scholarly journals Patients With IBD Receiving Methotrexate Are at Higher Risk of Liver Injury Compared With Patients With Non-IBD Diseases: A Meta-Analysis and Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Yang Wang ◽  
Yimin Li ◽  
Yun Liu ◽  
Yifan Zhang ◽  
Ziliang Ke ◽  
...  
Keyword(s):  
Relative Risk ◽  
Liver Injury ◽  
Adverse Events ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Future Research ◽  
The Difference ◽  
Trim And Fill ◽  
The Cochrane Library ◽  
Rr Relative Risk

Background: Methotrexate is well-known in treating inflammatory bowel disease (IBD), rheumatoid arthritis (RA), psoriasis (Ps), and psoriatic arthritis (PsA). Several reports have indicated a higher incidence of methotrexate (MTX)-related liver adverse events in patients with IBD. We aim to investigate the risk of liver injury in patients with IBD and those with non-IBD diseases treated with MTX.Methods: We searched PubMed, Embase, and the Cochrane Library for articles that reported liver adverse events in patients with IBD, RA, and Ps/PsA, receiving MTX therapy. Additional articles were obtained by screening the references of recent meta-analysis and reviews. Raw data from included articles were pooled to calculate the cumulative incidence of total liver injury (TLI), MTX discontinuation (MTX-D), and liver fibrosis (LF). RR (relative risk) was calculated to compare the difference between patients with IBD and those with non-IBD diseases.Results: A total of 326 articles with 128,876 patients were included. The patients with IBD had higher incidence of TLI [11.2 vs. 9.2%; relative risk (RR) = 1.22; P = 0.224] and MTX-D (2.6 vs. 1.8%; RR, 1.48; P = 0.089) than patients with non-IBD diseases. Due to the publication bias, trim-and-fill was performed. Afterwards, the patients with IBD showed significantly higher risk of TLI (11.2 vs. 3%; RR = 3.76; p < 0.001), MTX-D (3.3 vs. 0.7%; RR = 5; p < 0.001) and LF (3.1 vs. 0.1%; RR = 38.62; P = 0.001) compared with patients with non-IBD diseases.Conclusion: IBD is associated with a higher risk of MTX-related liver injury. The mechanism of MTX-induced hepatotoxicity might be different in IBD and non-IBD diseases, and needs to be verified in future research.

scholarly journals Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis

Pharmacology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Shan Deng ◽  
Yonghao Yu
Keyword(s):  
Femur Fracture ◽  
Meta Analysis ◽  
Sensory Block ◽  
Cochrane Library ◽  
Rescue Analgesia ◽  
Block Level ◽  
Block Time ◽  
Sedation Scores ◽  
The Difference ◽  
The Cochrane Library

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Patients who received DEX infusion had a significant longer time to rescue analgesia compared with those without DEX coadministration. DEX treatment seemed to reduce the visual analog score; however, the significance did not reach any statistical difference. DEX as an analgesic adjuvant did not reduce the onset of sensory block time, shorten the time to achieve maximum sensory block level, and provide a longer duration of sensory block. The difference in mean sedation scores between 2 groups was not statistically significant. As for adverse effects, DEX therapy significantly increased the rate of hypotension. In conclusion, dexmedetomidine as a local anesthetic adjuvant in femur fracture surgery had a longer duration of rescue analgesia. However, the incidence of hypotension was markedly increased in these patients. It was worth noting that the evidence was of low to moderate quality.

scholarly journals The Anterior Chamber Injection of Moxifloxacin Injection to Prevent Endophthalmitis after Cataract Surgery: A Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao-lei Wang ◽  
Xiao-yong Huang ◽  
Zhen Wang ◽  
Wei Sun
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Meta Analysis ◽  
Corneal Edema ◽  
Intraventricular Injection ◽  
Cochrane Library ◽  
Study Selection ◽  
Computer Based ◽  
The Difference ◽  
The Cochrane Library

Purpose. A meta-analysis was performed to compare the efficacy of an anterior chamber injection of moxifloxacin in the prevention of endophthalmitis after cataract surgery. Methods. A computer-based search of PubMed, Embase, the Cochrane Library, and the Clinical Trial database for articles related to anterior intraventricular injection of moxifloxacin for the prevention of endophthalmitis after cataract surgery was performed through April 2019. Study selection, data exclusion, and quality assessment were performed by two independent observers. Statistical analysis for the meta-analysis was performed by RevMan5.3 software. Results. Eight studies were included, with a total of 123,819 eyes. The meta-analysis showed that an anterior chamber injection of moxifloxacin can prevent the incidence of endophthalmitis after cataract surgery (OR = 0.29, 95% CI (0.15, 0.56), P=0.0002), and the difference was statistically significant. There were no significant differences between the moxifloxacin injection and nonmoxifloxacin injection groups in regard to UCVA (log MAR) (SMD = −0.13, 95% CI (−0.62, 0.35), P=0.60), BCVA (log MAR) (SMD = −0.27, 95% CI (−1.28, 0.74), P=0.60), IOP (SMD = −0.04, 95% CI (−0.02, 0.01), P=0.22), corneal edema (OR = 1.03, 95% CI (0.23, 4.69), P=0.97), CCT (SMD = −0.01, 95% CI (−0.07, 0.05), P=0.77), or ECD (SMD = 0.00, 95% CI (−0.06, 0.07), P=0.94). Conclusion. An anterior chamber injection of moxifloxacin can effectively prevent the incidence of endophthalmitis after cataract surgery, while the moxifloxacin injection and nonmoxifloxacin injection groups had similar results in regard to UCVA (log MAR), BCVA (log MAR), IOP, corneal edema, CCT, and ECD.

A Systematic Review and Meta-Analysis of Thalidomide in Patients with Previously Untreated Multiple Myeloma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3570-3570 ◽  
Author(s):  
Lisa Hicks ◽  
Adam Haynes ◽  
Donna E. Reece ◽  
Irwin Walker ◽  
Jordan A. Herst ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Relative Risk ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Response Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Number Needed To Treat ◽  
Vte Prophylaxis ◽  
American Society

Abstract Background: Multiple myeloma disproportionately affects the elderly and is currently an incurable malignancy. New therapies for myeloma, particularly oral therapies, are urgently needed. Objectives: To determine if thalidomide with or without other agents, improves response rate (≥ 50% reduction in monoclonal protein), survival, and/or progression in patients with previously untreated myeloma. To determine the frequency and significance of major adverse events associated with thalidomide in this setting. Methods: A literature search of Medline (1966–June 2006), Embase (1980–June 2006), the Cochrane Library, abstracts from the annual meetings of the American Society of Hematology (1999–2005) and the American Society of Oncology (1999–2006) was completed with a pre-specified search strategy. No language restrictions were applied. Randomized controlled trials of induction thalidomide (any dose, any duration) for adults with previously untreated multiple myeloma were included. Trials of exclusively maintenance therapy were excluded. Two reviewers independently extracted data. The methodological quality of selected trials was assessed and summarized. Weighted data was expressed as relative risk, risk difference, number needed to treat (NNT), and number needed to harm (NNH). A random-effects model was used. Results: Six eligible studies involving almost two thousand patients (N=1875) were identified and meta-analyzed. Two studies were published and four were reported in abstract form only. Five studies reported overall response rate (ORR); the four largest trials reported statistically significant improvements in ORR with the addition of thalidomide to standard therapy. The weighted relative risk of responding to a thalidomide-containing regimen versus control was 1.50 (95% CI 1.21 to 1.86). The NNT to achieve one additional response with thalidomide was 4 (95% CI 2.9 to 8.3). Two trials reported improvements in EFS/PFS. One trial reported an improvement in OS. The risk of VTE, peripheral neuropathy, and constipation was consistently elevated with thalidomide such that for every 50 patients treated with a thalidomide-containing-regimen, one could expect 12 to 13 additional patients to respond, 4 additional patients to develop VTE (NNH 12.5; 95% CI 8.3 to 20), 2 additional patients to develop peripheral neuropathy (NNH 25; 95% CI 16.7 to 50), and 4 additional patients to develop constipation (NNH14; 95% CI 10 to 25). In our analyses, prophylactic anticoagulation appeared to decrease, but not abolish, the risk of VTE with thalidomide. Conclusions: Thalidomide improves response rate and possibly progression free and overall survival in patients with previously untreated myeloma. It also increases the incidence of VTE, neuropathy, constipation and other adverse events. Further studies are required to confirm the survival advantage seen in one study, and to determine the optimum strategy for VTE prophylaxis.

scholarly journals Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

2019 ◽  
Author(s):  
Jie Qin ◽  
Tingting Fu ◽  
Qi Tang ◽  
Lu Yang ◽  
Min Chen
Keyword(s):  
Meta Analysis ◽  
Corneal Biomechanics ◽  
Cochrane Library ◽  
Surgical Methods ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
Lenticule Extraction ◽  
The Difference ◽  
The Cochrane Library ◽  
Chinese Group

Abstract Background: To evaluate and compare corneal biomechanics after treatment of myopia using small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods: We performed a meta-analysis and searched for reports concerning corneal biomechanics after SMILE and FS-LASIK using MEDLINE, EMbase, CNKI and the Cochrane Library. The analysis included corneal hysteresis (CH) and corneal resistance factor (CRF) before and 3 months after the surgery. The quality of the reports was evaluated using the Newcastle-Ottawa scale (NOS). Statistical analysis was performed using RevMan5. Results: Only six studies with a total of 771 eyes were ultimately included in this meta-analysis, and the random effects model was adopted. The preoperative and three-month postoperative CH and CRF of SMILE and FS-LASIK were compared by the meta-analysis. No statistically significant difference was found in CH or CRF between the SMILE group and the FS-LASIK group before the surgery (WMD，-0.12; 95% CI，-0.31～0.06; P，0.19; WMD，-0.05; 95% CI，-0.29～0.19; P，0.69). There was no statistically significant difference in CH between the two surgical methods 3 months after the operation in the foreign group (WMD，0.19; 95% CI，-1.02～1.41; P，0.75) or in the Chinese group (WMD，0.13; 95% CI，-0.16～0.41; P，0.75). Likewise, no statistically significant difference was found in CRF between the two surgical methods in the foreign group 3 months after the operation (WMD，-0.11; 95% CI，-2.53～-2.31; P，0.93). Nevertheless, the difference in CRF between the two surgical methods was statistically significant in the Chinese group (WMD，0.26; 95% CI，0.06～0.47; P，0.01). Concusion: This meta-analysis indicated that SMILE showed no significant postoperative advantage in CH in comparison with FS-LASIK. For CRF, SMILE exhibited no obvious postoperative advantage in comparison with FS-LASIK in the foreign group, whereas SMILE was superior to FS-LASIK in the Chinese group.

scholarly journals The effect of the head-up position in cardiopulmonary resuscitation – A systematic review and meta-analysis

2021 ◽  
Author(s):  
Cheng-Chieh Huang ◽  
Kuan-Chih Chen ◽  
Zih-Yang Lin ◽  
Yu-Hsuan Chou ◽  
Wen-Liang Chen ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Perfusion Pressure ◽  
Meta Analysis ◽  
Spontaneous Circulation ◽  
Cochrane Library ◽  
Pros And Cons ◽  
The Difference ◽  
The Cochrane Library ◽  
Acd Cpr ◽  
Impedance Threshold Device

Abstract ObjectiveThe pros and cons of the head-up position (HUP) in cardiopulmonary resuscitation (CPR) have been controversial in previous studies. This study aims to clarify the effect of HUP CPR compared to supine position (SUP) CPR.MethodThree databases were comprehensively searched (PubMed, EMBASE and the Cochrane Library) for articles published from database inception to 10 May 2021. The primary outcome was cerebral perfusion pressure (CerPP). The secondary outcomes were mean intracranial pressure (ICP), mean artery pressure (MAP), coronary artery perfusion pressure (CoPP) and the return of spontaneous circulation (ROSC) rate.ResultA total of 7 studies including 138 animals were included. We found that CerPP (SMD, 1.58; 95% CI, 0.98–2.19; p < 0.01; I2 = 51%) and ICP (SMD, -3.59; 95% CI, -5.16– -2.02; p < 0.01; I2 = 87%) were decreased significantly in the HUP group. HUP had a similar MAP (SMD, -0.54; 95% CI, -1.75–0.66; p = 0.38; I2 = 87%) and ROSC rate (RR, 0.9; 95% CI, 0.31–2.60; p = 0.84; I2 = 65%) to SUP. In addition, there was an increased CoPP trend in HUP, but the difference was not statistically significant (SMD, 0.92; 95% CI, -0.24–2.08; p = 0.12; I2 = 84%)ConclusionThe HUP 30° in active compression-decompression CPR (ACD-CPR) with an impedance threshold device (ITD) can increase CerPP by significantly lowering ICP and maintaining MAP compared to SUP, and the effect is immediate and lasts the whole CPR duration. In addition, CoPP might also be increased compared to that with SUP.

Differences in the roles of types 1 and 2 diabetes in the susceptibility to the risk of fracture: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Jiaqing Dou ◽  
Jing Wang ◽  
Qiu Zhang
Keyword(s):  
Meta Analysis ◽  
Indirect Comparison ◽  
Excess Risk ◽  
Cochrane Library ◽  
Upper Arm ◽  
Risk Of Fracture ◽  
Comparison Results ◽  
Increased Risk ◽  
The Difference ◽  
The Cochrane Library

Abstract Background: Diabetes mellitus (DM) causes excess risk of fracture at varied sites. Whereas, the difference between the roles of types 1 DM (T1DM) and 2 DM (T2DM) diabetes in the risk of fractures remains limited and inconclusive. We, therefore, conducted a meta-analysis to assess the differences for the associations of T1DM and T2DM with the risk of fractures.Methods: We systematically searched PubMed, Embase, and the Cochrane library for eligible studies until May 2021. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the pooled effect estimates for the associations of T1DM and T2DM with the risk of fractures using the random-effects model. An indirect comparison results for the ratio of OR (ROR) with 95% CI were also applied to assess the difference between T1DM and T2DM with the risk of fractures.Results: Twenty-two cohort studies involving a total of 6,484,851 individuals were selected for meta-analysis. We noted that T1DM was associated with an increased risk of all fractures (OR: 1.72; 95% CI: 1.36–2.19; P < 0.001), and fractures at the hip (OR: 4.01; 95% CI: 2.90–5.54; P < 0.001), upper arm (OR: 2.20; 95% CI: 1.61–3.00; P < 0.001), ankle (OR: 1.97; 95% CI: 1.24–3.14; P = 0.004), and vertebrae (OR: 2.18; 95% CI: 1.85–2.57; P < 0.001). Moreover, T2DM induced excess risk to all fractures (OR: 1.19; 95% CI: 1.09–1.31; P < 0.001), including fractures at the hip (OR: 1.25; 95% CI: 1.15–1.35; P < 0.001), upper arm (OR: 1.42; 95% CI: 1.20–1.67; P < 0.001), and ankle (OR: 1.15; 95% CI: 1.01–1.31; P = 0.029). Furthermore, we noted that T1DM versus T2DM was associated with greater risk to all fractures (ROR: 1.45; 95% CI: 1.12–1.87; P = 0.005), including fractures at the hip (ROR: 3.21; 95% CI: 2.30–4.48; P < 0.001), upper arm (ROR: 1.55; 95% CI: 1.09–2.20; P = 0.015), and ankle (ROR: 1.71; 95% CI: 1.06–2.78; P = 0.029).Conclusions: This study found that T1DM caused an excess risk to all fractures, including fractures at the hip, upper arm, and ankle than T2DM. Further studies should therefore be conducted to directly compare the differences between T1DM and T2DM with the risk of fractures at various sites.

Efficacy of Conversion to Aflibercept for Diabetic Macular Edema Previously Refractory to Bevacizumab or Ranibizumab: A Meta-analysis of High-Quality Nonrandomized Studies

2020 ◽  
Vol 54 (8) ◽  
pp. 750-756
Author(s):  
Kang Xiao ◽  
Fu-Zhen Li ◽  
Shen-Zhi Liang ◽  
Jiong Wang ◽  
Cheng Qian ◽  
...  
Keyword(s):  
Adverse Events ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Science Data ◽  
Study Heterogeneity ◽  
Mean Differences ◽  
The Cochrane Library

Background: Aflibercept has been widely used in treating diabetic macular edema (DME). However, the effect of aflibercept in treating DME refractory to bevacizumab or ranibizumab has not been well established. Objective: To assess the therapeutic effect of switching from bevacizumab or ranibizumab to aflibercept in the treatment of refractory DME. Methods: Relevant studies were searched from 3 databases: the Cochrane Library, PubMed, and Web of Science. Data on changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events within the follow-up period were collected and pooled using weighted mean differences (WMDs) with corresponding 95% CIs in a random effects model. The between-study heterogeneity was tested using the χ2 test and the I2 statistic, and funnel plots were used to evaluate the publication bias. Results: A total of 11 nonrandomized trials met the inclusion criteria and were included in the meta-analysis. Our studies showed significant improvements in the BCVA (WMD = 100.55; 95% CI = 68.46 to 132.63; P < 0.01) and reduction in CMT (WMD = 0.09; 95% CI = 0.03 to 0.14; P < 0.01) after switching to aflibercept. Although a large amount of heterogeneity was detected in the CMT results among these studies, the sensitivity analyses showed the reliability and stability of our results. Conclusion and Relevance: There were significant improvements in both visual and anatomical outcomes after switching from bevacizumab or ranibizumab to aflibercept, without risk of adverse events. Thus, switching therapy may be a safe and effective treatment for patients with refractory DME.

Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies

2017 ◽  
Vol 41 (S1) ◽  
pp. S290-S291 ◽  
Author(s):  
R. Calati ◽  
V. Di Mattei ◽  
P. Courtet
Keyword(s):  
Suicide Risk ◽  
Meta Analysis ◽  
Suicide Mortality ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Patients With Cancer ◽  
Competing Interest ◽  
Trim And Fill ◽  
Meta Analyses ◽  
The Cochrane Library

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiali Xue ◽  
Yan Chen ◽  
Xiaorong Mao ◽  
Huan Tu ◽  
Xinwei Yang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Future Research ◽  
Control Group ◽  
Low Back ◽  
Kinesio Taping ◽  
Significant Difference ◽  
The Difference

Abstract Background Low back pain during pregnancy affects the normal daily activities of pregnant women to a certain extent. Current studies have shown that Kinesio Taping (KT) may be a treatment for low back pain during pregnancy, but there is still a lack of key evidence. The purpose of this study is to evaluate the efficacy and safety of KT in the treatment of low back pain during pregnancy. Methods PubMed, Web of Science, The Cochrane Library, Scopus, Embase, Wanfang Data, CNKI, and VIP databases were searched to collect randomized controlled trials (RCTs) of the efficacy of KT intervention on low back pain in women during pregnancy. The retrieval time limit is from the establishment of the database to April 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software. Results A total of 7 RCTs were included, including 444 patients. Meta-analysis results showed that: Compared with the control group, KT intervention could significantly improve low back pain and dysfunction, VAS score (− 1.62, 95%CI − 2.08 to − 1.16, P < 0.00001, I2 = 77%), RMDQ score (− 1.00, 95%CI − 1.54 to − 0.46, P = 0.0003, I2 = 80%); The results of the meta-analysis of the subgroup showed that compared with the control group, the KT intervention was less than or equal to 1 week, and the waist pain and dysfunction were improved, with statistically significant differences. The difference in the improvement of low back pain was statistically significant after KT intervention for more than 1 week, but there was no statistically significant difference in RMDQ score (− 1.25, 95%CI − 2.66 to 0.15, P = 0.08, I2 =77%). Compared with the control group, KT intervention improved low back pain in the second and third trimesters, and the difference was statistically significant. Conclusion KT has a positive effect on the improvement of low back pain during pregnancy, KT intervention can significantly improve pregnant women’s low back pain and dysfunction problems, improve the quality of life. It is suggested that future research should focus on the prevention and treatment of low back pain during pregnancy to provide more research data for improving women’s health.

scholarly journals The safety and efficacy of mesenchymal stem cells in the treatment of COVID-19-associated pneumonia: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Junwu Wang ◽  
Pengzhi Shi ◽  
Dong Chen ◽  
Shuguang Wang ◽  
Pingchuan Wang ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adverse Events ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Safe Method ◽  
Radiographic Outcomes ◽  
The Difference

Mesenchymal stem cells (MSCs) therapy is considered one of the most promising treatments in the context of the coronavirus disease 2019 (COVID-19) pandemic. However, the safety and effectiveness of MSCs in the treatment of COVID-19-associated pneumonia patients need to be systematically reviewed and analyzed. Two independent researchers searched for the relevant studies published between October 2019 and April 2021 in PubMed, Embase, Cochrane Library, WAN FANG, and CNKI databases. A total of 22 studies involving 371 patients were included in the present study. MSCs were administered in 247 participants, and MSCs were allogeneic from umbilical cord, adipose tissue, menstrual blood, placenta, Wharton's jelly, or unreported sources. Combined results found that MSCs group significantly reduced the incidence of adverse events (OR = 0.43, 95%CI. = 0.22~0.84, P = 0.01) and mortality (OR = 0.17, 95%CI. = 0.06~0.49, P < 0.01), and the difference compared with control group was statistically significant. No MSCs treat-related serious adverse events were reported. The lung function and radiographic outcomes, and biomarker levels of inflammation and immunity all showed improvement trends. Therefore, MSCs therapy is an effective and safe method in the treatment of COVID-19-associated pneumonia and shows advantages in less adverse events and mortality. However, a standard and effective MSCs treatment program needs to be developed.

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