scholarly journals Lopinavir/Ritonavir in the Treatment of COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (5) ◽  
pp. 19-25
Author(s):  
Yan Du ◽  
Tongtong Wang ◽  
Bo Li ◽  
Fang Pang ◽  
Xuanguo Zhang ◽  
...  

Objective: To systematically evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) in the treatment of COVID-19. Methods: PubMed, Embase, Ovid, CNKI, CBM, Wanfang, and VIP databases were searched to obtain the clinical studies of LPV/r in the treatment of COVID-19 from December 2019 to July 2020. The literatures were screened according to the inclusion and exclusion criteria. Their qualities were evaluated according to the Newcastle-Ottawa Scale (NOS) and RevMan 5.3 software was used for meta-analysis. Results: A total of 688 patients were included in five studies, involving China and France. Compared with patients in the control group, who was only treated with routine treatment, there were no significant differences of the 7-day nucleic acid negative conversion rate and 14-day nucleic acid negative conversion rate in the treatment group. However, the use of LPV/r increased the incidence of adverse reactions in the treatment group compared to the control group. Conclusion: There is no available evidence to support the use of Lopinavir/ritonavir in the treatment of COVID-19.

Author(s):  
Ruyi Cai ◽  
Jinshi Zhang ◽  
Yifan Zhu ◽  
Lin Liu ◽  
Yueming Liu ◽  
...  

AbstractAt the beginning of 2020, the outbreak of coronavirus disease 2019 (COVID-19) led to a worldwide pandemic and mass panic. The number of infected people has been increasing exponentially since, and the mortality rate has also been concomitantly increasing. At present, no study has summarized the mortality risk of COVID-19 in patients with chronic kidney disease (CKD). Therefore, the aim of the present study was to conduct a literature review and meta-analysis to understand the frequency of mortality among CKD patients infected with COVID-19. A comprehensive systematic search was conducted on the PubMed, Embase, and Cochrane databases to find articles published until May 15, 2020. Study quality was assessed using a modified version of the Newcastle–Ottawa Scale. After careful screening based on the inclusion and exclusion criteria, 3,867,367 patients from 12 studies were included. The mortality rate was significantly higher among CKD patients with COVID-19 infection than among CKD patients without COVID-19 infection, as indicated by a pooled OR of 5.81 (95% CI 3.78–8.94, P < 0.00001, I2 = 30%). The patients were then stratified into ≥ 70 and < 70 years, and subgroup analysis revealed that among CKD patients with COVID-19 infection, the mortality rate was higher in the < 70 years group (OR 8.69, 95% CI 7.56–9.97, P < 0.0001) than in the ≥ 70 years group (OR 2.44, 95% CI 0.75–6.63, P = 0.15). Thus, COVID-19 patients with CKD have a high mortality risk and require a comprehensive multidisciplinary management strategy.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1450-1450 ◽  
Author(s):  
Zhuanzhen Zheng ◽  
Zhang Yuna ◽  
Zhang Huimin ◽  
Qingchi Liu ◽  
Yanping Ma ◽  
...  

Abstract Objective To evaluate the clinical efficacy and safety of allogenic dendritic cells (DCs) and cytokine-induced killer (CIK) cells in the eliminating minimal residual leukemia (MRL). Methods 48 acute leukemia patients with hematological complete remission (CR) but without molecular biological remission (CRM), or patients with minimal residual Leukemia (MRL) were selected from Ping’an Hospital of Shijiazhuang during Jan. 2009 to Jun. 2011. According to the patients’ will, 48 patients divided into combined treatment group and chemotherapy group 24 each. All the patients were in the same general information and disease level. The combined treatment group was treated with DC-CIK and consolidation chemotherapy, and the chemotherapy group was treated with consolidation chemotherapy. PBMCs were collected from healthy donors (the patient's parents or children) to prepare DC-CIK cells. DC-CIK cells were intravenous injected into patients once every 15 days, a total of 4-6 times infusion. The blood routine, bone marrow cells, leukemia related genes, urine and stool routine, liver and kidney biochemistry function, and ECG were observed. Changes of peripheral lymphocyte subsets in patients were detected by flow cytometry. Adverse reactions were examined. Results (1)Eleven cases in the combined treatment group achieved CRM, and the CRM rate was 45.8%; whereas only 2 cases in the chemotherapy group achieved CRM and the CRM rate was 8.3%,the difference was statistically significant(χ2=8.55, P<0.01).(2) Compared with the chemotherapy group, the CFIM (four-color combination flow cytometric immunophenotype of minimal residual leukemia) negative conversion rate of patients in the combined treatment group was significantly raised (66.7% vs 25.0%,χ2=8.39, P<0.01). (3)The negative conversion rate of MRL was higher in the combined treatment group than the chemotherapy group (66.7% vs25.0%, χ2=8.39, P<0.01). (4) After treatment the ratio of CD4+/CD8+ cells was significant increased than before treatment in the combined treatment group (1.3±0.4 vs 0.8±0.4, P<0.05). (5)The complete remission rate (CCR) of patients in the combined treatment group after 3 years was 79.2%, while that in the chemotherapy group was 45.8% (χ2=5.69, P<0.05).(6)No dysfunction of critical organs such as heart, liver and kidney and serious adverse reactions were observed while DC-CIK cells infusion. Conclusion DC-CIK combined with chemotherapy can inhibit leukemia gene, promote the negative conversion rate of CFIM, facilitate the clear of MRL, improve immune function and prolong remission of the patients.No serious adverse reactions were found in patients with DC-CIK infusion. Disclosures: No relevant conflicts of interest to declare.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Minghui Xiao ◽  
Jie Liu ◽  
Jianping Hui

Objective: To analyze the effect of pantoprazole and omeprazole in the treatment of patients with gastric ulcer. Methods: The treatment effect, recurrence rate, helicobacter pylori negative conversion rate, adverse reaction status and pain relief time of the two groups were compared. Results: The total effective rate of the experimental group (97.78%, 44 / 45) was higher than that of the control group (84.44%, 38 / 45), P < 0.05;The recurrence rate (4.44%, 2 / 45) and Helicobacter pylori negative conversion rate (95.56%, 43 / 45) of the experimental group were significantly higher than those of the control group (P < 0.05); The incidence of adverse reactions in the experimental group (11.11%, 5 / 45) was lower than that in the control group (15.56%, 7 / 45) (P > 0.05);The pain relief time of the experimental group was (2.24 ± 1.16) d, which was shorter than that of the control group (P < 0.05). Conclusion: In the process of clinical treatment of gastric ulcer, pantoprazole has significant curative effect and low recurrence rate, which can eradicate Helicobacter pylori as soon as possible, shorten the pain time and make the treatment safer.


2021 ◽  
Author(s):  
Yazmin Hernández-Díaz ◽  
Thelma Beatriz González-Castro ◽  
Carlos Tovilla-Zarate ◽  
María Lilia López-Narváez ◽  
Alma Delia Genis-Mendoza ◽  
...  

Abstract Schizophrenia is a mental and disabling disease. Levels of oxytocin have been proposed as a biomarker of schizophrenia; however, the observed levels of oxytocin in individuals with schizophrenia have been inconsistent across studies. We performed a meta-analysis to evaluate oxytocin levels in plasma, serum and cerebrospinal fluid to see if there are statistically different concentrations between individuals with schizophrenia and the comparison group.The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to guarantee a high quality and reproducibility.Following the inclusion and exclusion criteria, 14 studies were included in the meta-analysis. The quality of the study was evaluated by the Newcastle-Ottawa Scale (NOS). A random-effects model was performed using the Comprehensive Meta-analysis software with the standardized mean difference (SMD) and 95% confidence intervals (CIs).Serum oxytocin levels in individuals with schizophrenia were significantly lower than that in comparison group (SMD = − 1.74, 95% CI = − 3.22 to − 0.26, p = 0.02) but cerebrospinal fluid oxytocin levels in individuals with schizophrenia were significantly higher than those in the comparison group (SMD = 0.55, 95% CI = 0.05 to 1.04, p = 0.03).Our results suggest that oxytocin levels in cerebrospinal fluid are increased in individuals with schizophrenia but decreased in serum. Therefore, the oxytocin system dysregulation may play a role in the pathophysiology of schizophrenia and it should be measured in more populations for a possible implementation as a biomarker of schizophrenia.


Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.


Lupus ◽  
2021 ◽  
pp. 096120332110071
Author(s):  
Jiaoniu Duan ◽  
Dan Ma ◽  
Xiaoting Wen ◽  
Qianyu Guo ◽  
Jinfang Gao ◽  
...  

Objectives This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases’ inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ− group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software. Results Nine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ− group (OR 0.35, 95% CI 0.21–0.59), (OR 0.41, 95% CI 0.19–0.89) and (OR 0.55, 95% CI 0.36–0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19–3.96), gestational diabetes (OR 2.3, 95% CI 0.44–12.12), thrombotic events (OR 0.26, 95% CI 0.05–1.51), spontaneous abortion (OR 1.77, 95% CI 0.96–3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24–1.39), oligohydramnios (OR 0.90, 95% CI 0.38–2.14), live birth (OR 1.22, 95% CI 0.60–2.47), stillbirth (OR 1.00, 95% CI 0.50–2.00), congenital malformation (OR 0.53, 95% CI 0.14–2.04), low birth weight (OR 0.77, 95% CI 0.43–1.39), intrauterine distress (OR 1.07, 95% CI 0.41–2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06–5.43), or five-minute APGAR score <7 (OR 0.72, 95% CI 0.20–2.58) between the two groups. Conclusions HCQ treatment during pregnancy could reduce the risk of preeclampsia, pregnancy hypertension and prematurity in SLE patients. The certainty of evidence is high but majority of the studies included are retrospective studies and not randomized controlled trials. Therefore, the multidisciplinary management of pregnant patients with SLE should promote HCQ use, irrespective of disease activity or severity.


2018 ◽  
Vol 21 (4) ◽  
pp. 146-154 ◽  
Author(s):  
Amparo Díaz-Román ◽  
Junhua Zhang ◽  
Richard Delorme ◽  
Anita Beggiato ◽  
Samuele Cortese

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiaowei Gong ◽  
Boyun Yuan ◽  
Yadong Yuan ◽  
Fengju Li

Coronavirus disease 2019 (COVID-19) has become a global pandemic. Community and close contact exposures continue to drive the COVID-19 pandemic. There is no confirmed effective treatment for suspected cases and close contacts. Lianhuaqingwen (LH) capsules, a repurposed Chinese herbal product that is currently on the market, have proven effective for influenza and COVID-19. To determine the safety and efficacy of LH capsules for the prevention of COVID-19, we conducted a prospective open-label controlled trial of LH capsules on subjects who had close contact with people infected with COVID-19. Subjects received LH capsules (4 capsules, three times daily) or the usual medical observation for 14 days. The primary endpoint was the rate of positive nucleic acid tests of nasal and pharyngeal swabs during the quarantine medical observation period. We included 1976 patients, including 1101 in the treatment group and 875 in the control group. The rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.27% vs. 1.14%, respectively; mean difference: −0.87%; 95% CI: −1.83 to −0.13; p = 0.0174 ) during the quarantine medical observation period (14 days). Among subjects with different close contact states, there was no significant difference in the rate of positive nucleic acid test results among close contacts in the treatment group and the control group (6.45% vs. 11.43%, respectively; p = 0.6762 ). Among secondary close contacts, the rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.09% vs. 0.71%, respectively; p = 0.0485 ). No serious adverse events were reported. Taken together, and in light of the safety and effectiveness profiles, these results show that LH capsules can be considered to prevent the progression of COVID-19 after close contact with an infected person. This trial is registered with ChiCTR2100043012.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247662
Author(s):  
Jingjing He ◽  
Desheng Kong ◽  
Zhifen Yang ◽  
Ruiyun Guo ◽  
Asiamah Ernest Amponsah ◽  
...  

Background Diabetes mellitus as a chronic metabolic disease is threatening human health seriously. Although numerous clinical trials have been registered for the treatment of diabetes with stem cells, no articles have been published to summarize the efficacy and safety of mesenchymal stem cells (MSCs) in randomized controlled trials (RCTs). Methods and findings The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to provide a reliable numerical summary and the most comprehensive assessment of therapeutic efficacy and safety with MSCs in diabetes. PubMed, Web of Science, Ovid, the Cochrane Library and CNKI were searched. The retrieval time was from establishment of these databases to January 4, 2020. Seven RCTs were eligible for analysis, including 413 participants. Meta-analysis results showed that there were no significant differences in the reduction of fasting plasma glucose (FPG) compared to the baseline [mean difference (MD) = -1.05, 95% confidence interval (CI) (-2.26,0.16), P<0.01, I2 = 94%] and the control group [MD = -0.62, 95%CI (-1.46,0.23), P<0.01, I2 = 87%]. The MSCs treatment group showed a significant decrease in hemoglobin (Hb) A1c [random-effects, MD = -1.32, 95%CI (-2.06, -0.57), P<0.01, I2 = 90%] after treatment. Additionally, HbA1c reduced more significantly in MSC treatment group than in control group [random-effects, MD = -0.87, 95%CI (-1.53, -0.22), P<0.01, I2 = 82%] at the end of follow-up. However, as for fasting C-peptide levels, the estimated pooled MD showed that there was no significant increase [MD = -0.07, 95%CI (-0.30, 0.16), P<0.01, I2 = 94%] in MSCs treatment group compared with that in control group. Notably, there was no significant difference in the incidence of adverse events between MSCs treatment group and control group [relative risk (RR) = 0.98, 95%CI (0.72, 1.32), P = 0.02, I2 = 70%]. The most commonly observed adverse reaction in the MSC treatment group was hypoglycemia (29.95%). Conclusions This meta-analysis revealed MSCs therapy may be an effective and safe intervention in subjects with diabetes. However, due to the limited studies, a number of high-quality as well as large-scale RCTs should be performed to confirm these conclusions.


2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yao Zhou ◽  
Shi-min Jiang ◽  
Li Li ◽  
Ying Wang ◽  
Lei Ding ◽  
...  

Objective. To systematically evaluate the efficacy and safety of tanshinone for chronic kidney disease (CKD). Methods. Randomized controlled trials (RCTs) on the treatment of CKD using tanshinone were searched using 4 Chinese databases (China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), Wanfang, and Chinese Biology Medicine (CBM)) and 3 English databases (PubMed, Cochrane Library, and Excerpta Medica Database (Embase)). The results included data on blood urine nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR), 24 h urine protein, microalbuminuria (mALB), β2-macroglobulin (β2-MG), cystatin C (CysC), and safety events. The data were analyzed using Revman 5.3 and Stata 12.0 software. Results. Twenty-one studies were entered into this meta-analysis, which involved 1857 patients including 954 cases from the tanshinone treatment group and 903 cases from the control group. BUN levels in the tanshinone treatment group were significantly reduced compared with the control (standardized mean difference (SMD) = −0.65, 95% confidence interval (CI): −0.81 to −0.49, p<0.01). In addition, subgroup analysis indicated that tanshinone had a significant effect in reducing Scr levels at 14, 21, and 28 days. Scr levels in the tanshinone treatment group were significantly reduced compared with the control group (SMD = −1.40, 95% CI: −2.09 to −0.71, p<0.01); subgroup analysis based on treatment time also yielded the same results. GFR in the tanshinone treatment group was better than that in the control group (SMD = 0.83, 95% CI: 0.59 to 1.07, p<0.01). In terms of urine protein levels, 24 h urine protein level, mALB, and β2-MG of CKD patients were reduced to some degree compared with controls, and CysC levels in the tanshinone treatment group were also significantly reduced compared with the control group (SMD = −0.24, 95% CI: −0.44 to −0.03, p<0.05). Safety in the tanshinone treatment group did not differ significantly from that of the control group (risk ratio (RR) = 7.78, 95% CI: 0.99 to 61.05, p>0.05). Conclusion. This meta-analysis showed that tanshinone could control urine protein level in CKD patients, improve kidney function, and delay the evolution of CKD without significant side effects. However, the results were limited and should be interpreted with caution because of the low quality of the included studies. In the future, more rigorous clinical trials need to be conducted to provide sufficient and accurate evidence.


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