scholarly journals Impact of Hydroxychloroquine on Mortality in Hospitalized Patients with COVID-19: Systematic Review and Meta-Analysis

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 208
Author(s):  
Thomas S. Hong ◽  
Jimmy Gonzalez ◽  
Ronald G. Nahass ◽  
Luigi Brunetti
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Potential Role ◽  
Web Of Science ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Hospitalized Patients ◽  
Inpatient Setting ◽  
Random Effects Model ◽  
Significant Health

Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused significant health and economic havoc around the globe. One of the early agents targeted for repurposing to treat and prevent COVID-19 was hydroxychloroquine (HCQ). In this systematic review and meta-analysis, HCQ is evaluated for its potential role in decreasing mortality in hospitalized patients with COVID-19. We searched PubMed, Web of Science, and medRxiv databases using combinations of the terms “COVID-19”, “SARS-CoV-2”, “coronavirus”, “hydroxychloroquine”, and “mortality”. Articles were selected for further review based on the content of their abstracts. Studies were excluded if they were of poor methodological quality, were not based in the inpatient setting, or did not have available data to assess the primary outcome of death between patients treated with HCQ versus standard of care. Once the final dataset was compiled, a meta-analysis using the random-effects model was performed. Our search identified 14 studies involving 24,780 patients of whom 12,707 patients were on HCQ alone or in combination with other adjuvant therapies. HCQ alone or in combination with other drugs did not significantly decrease mortality in hospitalized patients with COVID-19 (odds ratio [OR], 0.95; 95% CI, 0.72–1.26; p = 0.732; I2 = 91.05). Similar findings were observed in all subgroup analyses. HCQ did not significantly impact mortality in hospitalized patients with COVID-19. Additional well-designed studies are essential due to the heterogeneity in available studies.

scholarly journals Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (10) ◽  
pp. 2016
Author(s):  
Mariachiara Ippolito ◽  
Barbara Simone ◽  
Carlotta Filisina ◽  
Francesca Romana Catalanotto ◽  
Giulia Catalisano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Web Of Science ◽  
Meta Analysis ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Secondary Outcome ◽  
Inclusion Criteria ◽  
Clinical Consequences

Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality of this patient population. Methods: A systematic search was performed on PubMed, EMBASE, and Web of Science from inception to 19 April 2021. The primary outcome was the occurrence of BSIs among hospitalized patients with COVID-19. The secondary outcome was mortality at the longest available follow-up. Results: Forty-six studies met the inclusion criteria, with a total of 42,694 patients evaluated. The estimated occurrence of BSIs was 7.3% (95% CI 4.7–1.1%) among hospitalized patients with COVID-19, with a mortality rate of 41% (95% CI 30%–52.8%). The subgroup analysis conducted on patients admitted to ICU provided an estimated occurrence of 29.6% (95% CI 21.7%–38.8%). A higher occurrence of BSI was observed in patients with COVID-19, in comparison with patients without COVID-19 (OR 2.77; 95% CI 1.53–5.02; p < 0.001). Conclusions: Our analysis estimated the occurrence of BSIs among hospitalized patients with COVID-19 at around 7%. A four-times higher occurrence was estimated among patients admitted to ICU.

scholarly journals Effect of Exercise and Meditation on Depression and Anxiety Reduction: A Systematic Review and Meta-analysis

2021 ◽  
Vol 27 (2) ◽  
pp. 144-161
Author(s):  
Saeed Mohammadi ◽  
◽  
Komeil Zahedi Tajrishi ◽  
Mojtaba Tashkeh ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Aerobic Exercise ◽  
Web Of Science ◽  
Meta Analysis ◽  
Female Gender ◽  
Anxiety Reduction ◽  
Control Group ◽  
Random Effects Model ◽  
Depression And Anxiety ◽  
Standardized Mean Difference

Objectives: Despite the studies that examined the effect of exercise and meditation on depression and anxiety, no meta-analysis has proved this effect so far. Also, the effect of these factors is unknown in terms of gender and aerobic exercise. This meta-analysis addressed these gaps. Methods: Major electronic databases, including PubMed, Web of Science, and Embase, were searched until July 2019. Studies addressing the effect of exercise and meditation on depression and anxiety were found. Q-test and I2 statistic investigated the heterogeneity across the studies. The probability of publication bias was explored using Begg's and Egger's tests. The results were expressed as the Standardized Mean Difference (SMD) with a 95% confidence interval using a random-effects model. Results: We identified a total of 10015 references and 51 studies involving 3594 participants. Compared with the control group, the SMD estimate of anxiety was -0.7 (-1.20, -0.19) for meditation, -0.9 (-1.24, -0.57) for aerobic, and -1.07 (-1.67, -0.46) for other exercises. Also, the SMD estimate of depression was-0.84 (-1.26, -0.42) for meditation, -0.44 (-0.72, -0.17) for aerobic, and -1.10 (-1.55, -0.65) for other exercises. Conclusion: Exercise and meditation had a significant effect on depression and anxiety. Furthermore, there was an effect of the exercise and meditation on depression and anxiety regarding the female gender and aerobic exercise.

The Effect of β-Blockers for Burn Patients on Clinical Outcomes: Systematic Review and Meta-Analysis

2020 ◽  
pp. 088506662094018
Author(s):  
Nasreen Hassoun-Kheir ◽  
Oryan Henig ◽  
Tomer Avni ◽  
Leonard Leibovici ◽  
Mical Paul
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Hospitalized Patients ◽  
Sufficient Evidence ◽  
Selective Reporting ◽  
Significant Difference ◽  
Β Blocker ◽  
Β Blockers

Objectives: To assess the effects and safety of β-blockers in hospitalized patients with burns. Methods: A systematic review and meta-analysis of the literature. A broad search was conducted to identify all randomized controlled trials (RCTs) comparing β-blockers to control in hospitalized patients with burns. The primary outcome was 3-month all-cause mortality. Secondary outcomes were clinical patient-relevant end points. We subgrouped results by children/adults and burn severity. Risk of bias was assessed using the individual domain approach. Results: Four RCTs reported in 11 publications were included. Primary outcome of mortality was assessed in children (2 trials, n = 424) and adults (2 trials, n = 148) with severe burns. No significant difference was found between propranolol and control for mortality (risk ratio [RR] = 0.82, 95% CI = 0.48-1.39, 4 trials with broad confidence intervals in adults and children), sepsis (RR = 0.81, 95% CI = 0.46-1.43, 2 trials), and survivors’ length of stay (absolute mean difference = 2.53, 95% CI = −2.58–7.63, 3 trials). There was no significant difference in bradycardia (RR = 1.33, 95% CI = 0.77-2.3, 2 trials), hypotension (RR = 1.26, 95% CI = 0.73-2.17, 3 trials), or cardiac arrhythmia (RR: 2.97, 95% CI: 0.12-71.87, 1 trial). The evidence was graded as very low certainty, due to trial’s internal risk of bias, imprecision, and possible selective reporting. Conclusions: No sufficient evidence was found to support or refute an advantage for β-blocker use in children or adults after burns. Additional studies are needed to create a consensus and formulate practice guidelines on the optimal β-blocker to use, indications for initiation, and duration of treatment.

scholarly journals Effect of Exercise and Meditation on Depression and Anxiety Reduction: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Saeed Mohammadi ◽  
◽  
Komeil Zahedi ◽  
Mojtaba Tashkeh ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Aerobic Exercise ◽  
Web Of Science ◽  
Meta Analysis ◽  
Female Gender ◽  
Anxiety Reduction ◽  
Control Group ◽  
Random Effects Model ◽  
Depression And Anxiety ◽  
Standardized Mean Difference

Objectives: Despite the existence of studies that associated effect of exercise and meditation on depression and anxiety, there was no meta-analysis to date, that can prove this effect definitely. Also, the effect of these factors by gender and aerobic exercise are unknown. This gap was addressed by this meta-analysis. Methods: Major electronic databases, including PubMed, Web of Science, and Embase were searched until July 2019. Studies addressing the effect of exercise and meditation on depression and anxiety were enrolled. The heterogeneity across studies was investigated by Q-test and I2 statistic. The probability of publication bias was explored using Beggchr('39')s and Eggerchr('39')s tests. The results were expressed as the standardized mean difference (SMD) with 95% confidence intervals (CI) using a random-effects model. Results: We identified a total of 10,015 references and included 51 studies involving 3,594 participants. Compared control group, the SMD estimate of anxiety was -0.7 (-1.20, -0.19) for meditation, -0.9 (-1.24, -0.57) for aerobic, -1.07 (-1.67, -0.46) for other exercise, and the SMD estimate of depression was-0.84 (-1.26, -0.42) for meditation, -0.44 (-0.72, -0.17) for aerobic, and -1.10 (-1.55, -0.65) for other exercise. Conclusions: Exercise and meditation had a significant effect on depression and anxiety. Furthermore, there was an effect of the exercise and meditation on depression and anxiety by female gender and aerobic exercise.

scholarly journals Relationship between gestational acrylamide exposure and offspring’s growth: a systematic review and meta-analysis of cohort studies

2020 ◽  
Vol 23 (10) ◽  
pp. 1791-1799
Author(s):  
Yongle Zhan ◽  
Ying Xiao ◽  
Tianjia Guan ◽  
Shuyang Zhang ◽  
Yu Jiang
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Web Of Science ◽  
Meta Analysis ◽  
Maternal Diet ◽  
Effect Sizes ◽  
Current Evidence ◽  
Random Effects Model ◽  
Exposure Group ◽  
Dietary Strategy

AbstractObjective:To estimate the current evidence regarding the association between gestational acrylamide (AA) exposure and offspring’s growth.Design:Systematic review and meta-analysis.Setting:A systematic literature search for relevant publications was conducted using PubMed, Medline, Embase, Web of Science databases from inception to 26 April 2019. The standardised mean difference (SMD) or OR with 95 % CI was selected as the effect sizes and was calculated using a random effects model.Results:Five cohort studies including 54 728 participants were identified. Offspring’s birth weight was significantly lower in high AA exposure group than in low AA exposure group (SMD –0·05, 95 % CI –0·09, –0·02, P = 0·005). There was also an association between maternal AA exposure and small for gestational age (OR 1·14, 95 % CI 1·06, 1·23, P < 0·001). In addition, pooled ORs suggested that children had a high risk of developing overweight/obesity in the future in maternal high AA exposure group (OR 1·14, 95 % CI 1·08, 1·21, P < 0·001 at age 3; OR 1·13, 95 % CI 1·07, 1·19, P < 0·001 at age 5; OR 1·09, 95 % CI 1·02, 1·16, P = 0·020 at age 8).Conclusions:These findings have important implications for conducting health education, providing guidance on maternal diet and developing an appropriate dietary strategy for pregnant women to reduce dietary AA exposure.

scholarly journals Systemic Coagulopathy in Hospitalized Patients With Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 27 ◽  
pp. 107602962098762
Author(s):  
Noppacharn Uaprasert ◽  
Chatphatai Moonla ◽  
Darintr Sosothikul ◽  
Ponlapat Rojnuckarin ◽  
Thita Chiasakul
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Coagulation Activation ◽  
Pooled Prevalence ◽  
Cochrane Database ◽  
High Incidence ◽  
D Dimer

Coagulation activation has been reported in several cohorts of patients Coronavirus Disease 2019 (COVID-19). However, the true burden of systemic coagulopathy in COVID-19 remains unknown. In this systematic review and meta-analysis, we performed a literature search using PubMed, EMBASE, and Cochrane Database to identify studies that reported the prevalence of systemic coagulopathy using established criteria in patients with COVID-19. The primary outcome was the prevalence of systemic coagulopathy (disseminated intravascular coagulation [DIC] and/or sepsis-induced coagulopathy [SIC]). Pooled prevalences and 95% confidence intervals [CIs] were calculated using random-effects model. A total of 5 studies including 1210 patients with confirmed COVID-19 were included. The pooled prevalence of systemic coagulopathy was 7.1% (95%CI: 3.2%,15.3%, I2 = 93%). The pooled prevalence of DIC (N = 721) and SIC (N = 639) were 4.3% (95%CI 1.7%, 10.4%, I2 = 84%) and 16.2% (95%CI: 9.3%, 26.8%, I2 = 74%), respectively. Only 2 studies reported the prevalence of elevated D-dimer levels with the pooled prevalence of 84.6% (95%CI: 52.0%,96.5%, I2 = 94%). Average D-dimer and fibrinogen levels were remarkably increased, while platelet counts, PT, and aPTT ratios were minimally affected in COVID-19. The estimated prevalence of systemic coagulopathy in patients with COVID-19 was low despite D-dimer elevation in most patients. Relatively low systemic coagulopathy in COVID-19 may contribute to the high incidence of thrombosis rather than bleeding in patients with COVID-19.

scholarly journals Ventilator-Associated Pneumonia in Patients with COVID-19: A Systematic Review and Meta-Analysis

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 545
Author(s):  
Mariachiara Ippolito ◽  
Giovanni Misseri ◽  
Giulia Catalisano ◽  
Claudia Marino ◽  
Giulia Ingoglia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Web Of Science ◽  
Comparison Group ◽  
Meta Analysis ◽  
Random Effect ◽  
Ventilator Associated Pneumonia ◽  
Icu Length Of Stay ◽  
Reporting Data

The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of ventilator-associated pneumonia (VAP) among patients admitted to an intensive care unit with COVID-19 and mortality of those who developed VAP. We performed a systematic search on PubMed, EMBASE and Web of Science from inception to 2nd March 2021 for nonrandomized studies specifically addressing VAP in adult patients with COVID-19 and reporting data on at least one primary outcome of interest. Random effect single-arm meta-analysis was performed for the occurrence of VAP and mortality (at the longest follow up) and ICU length of stay. Twenty studies were included in the systematic review and meta-analysis, for a total of 2611 patients with at least one episode of VAP. The pooled estimated occurrence of VAP was of 45.4% (95% C.I. 37.8–53.2%; 2611/5593 patients; I2 = 96%). The pooled estimated occurrence of mortality was 42.7% (95% C.I. 34–51.7%; 371/946 patients; I2 = 82%). The estimated summary estimated metric mean ICU LOS was 28.58 days (95% C.I. 21.4–35.8; I2 = 98%). Sensitivity analysis showed that patients with COVID-19 may have a higher risk of developing VAP than patients without COVID-19 (OR 3.24; 95% C.I. 2.2–4.7; P = 0.015; I2 = 67.7%; five studies with a comparison group).

scholarly journals The Association between Season and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Lingyun Liao ◽  
Xiaohong Wei ◽  
Min Liu ◽  
Yijie Gao ◽  
Yangxue Yin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Random Effects ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
The Cochrane Library

Abstract Background: There is increasing and inconsistent evidence of a relationship between hypertensive disorders of pregnancy (HDP) and season of delivery or conception.Methods: Four databases, the Cochrane Library, PubMed, EMBASE and Web of Science, were searched until September 29th, 2021. Two authors extracted data independently. A random effects model and the Mantel-Haenszel method were used to calculate pooled ORs and 95% CIs.Results: Twenty articles were included in the systematic review, and 11 articles were included in the meta-analysis. The quantitative analysis of the association between delivery season and HDP showed that the odds of HDP was higher in women who deliver in winter than in those who delivered in summer (OR=1.18, 95% CI 1.02-1.38, p < 0.001) and all other seasons (OR = 1.17, 95% CI 1.03-1.34, p <0.001). In the qualitative analysis of the association between conception season and HDP, 4 of 7 studies suggested that women who conceived in summer had a higher risk of HDP than those who conceived in other seasons.Conclusions: Based on the evidence to date, we found weakly positive relationships between HDP and summer conception and winter delivery.

scholarly journals Virtual reality biofeedback interventions for treating anxiety

2022 ◽  
Author(s):  
Oswald D. Kothgassner ◽  
Andreas Goreis ◽  
Ines Bauda ◽  
Amelie Ziegenaus ◽  
Lisa M. Glenk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Virtual Reality ◽  
Primary Outcome ◽  
Web Of Science ◽  
Meta Analysis ◽  
Research Synthesis ◽  
Waiting List ◽  
Controlled Trials ◽  
Randomized Controlled

Summary Background Virtual reality (VR)-based biofeedback is a relatively new intervention and is increasingly being used for the treatment of anxiety disorders. This is the first research synthesis regarding effects and efficacy of this novel mode of treatment. Method We conducted a systematic review and meta-analysis of the VR biofeedback literature on treating anxiety symptoms. The MEDLINE/PubMed, Scopus and Web of Science databases were searched for eligible pre-post comparisons and randomized controlled trials (RCTs). We used self-reported anxiety, heart rate (HR), and heart rate variability (HRV) as primary outcome measures. Results A total of 7 studies with 191 participants reported VR biofeedback interventions. Of these studies 5 were RCTs, with 103 participants receiving VR biofeedback and 99 control participants (either 2D biofeedback or waiting list controls). We found that VR biofeedback significantly lowers self-reported anxiety (g = −0.28) and HR (g = −0.45), but not HRV. Furthermore, there were no significant differences in outcomes between VR biofeedback and 2D biofeedback but a significant reduction in HR in the VR biofeedback group compared with the waiting list (g = −0.52). Conclusion While the first findings are optimistic, more controlled studies with a wider variety of samples are needed to bring this field forward. Particularly, children and adolescents may profit from the combination of gamification elements, VR, and biofeedback.

scholarly journals Distribution of Streptococcus agalactiae Among Iranian Women from 1992 to 2018: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Maryam Sadeh ◽  
Amin Salehi-Abargouei ◽  
Nastaran Azartoos ◽  
Farzaneh Mirzaei ◽  
Mohammad Bagher Khalili
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Web Of Science ◽  
Meta Analysis ◽  
Group B Streptococcus ◽  
Random Effects Model ◽  
Iranian Women ◽  
Context Group ◽  
Group B ◽  
Colonization Rates

Context: Group B Streptococcus has the capacity of being colonized in the rectovaginal organ of women and causes infections in a mother and her fetus, thereby leading to neonatal diseases. Evidence Acquisition: The aim of this review was to summarize all of the relevant articles published to highlight the prevalence of group B Streptococcus colonization or infection in different regions of Iran. A systematic literature review was conducted by searching PubMed, Scopus, Web of Science (ISI), ScienceDirect, Google Scholar, and domestic databases for papers published in English or Persian from 1992 up to July 2019, concerning the prevalence of group B Streptococcus among Iranian women. All information regarding year, location of cases, frequency, author’s name, date of publication, participants, pregnancy period, sampling, and quality assessment were recorded. Summary effects were derived using the random effects model. Results: Among 61 suitable papers, data revealed that 36,807 cases of pregnant and non-pregnant women had been tested for group B Streptococcus during 1992-2018. Overall, 11.9% of pregnant and 5.3% of non-pregnant women were positive. Further results were as follows: vaginal, recto-vaginal, rectal, and endocervical colonization rates were 12.9%, 9.7%, 18.5%, and 3.7%, respectively. Group B Streptococcus incidence was the highest in Sanandaj (61.5%), and the lowest in Tabriz (1.8%). Conclusions: Although the prevalence distribution in Iran seems to be acceptable, more investigations are needed to represent the real incidence of group B Streptococcus around the country. In addition, a program with a standard lab technique is needed to screen pregnant women for further treatment before birth.

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