Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22–34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work

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COVID-19, MERS and SARS with Concomitant Liver Injury—Systematic Review of the Existing Literature

Journal of Clinical Medicine ◽

10.3390/jcm9051420 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1420 ◽

Cited By ~ 14

Author(s):

Michał Kukla ◽

Karolina Skonieczna-Żydecka ◽

Katarzyna Kotfis ◽

Dominika Maciejewska ◽

Igor Łoniewski ◽

...

Keyword(s):

Systematic Review ◽

Liver Injury ◽

Clinical Course ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Intensive Care Treatment ◽

The Novel ◽

Massive Necrosis ◽

Novel Coronavirus ◽

Elevated Transaminases

The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has been predominantly linked to respiratory distress syndrome, but gastrointestinal symptoms and hepatic injury have also been reported. The mechanism of liver injury is poorly understood and may result as a consequence of viral hepatitis, systemic inflammatory response, gut barrier and microbiome alterations, intensive care treatment or drug toxicity. The incidence of hepatopathy among patients with coronavirus disease 2019 (COVID-19) is unclear, but studies have reported liver injury in patients with SARS and Middle East respiratory syndrome (MERS). We aimed to systematically review data on the prevalence of hepatic impairments and their clinical course in SARS and MERS Coronaviridae infections. A systematic literature search (PubMed/Embase/Cinahl/Web of Science) according to preferred reporting items for systematic review and meta-analysis protocols (PRISMA) was conducted from database inception until 17/03/2020 for studies that evaluated the incidence of hepatic abnormalities in SARS CoV-1, SARS CoV-2 and MERS infected patients with reported liver-related parameters. A total of forty-three studies were included. Liver anomalies were predominantly mild to moderately elevated transaminases, hypoalbuminemia and prolongation of prothrombin time. Histopathology varied between non-specific inflammation, mild steatosis, congestion and massive necrosis. More studies to elucidate the mechanism and importance of liver injury on the clinical course and prognosis in patients with novel SARS-CoV-2 infection are warranted.

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Cardiovascular manifestations in COVID-19 patients: A systematic review and meta-analysis

Journal of Cardiovascular and Thoracic Research ◽

10.34172/jcvtr.2021.30 ◽

2021 ◽

Vol 13 (3) ◽

pp. 181-189

Author(s):

Seyyedmohammadsadeq Mirmoeeni ◽

Amirhossein Azari Jafari ◽

Seyedeh Zohreh Hashemi ◽

Elham Angouraj Taghavi ◽

Alireza Azani ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Systolic Pressure ◽

Clinical Manifestations ◽

Laboratory Findings ◽

Cross Sectional ◽

Cardiovascular Comorbidities ◽

Study Characteristics ◽

Novel Coronavirus ◽

Cardiac Manifestations

Since December 2019, the COVID-19 pandemic has affected the global population, and one of the major causes of mortality in infected patients is cardiovascular diseases (CVDs).For this systematic review and meta-analysis, we systematically searched Google Scholar, Scopus, PubMed, Web of Science, and Cochrane databases for all articles published by April 2, 2020. Observational studies (cohort and cross-sectional designs) were included in this meta-analysis if they reported at least one of the related cardiovascular symptoms or laboratory findings in COVID-19 patients. Furthermore, we did not use any language, age, diagnostic COVID-19 criteria, and hospitalization criteria restrictions. The following keywords alone or in combination with OR and AND operators were used for searching the literature: "Wuhan coronavirus", "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "2019 novel coronavirus" "cardiovascular disease", "CVD", "hypertension", "systolic pressure", "dyspnea", "hemoptysis", and "arrhythmia". Study characteristics, exposure history, laboratory findings, clinical manifestations, and comorbidities were extracted from the retrieved articles. Sixteen studies were selected which involved 4754 patients, including 2103 female and 2639 male patients. Among clinical cardiac manifestations, chest pain and arrhythmia were found to have the highest incidence proportion. In addition, elevated lactate dehydrogenase (LDH) and D-dimer levels were the most common cardiovascular laboratory findings. Finally, hypertension, chronic heart failure, and coronary heart disease were the most frequently reported comorbidities. The findings suggest that COVID-19 can cause various cardiovascular symptoms and laboratory findings. It is also worth noting that cardiovascular comorbidities like hypertension have a notable prevalence among COVID-19 patients.

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The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-Analysis of Clinical and Paraclinical Characteristics

BioMed Research International ◽

10.1155/2020/3149020 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16 ◽

Cited By ~ 3

Author(s):

Hamidreza Hasani ◽

Shayan Mardi ◽

Sareh Shakerian ◽

Nooshin Taherzadeh-Ghahfarokhi ◽

Parham Mardi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Clinical Laboratory ◽

Meta Analysis ◽

Ct Scanning ◽

Imaging Features ◽

The Novel ◽

Laboratory Findings ◽

Global Concern ◽

Novel Coronavirus

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.

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625 EFFICACY OF MYOTOMY IN PATIENTS WITH SIGMOID MEGAESOPHAGUS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Diseases of the Esophagus ◽

10.1093/dote/doab052.625 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Marina Orlandini ◽

Maria Carolina Serafim ◽

Letícia Datrino ◽

Clara Santos ◽

Luca Tristão ◽

...

Keyword(s):

Systematic Review ◽

Heller Myotomy ◽

Selection Process ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Cochrane Library ◽

Cross Sectional ◽

Manual Search ◽

The Mean

Abstract Megaesophagus progress to sigmoid megaesophagus (SM) in 10–15% of patients, presenting tortuosity and sigmoid colon aspect. Esophagectomy is the choice treatment but is associated with high complications and mortality rates. To avoid the esophagectomy inherent morbidity, several authors recommend Heller myotomy (HM) with pull-down technique for SM, mainly for patients with comorbidities and the elderly. This systematic review and meta-analysis is the first to analyze the effectiveness of HM for treating SM. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, Lilacs (BVS), and manual search of references. Inclusion criteria were: a) clinical trials, cohort studies, case series; b) patients with SM and esophageal diameter ≥ 6 cm; and c) patients undergoing primary myotomy. The exclusion criteria were: a) reviews, case reports, cross-sectional studies, editorials, letters, congress abstracts, full-text unavailability; b) animal studies, c) previous surgical treatment for achalasia; and d) pediatric studies. There were no restrictions on language or date of publication, and no filters were applied for the selection process. Random model and a 95% confidence interval (CI) were used. Results Sixteen articles were selected, encompassing 231 patients. The mean age ranged from 36 to 61 years old, and the mean follow-up ranged from 16 to 109 months. The analyzed outcomes include mortality, complications (pneumonia, pneumothorax, gastroesophageal reflux), need for reintervention (remyotomy, dilation and esophagectomy), and results classified as ‘good’ and ‘excellent’. Mortality rate was 0.035 (CI: 0.017–0.07; p < 0.01). Complications rate was 0.08 (CI: 0.04–0.153; p = 0.01). Need for retreatment rate was 0.161 (CI: 0.053–0.399; p < 0.01). Probability of good or excellent outcomes after myotomy was 0.762 (CI: 0.693–0.819; p < 0,01). Conclusion Heller myotomy is an option for avoiding esophagectomy in achalasia, with a low morbimortality rate and good results. It is effective for most patients but will fail in a minority of patients and demand retreatment, be it a remyotomy, endoscopic treatment or esophagectomy.

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The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries

PLoS ONE ◽

10.1371/journal.pone.0234765 ◽

2020 ◽

Vol 15 (6) ◽

pp. e0234765 ◽

Cited By ~ 51

Author(s):

Michael C. Grant ◽

Luke Geoghegan ◽

Marc Arbyn ◽

Zakaria Mohammed ◽

Luke McGuinness ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

The Novel ◽

Novel Coronavirus

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The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis

Pain Research and Management ◽

10.1155/2020/2763808 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Hooman Ghasemi ◽

Behnam Khaledi-Paveh ◽

Alireza Abdi ◽

Rostam Jalali ◽

Nader Salari ◽

...

Keyword(s):

Systematic Review ◽

Sample Size ◽

Restless Legs Syndrome ◽

Meta Analysis ◽

Total Sample ◽

Knowledge Network ◽

Cross Sectional ◽

Neurologic Disorder ◽

Restless Legs ◽

Persian Language

Background. Migraine is a severe and debilitating neurologic disorder and is claimed to be the sixth disabling illness in the world. This study aimed to determine the overall prevalence of restless legs syndrome (RLS) in patients with migraine through a systematic review and meta-analysis. Methods. To identify and select related studies, the Scopus, ScienceDirect, Embase, SID, IranDoc, Web of Science, Knowledge Network System Medline (PubMed), and Google Scholar databases were searched. All related cross-sectional studies, published in English or Persian language between January 2000 and December 2019 and using the keywords such as migraine, restless leg syndrome, sleep disorder, RLS, and migraine disorder, were collected. The heterogeneity of the studies was assessed using the I2 index, and the data analysis was performed using the Comprehensive Meta-Analysis software. Results. Analysis was conducted on the reported results of the final 12 articles with the total sample size of 15196. The overall prevalence of RLS in patients with migraine was 16.3% (95% CI: 12.6–20.8%). The prevalence of RLS migraine patients decreased with increasing the sample size, and the prevalence of RLS migraine patients increased with increasing the research year, which was statistically significant (P<0.05). Conclusion. This study highlights that RLS is high in patients with migraine, and therefore, the clinicians should be aware of its incidence and take preventive measures.

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Epidural spinal cord stimulation for motor recovery in spinal cord injury: A systematic review

Neurorehabilitation ◽

10.3233/nre-210093 ◽

2021 ◽

pp. 1-24

Author(s):

Conor Mc Hugh ◽

Clare Taylor ◽

David Mockler ◽

Neil Fleming

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Motor Function ◽

Spinal Cord Stimulation ◽

Meta Analysis ◽

Total Sample ◽

Post Intervention ◽

Manual Search ◽

Cord Injury ◽

Epidural Spinal Cord Stimulation

BACKGROUND: Epidural spinal cord stimulation (ESCS) emerged as a technology for eliciting motor function in the 1990’s and was subsequently employed therapeutically in the spinal cord injured (SCI) population. Despite a considerable number of ESCS studies, a comprehensive systematic review of ESCS remains unpublished. OBJECTIVE: The current review of the existing literature evaluated the efficacy of ESCS for improving motor function in individuals with SCI. METHODS: A search for ESCS studies was performed using the following databases: Medline (Ovid), Web of Science and Embase. Furthermore, to maximize results, an inverse manual search of references cited by identified articles was also performed. Studies published between January 1995 and June 2020 were included. The search was constructed around the following key terms: Spinal cord stimulation, SCI and motor response generation. RESULTS: A total of 3435 articles were initially screened, of which 18 met the inclusion criteria. The total sample comprised of 24 participants with SCI. All studies reported some measure of improvement in motor activity with ESCS, with 17 reporting altered EMG responses. Functional improvements were reported in stepping (n = 11) or muscle force (n = 4). Only 5 studies assessed ASIA scale pre- and post-intervention, documenting improved classification in 4 of 11 participants. Appraisal using the modified Downs and Black quality checklist determined that reviewed studies were of poor quality. Due to heterogeneity of outcome measures utilized in studies reviewed, a meta-analysis of data was not possible. CONCLUSION: While the basic science is encouraging, the therapeutic efficacy of ESCS remains inconclusive.

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Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies

Systematic Reviews ◽

10.1186/s13643-021-01727-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Florence Perquier ◽

Sarah Hetrick ◽

Terri Rodak ◽

Xin Jing ◽

Wei Wang ◽

...

Keyword(s):

Systematic Review ◽

Suicidal Ideation ◽

Observational Studies ◽

Meta Analysis ◽

Random Effect ◽

Children And Youth ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Cross Sectional ◽

Wide Range

Abstract Background Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. Methods Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies’ quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger’s test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants’ characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. Discussion In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. Systematic review registration PROSPERO CRD42020165345

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