Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis

There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11–0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36–0.52) and aphthous lesions 0.10 (95% CI 0.01–0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.

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Prevalence of Invasive Streptococcus pneumoniae Infections among Iranian Children: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i6.6412 ◽

2021 ◽

Author(s):

Arshid Yousefi Avarvand ◽

Mehrdad Halaji ◽

Donya Zare ◽

Meysam Hasannejad-Bibalan ◽

Hadi Sedigh Ebrahim-Saraie

Keyword(s):

Systematic Review ◽

Streptococcus Pneumoniae ◽

Web Of Science ◽

Data Extraction ◽

Meta Analysis ◽

Single Center ◽

Inclusion Criteria ◽

Pooled Prevalence ◽

Iranian Children ◽

The Web

Background: Streptococcus pneumoniae is an important pathogen of children, mostly in developing countries. We aimed to investigate the prevalence of invasive S. pneumoniae among Iranian children using a systematic review and meta-analysis. Methods: A systematic search was carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January of 2010 to December of 2017. Then, seven publications that met our inclusion criteria were selected for data extraction and analysis. Results: Totally, one study was multicenter, and six were single-center based studies. Meanwhile, all of the included studied performed among hospitalized patients. Seven studies reported the prevalence of invasive S. pneumoniae isolated from children, of these the pooled prevalence of S. pneumoniae was 2.5% (95% CI: 0.7%-9.1%). Conclusion: The overall prevalence of invasive S. pneumoniae infections among Iranian children is low (2.5%). However, further clinical studies are required to elucidate the burden of infections among Iranian children, especially in eastern regions.

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Post COVID-19 Organizing Pneumonia: A Systematic Review and Meta-analysis

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i38b32122 ◽

2021 ◽

pp. 259-270

Author(s):

Talal Khalid Abdullah Alanazi ◽

Nasser Faris Ali Alahmari ◽

Faris Essa Ibrahim Qubays ◽

Solaiman Hosaian ibraheem Alenezi ◽

Meshal Faleh Mofadhe Alenezi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Web Of Science ◽

Case Reports ◽

Meta Analysis ◽

Organizing Pneumonia ◽

Eligible Study ◽

Data Synthesis ◽

Electronic Search ◽

Review Manager

Introduction: Several observational studies have found parallels between COVID-19 pneumonia and organizing pneumonia (OP). This study aims to investigate the published literature of OP related to COVID-19, estimates the prevalence of OP among COVID-19 patients, and assesses the risk or COVID-19 severity associated with OP. Methodology: This was a systematic review and meta-analysis. A systematic electronic search through PubMed, Web of Science, Science Direct, EBSCO, and Google Scholar was conducted to include relevant and eligible literature. The authors used Review Manager 5.4 to perform quantitative data synthesis for the condition of interest analyses. Results: A total of 9 eligible study articles and 12 case reports were included in this study. The estimated pooled organizing pneumonia prevalence among COVID-19 patients was 45.6% [23.1%-68.2%]. The association between OP and severe COVID-19 infection revealed a pooled OR [95% CI] of 5.22 [-0.96-11.41]. Conclusion: COVID-19 patients had a rather high OP prevalence (43%). Surprisingly, cancer patients with COVID-19 infection had the lowest OP prevalence. OP was identified as a possible risk factor for the severity of COVID-19 infection.

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Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies

BioMed Research International ◽

10.1155/2021/6661457 ◽

2021 ◽

Vol 2021 ◽

pp. 1-24

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Zelalem Tenaw ◽

Animut Alebel ◽

Teshager Worku ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Observational Studies ◽

Meta Analysis ◽

High Income ◽

Pooled Prevalence ◽

Obese Population

Introduction. Metabolic syndrome (MetS) is an assemblage of interconnected cardiovascular risk factors that are prevalent among children and adolescents in high-income countries (HICs). Despite the presence of several studies on the issue, the study findings are incongruent due to the absence of a gold standard diagnostic method of MetS in children. Thus, the findings of the original studies are inconclusive for policy makers and other stakeholders. This systematic review and meta-analysis is aimed at giving conclusive evidence about MetS among children and adolescents in HICs. Methods. We conducted searches using electronic databases (PubMed, Scopus, Web of Science, CINAHL (EBSCOhost), EMBASE (Elsevier), and Medline (EBSCOhost)) and other sources (Google Scholar and Google) up to September 2020. Observational studies reporting the prevalence of MetS were eligible in this study. The pooled estimates were computed in fixed and random effect models using six diagnostic methods (IDF, ATP III, de Ferranti et al., WHO, Weiss et al., and Cruz and Goran). Publication bias was verified using funnel plots and Egger’s regression tests. Subgroup and sensitivity analysis were performed in case of higher heterogeneities among the included studies. Result. In this study, 77 studies with a total population of 125,445 children and adolescents were used in the final analysis. Metabolic syndrome among the overweight and obese population was computed from 28 studies with the pooled prevalence of 25.25%, 24.47%, 39.41%, 29.52%, and 33.36% in IDF, ATP III, de Ferranti et al., WHO, and Weiss et al. criteria, respectively. Likewise, 49 studies were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, MetS was found in 3.70% (IDF), 5.40% (ATP III), 14.78% (de Ferranti et al.), 3.90% (WHO), and, 4.66% (Cruz and Goran) of study participants. Regarding the components of MetS, abdominal obesity in the overweight and obese population, and low HDL-C in the general population were the most common components. Besides, the prevalence of Mets among males was higher than females. Conclusion. This study demonstrates that MetS among children and adolescents is undoubtedly high in HICs. The prevalence of MetS is higher among males than females. Community-based social and behavioral change communications need to be designed to promote healthy eating behaviors and physical activities. Prospective cohort studies could also help to explore all possible risk factors of MetS and to design specific interventions accordingly.

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Prevalence and Risk Factors for Spasticity After Stroke: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2020.616097 ◽

2021 ◽

Vol 11 ◽

Author(s):

Huangling Zeng ◽

Jian Chen ◽

Yang Guo ◽

Sheng Tan

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Observational Studies ◽

Hemorrhagic Stroke ◽

Meta Analysis ◽

Cochrane Library ◽

Stroke Patients ◽

Pooled Prevalence ◽

Severe Spasticity

Background: Spasticity is a common sequela of stroke. The incidence of poststroke spasticity (PSS) has not been systematically reviewed in recent years, and some risk factors remain debated. This systematic review and meta-analysis was conducted to determine the prevalence and risk factors for PSS.Methods: We searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, WANFANG and CBM) inception to May 12, 2020. Observational studies summarizing the incidence or risk factors for PSS were included. Only cohort studies were enrolled in meta-analysis. For risk factors examined in at least three different studies, we combined effects into odds ratios (OR) and 95% confidence intervals (CI).Results: One thousand four hundred sixty-seven studies were retrieved and 23 were involved in meta-analysis. The pooled prevalence of spasticity after stroke was 25.3% and that after the first-ever stroke was 26.7%. The incidence of spasticity after the first-ever stroke with paresis was 39.5%. The prevalence of disabling or severe spasticity (MAS ≥ 3) in stroke patients with paresis was 9.4% (95% CI 0.056–0.133), and severe spasticity was 10.3% (95% CI 0.058–0.149). Moderate to severe paresis (OR = 6.573, 95% CI 2.579–16.755, I2 = 0.0%), hemorrhagic stroke (OR = 1.879, 95% CI 1.418–2.490, I2 = 27.3%) and sensory disorder were risk factors for PSS.Conclusions: The incidence of PSS was significantly higher in stroke patients with paresis. Patients with moderate to severe paresis and sensory disorder should be closely followed up. The role of hemorrhagic stroke in predicting PSS remains to be further explored.

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Hypertension and frailty: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-024406 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024406 ◽

Cited By ~ 18

Author(s):

Davide L Vetrano ◽

Katie M Palmer ◽

Lucia Galluzzo ◽

Simona Giampaoli ◽

Alessandra Marengoni ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Hypertension Status ◽

Cross Sectional ◽

Pooled Prevalence ◽

High Prevalence ◽

Registration Number ◽

Definition Of ◽

Study Setting

ObjectiveTo review the association between hypertension and frailty in observational studies.DesignA systematic review of the PubMed, Web of Science and Embase databases was performed. A meta-analysis was performed if at least three studies used the same definition of frailty and a dichotomous definition of hypertension.Setting, participants and measuresStudies providing information on the association between frailty and hypertension in adult persons, regardless of the study setting, study design or definition of hypertension and frailty were included.ResultsAmong the initial 964 articles identified, 27 were included in the review. Four longitudinal studies examined the incidence of frailty according to baseline hypertension status, providing conflicting results. Twenty-three studies assessed the cross-sectional association between frailty and hypertension: 13 of them reported a significantly higher prevalence of frailty in hypertensive participants and 10 found no significant association. The pooled prevalence of hypertension in frail individuals was 72% (95% CI 66% to 79%) and the pooled prevalence of frailty in individuals with hypertension was 14% (95% CI 12% to 17%). Five studies, including a total of 7656 participants, reported estimates for the association between frailty and hypertension (pooled OR 1.33; 95% CI 0.94 to 1.89).ConclusionsFrailty is common in persons with hypertension. Given the possible influence of frailty on the risk–benefit ratio of treatment for hypertension and its high prevalence, it is important to assess the presence of this condition in persons with hypertension.Trial registration numberCRD42017058303.

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Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11060777 ◽

2021 ◽

Vol 11 (6) ◽

pp. 777

Author(s):

Woon-Man Kung ◽

Sheng-Po Yuan ◽

Muh-Shi Lin ◽

Chieh-Chen Wu ◽

Md. Mohaimenul Islam ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Observational Studies ◽

Web Of Science ◽

Meta Analysis ◽

The Elderly ◽

Previous Evidence ◽

Increased Risk ◽

Meta Analyses ◽

Risk Ratios

Background: Cognitive impairment is one of the most common, burdensome, and costly disorders in the elderly worldwide. The magnitude of the association between anemia and overall cognitive impairment (OCI) has not been established. Objective: We aimed to update and expand previous evidence of the association between anemia and the risk of OCI. Methods: We conducted an updated systematic review and meta-analysis. We searched electronic databases, including EMBASE, PubMed, and Web of Science for published observational studies and clinical trials between 1 January 1990 and 1 June 2020. We excluded articles that were in the form of a review, letter to editors, short reports, and studies with less than 50 participants. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We estimated summary risk ratios (RRs) with random effects. Results: A total of 20 studies, involving 6558 OCI patients were included. Anemia was significantly associated with an increased risk of OCI (adjusted RR (aRR) 1.39 (95% CI, 1.25–1.55; p < 0.001)). In subgroup analysis, anemia was also associated with an increased risk of all-cause dementia (adjusted RR (aRR), 1.39 (95% CI, 1.23–1.56; p < 0.001)), Alzheimer’s disease [aRR, 1.59 (95% CI, 1.18–2.13; p = 0.002)], and mild cognitive impairment (aRR, 1.36 (95% CI, 1.04–1.78; p = 0.02)). Conclusion: This updated meta-analysis shows that patients with anemia appear to have a nearly 1.39-fold risk of developing OCI than those without anemia. The magnitude of this risk underscores the importance of improving anemia patients’ health outcomes, particularly in elderly patients.

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A systematic review and meta-analysis of the efficacy of medical masks and N95 respirators for protection against respiratory infectious diseases, including COVID-19 in medical staff

10.21203/rs.3.rs-47687/v1 ◽

2020 ◽

Author(s):

MM Gao-hong Wu ◽

MB Ping Jiang ◽

MB Huan Yuan ◽

Shi ◽

Zhu

Keyword(s):

Systematic Review ◽

Infectious Diseases ◽

Observational Studies ◽

Web Of Science ◽

Meta Analysis ◽

Control Group ◽

Significant Protection ◽

Randomized Controlled ◽

Respiratory Infectious Diseases ◽

N95 Respirators

Abstract To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.50; 95% CI: 0.29–0.84). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.59; 95% CI: 0.42–0.82). However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Therefore, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.

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Prevalence of dysphagia in patients with multiple sclerosis; a systematic review and meta-analysis

10.1101/2021.06.07.21258473 ◽

2021 ◽

Author(s):

Omid Mirmosayyeb ◽

Narges Ebrahimi ◽

Arman Shekarian ◽

Sara Bagherieh ◽

Alireza Afshari-Safavi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Literature Search ◽

Web Of Science ◽

Meta Analysis ◽

Final Analysis ◽

Self Report ◽

Pooled Prevalence ◽

Screening Strategies ◽

Conference Papers

Objectives: Dysphagia is a major comorbidity observed in patients with multiple sclerosis, yet different prevalence rates are reported for it. Therefore, we have designed this systematic review to estimate the pooled prevalence of dysphagia in patients with MS. Method: We searched PubMed, Scopus, EMBASE, Web of Science, and gray literature including references from the identified studies, reviews studies, and conference abstracts which were published up to February 2021. Articles that were relevant to our topic and could provide information regarding the prevalence of dysphagia among MS patients were included; however, articles with self-report screening strategies were excluded. Results: The literature search found 1993 articles. After eliminating duplicates, 1272 articles remained. Sixteen abstract conference papers were included for final analysis. A total of 10846 MS cases and 4913 MS patients with dysphagia included in the analysis. The pooled prevalence of dysphagia in the included studies was 45.3% (95% CI: [40.7%-50%]) Conclusion: The results of this systematic review shows that the prevalence of dysphagia in MS patients is 45% which is greatly higher compared to the general population.

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Abstract 14699: Arterial and Venous Thromboembolism in Covid-19: A Study-level Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.14699 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Vicky Mai ◽

Kim Boun Tan ◽

Sabine Mainbourg ◽

Arnaud Frigerri ◽

Laurent Bertoletti ◽

...

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Observational Studies ◽

Web Of Science ◽

Meta Analysis ◽

Thromboembolic Events ◽

Vein Thrombosis ◽

Coronary Syndrome ◽

Specific Effects ◽

Deep Vein

Introduction: The prevalence of venous (VTE) and arterial (ATE) thromboembolic events in patients with COVID-19 remains largely unknown. Methods: In this systematic review and meta-analysis, we systematically searched Pubmed MEDLINE, Google Scholar, and Web of Science for observational studies describing the prevalence of VTE and ATE amongst patients with COVID-19 published between Jan 1, 2020 and May 20, 2020. The websites of major journals were also searched. Results: We analysed findings from 15 studies totalizing 1,755 patients, mainly in intensive care units (ICU). The weighted frequency of COVID-19-related VTE was 16.6% (95%CI 9.5-25.1%, I 2 =94%, 13 studies: 1,546 patients). The overall prevalence of PE and deep vein thrombosis (DVT) were 9.1% (95%CI 3.7-16.6%, I 2 =95%; 15 studies; 1,755 patients) and, 7.8% (95%CI 3.4-13.8%; I 2 =92%; 13 studies; 1,445 patients), respectively. Few were isolated subsegmental PE or distal DVT. The VTE prevalence was significantly higher in ICU (21.6%; 95%CI 12.6-32.2%; I2=91% versus 4.6%; 95%CI 1.0-10.7%, I 2 =87%, p interaction =0.002 in subgroup analysis). The weighted frequency of myocardial infarction/acute coronary syndrome, stroke, and other ATE (6 studies, 812 patients) was 3.2% (95%CI 2.1-4.5%, I 2 =0%), 0.7% (95%CI 0.0-2.2%, I 2 =64%), 2.0% (95%CI 1.2-3.0%, I 2 =40%), and 0.5% (95%CI 0.0-1.6%, I 2 =60%), respectively. Conclusions: Patients admitted in the ICU for severe COVID-19 had a high risk of VTE. Conversely, further studies are needed to determine the specific effects of COVID-19 on the risk of ATE or VTE in less severe forms of the disease.

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Accuracy of SARS-CoV-2 Detection in Saliva for COVID-19 Diagnosis: A Systematic Review and Meta-Analysis

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i4.6697 ◽

2021 ◽

Author(s):

Dina M. Elkady ◽

Walid Shaban Abdella ◽

Muhamed Abdella ◽

Abdelrahman Elsayed Kopeya ◽

Aboalmagd Hamdallah

Keyword(s):

Systematic Review ◽

Literature Search ◽

Web Of Science ◽

Meta Analysis ◽

High Accuracy ◽

Oral Manifestations ◽

Oral Diseases ◽

Mouth Dryness ◽

Pooled Data ◽

Saliva Test

Context: There is an unmet clinical need to develop simple, easy, rapid, and accessible testing for the detection of SARS-CoV-2. Recent reports suggested that saliva may be a host for the virus. The existence of SARS-CoV-2 in saliva can be associated with oral manifestations in infected patients. A systematic review was conducted as well as a meta-analysis to evaluate the diagnostic accuracy of detecting SARS-CoV-2 in saliva and investigate the association between positive saliva test and oral manifestations of COVID-19. Evidence acquisition: A literature search in MEDLINE via PubMed, Scopus, Web of Science, and Cochrane was done in June 2020 and updated in February 2021 using relevant keywords. We screened studies for eligibility. The extracted data were analyzed using Meta-Disc software. Results: Eighteen studies were included. Pooled data from eligible studies showed that the sensitivity of diagnosis of SARS-CoV-2 in saliva was 0.86 (95% CI, 0.83–0.89), and the specificity was 0.98 (95% CI, 0.96–0.98). COVID-19 was associated with oral diseases as amblygeustia, dry mouth, dryness, inflammation of the mouth, and enlargement of lymph nodes in the submandibular regions. Conclusions: Our results showed that the saliva has a high accuracy in the detection of SARS-CoV-2.

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