermented Dairy

Abstract Background Previous studies have suggested that the consumption of probiotic fermented dairy products (PFDP) may have a protective effect on respiratory tract infections (RTIs). However, the results of studies are inconclusive. We aimed to systematically investigate the effect of PFDP on RTIs by performing a meta-analysis of randomized controlled trials (RCTs). Methods PubMed and Scopus databases were systematically searched up to October 2020 to identify eligible RCTs. Meta-analysis outcomes were risk of incidence of upper (URTIs ) and lower (LRTIs ) respiratory tract infections. A random-effects model was used to pool the relative risks (RR) and corresponding 95 % confidence intervals (CI) for outcomes following conception of PFDP. Results A total of 22 RCTs, with a total sample size of 10,190 participants, were included in this meta-analysis. Compared with placebo, consumption of PFDP had a significant protective effect against RTIs in the overall analysis (RR = 0.81, 95 %CI: 0.74 to 0.89) and in children (RR = 0.82, 95 %CI: 0.73 to 0.93), adults (RR = 0.81, 95 %CI: 0.66 to 1.00), and elderly population (RR = 0.78, 95 %CI: 0.61 to 0.98). The significant decreased risk of RTIs was also observed for URTIs (RR = 0.83, 95 %CI: 0.73 to 0.93), while, this effect was marginal for LRTIs (RR = 0.78, 95 %CI: 0.60 to 1.01, P = 0.06). The disease-specific analysis showed that PFDP have a protective effect on pneumonia (RR = 0.76, 95 %CI: 0.61 to 0.95) and common cold (RR = 0.68, 95 %CI: 0.49 to 0.96). Conclusions Consumption of PFDP is a potential dietary approach for the prevention of RTIs.

scholarly journals Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Milena Bergmann ◽  
Jörg Haasenritter ◽  
Dominik Beidatsch ◽  
Sonja Schwarm ◽  
Kaja Hörner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Respiratory Tract ◽  
Chronic Cough ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Current Guideline ◽  
Acute Cough ◽  
Reason For Encounter ◽  
Tract Infections

Abstract Background Cough is a relevant reason for encounter in primary care. For evidence-based decision making, general practitioners need setting-specific knowledge about prevalences, pre-test probabilities, and prognosis. Accordingly, we performed a systematic review of symptom-evaluating studies evaluating cough as reason for encounter in primary care. Methods We conducted a search in MEDLINE and EMBASE. Eligibility criteria and methodological quality were assessed independently by two reviewers. We extracted data on prevalence, aetiologies and prognosis, and estimated the variation across studies. If justifiable in terms of heterogeneity, we performed a meta-analysis. Results We identified 21 eligible studies on prevalence, 12 on aetiology, and four on prognosis. Prevalence/incidence estimates were 3.8–4.2%/12.5% (Western primary care) and 10.3–13.8%/6.3–6.5% in Africa, Asia and South America. In Western countries the underlying diagnoses for acute cough or cough of all durations were respiratory tract infections (73–91.9%), influenza (6–15.2%), asthma (3.2–15%), laryngitis/tracheitis (3.6–9%), pneumonia (4.0–4.2%), COPD (0.5–3.3%), heart failure (0.3%), and suspected malignancy (0.2–1.8%). Median time for recovery was 9 to 11 days. Complete recovery was reported by 40.2- 67% of patients after two weeks, and by 79% after four weeks. About 21.1–35% of patients re-consulted; 0–1.3% of acute cough patients were hospitalized, none died. Evidence is missing concerning subacute and chronic cough. Conclusion Prevalences and incidences of cough are high and show regional variation. Acute cough, mainly caused by respiratory tract infections, is usually self-limiting (supporting a “wait-and-see” strategy). We have no setting-specific evidence to support current guideline recommendations concerning subacute or chronic cough in Western primary care. Our study presents epidemiological data under non non-pandemic conditions. It will be interesting to compare these data to future research results of the post-pandemic era.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

scholarly journals Evaluation of the prevalence and seasonality of human parainfluenza virus over five year period in pediatric patients

2021 ◽  
Vol 8 (4) ◽  
pp. 260-265
Author(s):  
Meryem Colak ◽  
Selin Yigit ◽  
Anil Tapisiz ◽  
Hager Muftah ◽  
Kenan Yuce ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Pediatric Patients ◽  
Age Groups ◽  
Treatment Decision ◽  
Respiratory Illness ◽  
Common Type ◽  
Clinical Samples ◽  
Syncytial Virus ◽  
Tract Infections

Objective: Human Parainfluenza viruses (HPIVs) cause respiratory tract infections, and the second most common cause of acute respiratory illness-related hospitalizations after the respiratory syncytial virus in children <5 years of age. The aim of the study; determination of HPIVs positivity and common types in pediatric patients with respiratory tract infection; investigation the distribution of HPIV positivity by age groups, months and seasons, respectively. Material and Method: HPIV results of 1613 pediatric patients who were sent to the molecular virology laboratory from various pediatric clinics of Gazi Hospital between March 2016 and February 2021 (five years period) were investigated. Nucleic acid isolation was performed on the EZ1 Advanced (Qiagen, Germany) device using the EZ1 Virus Mini Kit by the manufacturer's protocol. Results: HPIV positivity was detected as 4.1% in clinical samples and, the most common HPIV type was found to be HPIV-3 (55%). The distribution of other HPIV types were; HPIV-2, HPIV-4 and HPIV-1 with 26%, 23% and 14%, respectively. HPIV-3 is the most common type in 2016, 2017, 2018 and 2019; however, HPIV-1 is the most common type in 2020. HPIVs co-infection was detected with other respiratory tract viruses in 51% of samples. The highest HPIV co-infection was detected in Rhinovirus. The highest HPIV positivity rate (45%) were determined in the 0-2 age group compared to other age groups (p<0.05). The highest positivity rate was in October in the autumn season (p<0.05), the lowest was in January and February in winter. The highest rate (8.1%) of HPIV positivity was found in 2016 and the lowest rate (0.7%) was in 2020. Conclusions: Since it is not possible to diagnose viral etiology of respiratory tract infections based on clinical findings, viral respiratory tract panel and Multiplex real-time PCR test are a fast and useful method in early diagnosis, treatment decision and prevention of unnecessary antibiotic use. HPIVs positivity is seen at higher rates in children aged 0-2 and in autumn months with seasonal differences.

scholarly journals Respiratory tract infections and gut microbiome modifications: A systematic review

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262057
Author(s):  
Claire A. Woodall ◽  
Luke J. McGeoch ◽  
Alastair D. Hay ◽  
Ashley Hammond
Keyword(s):  
Systematic Review ◽  
Respiratory Tract ◽  
Cohort Studies ◽  
Gut Microbiome ◽  
Respiratory Tract Infections ◽  
Respiratory Health ◽  
Meta Analysis ◽  
Bacterial Pathogen ◽  
Healthy Controls ◽  
Tract Infections

Respiratory tract infections (RTIs) are extremely common and can cause gastrointestinal tract symptoms and changes to the gut microbiota, yet these effects are poorly understood. We conducted a systematic review to evaluate the reported evidence of gut microbiome alterations in patients with a RTI compared to healthy controls (PROSPERO: CRD42019138853). We systematically searched Medline, Embase, Web of Science, Cochrane and the Clinical Trial Database for studies published between January 2015 and June 2021. Studies were eligible for inclusion if they were human cohorts describing the gut microbiome in patients with an RTI compared to healthy controls and the infection was caused by a viral or bacterial pathogen. Dual data screening and extraction with narrative synthesis was performed. We identified 1,593 articles and assessed 11 full texts for inclusion. Included studies (some nested) reported gut microbiome changes in the context of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (n = 5), influenza (H1N1 and H7N9) (n = 2), Tuberculosis (TB) (n = 4), Community-Acquired Pneumonia CAP (n = 2) and recurrent RTIs (rRTI) (n = 1) infections. We found studies of patients with an RTI compared to controls reported a decrease in gut microbiome diversity (Shannon) of 1.45 units (95% CI, 0.15–2.50 [p, <0.0001]) and a lower abundance of taxa (p, 0.0086). Meta-analysis of the Shannon value showed considerable heterogeneity between studies (I2, 94.42). Unbiased analysis displayed as a funnel plot revealed a depletion of Lachnospiraceae, Ruminococcaceae and Ruminococcus and enrichment of Enterococcus. There was an important absence in the lack of cohort studies reporting gut microbiome changes and high heterogeneity between studies may be explained by variations in microbiome methods and confounder effects. Further human cohort studies are needed to understand RTI-induced gut microbiome changes to better understand interplay between microbes and respiratory health.

scholarly journals Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: Systematic Review and Meta-Analysis of Randomised Controlled Trials

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 610
Author(s):  
Nahara Anani Martínez-González ◽  
Ellen Keizer ◽  
Andreas Plate ◽  
Samuel Coenen ◽  
Fabio Valeri ◽  
...  
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Usual Care ◽  
Respiratory Tract Infections ◽  
Point Of Care ◽  
Antibiotic Prescribing ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Meta Analyses ◽  
Tract Infections

C-reactive protein (CRP) point-of-care testing (POCT) is increasingly being promoted to reduce diagnostic uncertainty and enhance antibiotic stewardship. In primary care, respiratory tract infections (RTIs) are the most common reason for inappropriate antibiotic prescribing, which is a major driver for antibiotic resistance. We systematically reviewed the available evidence on the impact of CRP-POCT on antibiotic prescribing for RTIs in primary care. Thirteen moderate to high-quality studies comprising 9844 participants met our inclusion criteria. Meta-analyses showed that CRP-POCT significantly reduced immediate antibiotic prescribing at the index consultation compared with usual care (RR 0.79, 95%CI 0.70 to 0.90, p = 0.0003, I2 = 76%) but not during 28-day (n = 7) follow-up. The immediate effect was sustained at 12 months (n = 1). In children, CRP-POCT reduced antibiotic prescribing when CRP (cut-off) guidance was provided (n = 2). Meta-analyses showed significantly higher rates of re-consultation within 30 days (n = 8, 1 significant). Clinical recovery, resolution of symptoms, and hospital admissions were not significantly different between CRP-POCT and usual care. CRP-POCT can reduce immediate antibiotic prescribing for RTIs in primary care (number needed to (NNT) for benefit = 8) at the expense of increased re-consultations (NNT for harm = 27). The increase in re-consultations and longer-term effects of CRP-POCT need further evaluation. Overall, the benefits of CRP-POCT outweigh the potential harms (NNTnet = 11).

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