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Cheema HA, Ali A, Ali M, Shahid A, Ghafoor MS, Ur Rehman ME, Sah R, Sahra S, Ahmad S. Efficacy and Safety of Favipiravir for the Treatment of COVID-19 Outpatients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Ther 2024; 31:e328-e331. [PMID: 37647511 DOI: 10.1097/mjt.0000000000001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Huzaifa Ahmad Cheema
- Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Abraish Ali
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mirha Ali
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Abia Shahid
- Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | | | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Harvard Medical School, Boston, MA
| | - Syeda Sahra
- Department of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, OK; and
| | - Sharjeel Ahmad
- Department of Medicine, Section of Infectious Diseases, University of Illinois College of Medicine, Peoria
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Cheema HA, Jafar U, Shahid A, Masood W, Usman M, Hermis AH, Naseem MA, Sahra S, Sah R, Lee KY. Colchicine for the treatment of patients with COVID-19: an updated systematic review and meta-analysis of randomised controlled trials. BMJ Open 2024; 14:e074373. [PMID: 38631824 PMCID: PMC11029412 DOI: 10.1136/bmjopen-2023-074373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES We conducted an updated systematic review and meta-analysis to investigate the effect of colchicine treatment on clinical outcomes in patients with COVID-19. DESIGN Systematic review and meta-analysis. DATA SOURCES We searched PubMed, Embase, the Cochrane Library, medRxiv and ClinicalTrials.gov from inception to January 2023. ELIGIBILITY CRITERIA All randomised controlled trials (RCTs) that investigated the efficacy of colchicine treatment in patients with COVID-19 as compared with placebo or standard of care were included. There were no language restrictions. Studies that used colchicine prophylactically were excluded. DATA EXTRACTION AND SYNTHESIS We extracted all information relating to the study characteristics, such as author names, location, study population, details of intervention and comparator groups, and our outcomes of interest. We conducted our meta-analysis by using RevMan V.5.4 with risk ratio (RR) and mean difference as the effect measures. RESULTS We included 23 RCTs (28 249 participants) in this systematic review. Colchicine did not decrease the risk of mortality (RR 0.99; 95% CI 0.93 to 1.05; I2=0%; 20 RCTs, 25 824 participants), with the results being consistent among both hospitalised and non-hospitalised patients. There were no significant differences between the colchicine and control groups in other relevant clinical outcomes, including the incidence of mechanical ventilation (RR 0.75; 95% CI 0.48 to 1.18; p=0.22; I2=40%; 8 RCTs, 13 262 participants), intensive care unit admission (RR 0.77; 95% CI 0.49 to 1.22; p=0.27; I2=0%; 6 RCTs, 961 participants) and hospital admission (RR 0.74; 95% CI 0.48 to 1.16; p=0.19; I2=70%; 3 RCTs, 8572 participants). CONCLUSIONS The results of this meta-analysis do not support the use of colchicine as a treatment for reducing the risk of mortality or improving other relevant clinical outcomes in patients with COVID-19. However, RCTs investigating early treatment with colchicine (within 5 days of symptom onset or in patients with early-stage disease) are needed to fully elucidate the potential benefits of colchicine in this patient population. PROSPERO REGISTRATION NUMBER CRD42022369850.
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Affiliation(s)
| | - Uzair Jafar
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Abia Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Waniyah Masood
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Usman
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Alaa Hamza Hermis
- Nursing College, Al-Mustaqbal University, 51001 Hillah, Babylon, Iraq
| | | | - Syeda Sahra
- Department of Infectious Diseases, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ranjit Sah
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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Umer M, Naveed A, Maryam Q, Cheema HA, Shahid A, Hermis AH, Chinnam S, Swed S, Sahra S. Nigella sativa for the treatment of COVID-19 patients: A rapid systematic review and meta-analysis of randomized controlled trials. Food Sci Nutr 2024; 12:2061-2067. [PMID: 38455176 PMCID: PMC10916652 DOI: 10.1002/fsn3.3906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/17/2023] [Accepted: 12/01/2023] [Indexed: 03/09/2024] Open
Abstract
Nigella sativa is an herbal therapy for various afflictions. It has some potential to be a promising option as an efficacious treatment for COVID-19 patients that can contribute to global healthcare as a relatively cheap therapy but evidence of its use from randomized controlled trials (RCTs) is limited. Therefore, to explore the effect of N. sativa in combating COVID-19, we undertook this meta-analysis. We searched several databases to retrieve all RCTs investigating N. sativa for the treatment of COVID-19 as compared to placebo or standard care. We used RevMan 5.4 for all analyses with risk ratio (RR) or odds ratio (OR) as the effect measures. We included a total of seven RCTs in this review. N. sativa significantly reduced the risk of all-cause mortality in patients with COVID-19 compared to the control group (RR 0.27, 95% CI: 0.10 to 0.72; I 2 = 0%). N. sativa significantly reduced the rate of viral PCR positivity (RR 0.62, 95% CI: 0.39 to 0.97; I 2 = 0%). We did not find any significant difference in the risk of hospitalization (RR 0.26, 95% CI: 0.04 to 1.54; I 2 = 0%) and the rate of no recovery (OR 0.48, 95% CI: 0.20 to 1.15; I 2 = 84%) between the two groups. N. sativa is an easily available herbal medicine that may decrease the risk of mortality and improve virological clearance in COVID-19 patients. However, our results are limited by the small number of RCTs available. Further large-scale RCTs are needed to better understand the anti-inflammatory and antiviral effects of N. sativa in COVID-19 patients.
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Affiliation(s)
- Mohammad Umer
- Division of Infectious Diseases, Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Aiman Naveed
- Division of Infectious Diseases, Department of MedicineKing Edward Medical UniversityLahorePakistan
| | | | - Huzaifa Ahmad Cheema
- Division of Infectious Diseases, Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Abia Shahid
- Division of Infectious Diseases, Department of MedicineKing Edward Medical UniversityLahorePakistan
| | | | - Sampath Chinnam
- Department of ChemistryM. S. Ramaiah Institute of Technology (Affiliated with Visvesvaraya Technological University, Belgaum)BengaluruKarnatakaIndia
| | - Sarya Swed
- Faculty of MedicineAleppo UniversityAleppoSyria
| | - Syeda Sahra
- Department of Infectious DiseasesUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
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Ghaemi M, Hantoushzadeh S, Shafiee A, Gargari OK, Fathi H, Eshraghi N, Razavi J, Habibi GR, Jafarabady K. The effect of COVID-19 and COVID-19 vaccination on serum anti-Mullerian hormone: A systematic review and meta-analysis. Immun Inflamm Dis 2024; 12:e1136. [PMID: 38270314 PMCID: PMC10777886 DOI: 10.1002/iid3.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE The current study aims to evaluate the impact of COVID-19 infection and vaccination on ovarian reserve by detecting the anti-Mullerian hormone (AMH) level. METHOD PubMed, Embase, Web of Science, and Scopus has been searched for studies assessing the effect of COVID-19 infection and/or vaccination on AMH levels up to February 27, 2023. Based on PRISMA 2020 statement criteria, a systematic review and meta-analysis of included studies were performed. The studies' quality was assessed by the National Institute of Health (NIH) quality assessment tool. The standardized mean difference (MD) of the AMH level was used and the quantitative values of each study were pooled separately by using a random effect model. RESULTS Out of 246 studies screened, 18 were included in the systematic review and 14 in the meta-analysis. Included studies were published between 2021 and 2022 and were conducted in different countries, including the USA (n = 3), China (n = 2), Russia (n = 2), Turkey (n = 5), Israel (n = 3), Czech (n = 2), and Spain (n = 1). Eight studies investigated the effect of SARS-CoV-2 infection on AMH levels, and ten studies investigated the possible effect of COVID-19 vaccination on AMH levels. The pooled analysis showed a statistically significant decrease in AMH levels after COVID-19 infection (SMD: -0.24; 95% CI: -0.36 to -0.11; I2 = 0%; p = .0003). Vaccination analysis showed a nonstatistically significant change in AMH levels after COVID-19 vaccination (SMD: -0.11; 95% CI: -0.25 to 0.04; I2 = 35%; p = .14). CONCLUSION COVID-19 infection can result in ovarian reserve injury by reducing the AMH level but getting vaccinated against COVID-19 has no impact on the AMH level.
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Affiliation(s)
- Marjan Ghaemi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Sedigheh Hantoushzadeh
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Arman Shafiee
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
- Department of Psychiatry and Mental HealthAlborz University of Medical SciencesKarajIran
| | - Omid Kohandel Gargari
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Hanieh Fathi
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Nasim Eshraghi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Jafar Razavi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Gholam Reza Habibi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Kyana Jafarabady
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
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Shafiee A, Jafarabady K, Rajai S, Mohammadi I, Mozhgani SH. Sleep disturbance increases the risk of severity and acquisition of COVID-19: a systematic review and meta-analysis. Eur J Med Res 2023; 28:442. [PMID: 37853444 PMCID: PMC10583304 DOI: 10.1186/s40001-023-01415-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Understanding the association between sleep quality and COVID-19 outcomes is crucial for effective preventive strategies and patient management. This systematic review aims to evaluate the impact of sleep quality as a risk factor for acquiring COVID-19 infection and the severity of the disease. METHODS A comprehensive search of electronic databases was conducted to identify relevant studies published from the inception of the COVID-19 pandemic which was 31st of December 2019 until 30 April 2023. Studies investigating the relationship between sleep quality and COVID-19 infection, or disease severity were included. Random effect meta-analysis was performed with odds ratios (OR) and their 95% confidence intervals (95% CI) as effect measures. RESULTS Out of the initial 1,132 articles identified, 12 studies met the inclusion criteria. All studies were observational studies (cohort, case-control, and cross-sectional). The association between sleep quality and COVID-19 infection risk was examined in 6 studies, The results of our meta-analysis showed that participants with poor sleep quality showed a 16% increase regarding the risk of COVID-19 acquisition (OR 1.16; 95% CI 1.03, 1.32; I2 = 65.2%, p = 0.02). Our results showed that participants with poor sleep quality showed a 51% increase in the incidence of primary composite outcome (OR 1.51; 95% CI 1.25, 1.81; I2 = 57.85%, p < 0.001). The result of our subgroup analysis also showed significantly increased risk of mortality (RR 0.67; 95% CI 0.50, 0.90; I2 = 31%, p = 0.008), and disease severity (OR 1.47; 95% CI 1.19, 1.80; I2 = 3.21%, p < 0.001) when comparing poor sleep group to those with good sleep quality. CONCLUSION This study highlights a significant association between poor sleep quality and an increased risk of COVID-19 infection as well as worse disease clinical outcomes.
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Affiliation(s)
- Arman Shafiee
- Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran.
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Kyana Jafarabady
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Shahryar Rajai
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ida Mohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed-Hamidreza Mozhgani
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
- Non-Communicable Diseases Research Center, Alborz University of Medical, Sciences, Karaj, Iran.
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Cheema HA, Rehman AU, Elrashedy AA, Mohsin A, Shahid A, Ehsan M, Ayyan M, Ismail H, Almas T. Antiandrogens for the treatment of COVID-19 patients: A meta-analysis of randomized controlled trials. J Med Virol 2023; 95:e28740. [PMID: 37185842 DOI: 10.1002/jmv.28740] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/27/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
Antiandrogens may carry a potential benefit as a therapeutic agent against COVID-19. However, studies have been yielding mixed results, thus hindering any objective recommendations. This necessitates a quantitative synthesis of data to quantify the benefits of antiandrogens. We systematically searched PubMed/MEDLINE, Cochrane Library, clinical trial registers, and reference lists of included studies to identify relevant randomized controlled trials (RCTs). Results from the trials were pooled using a random-effects model and outcomes were reported as risk ratios (RR) and mean differences (MDs) with 95% confidence intervals (CIs). Fourteen RCTs with a total sample size of 2593 patients were included. Antiandrogens yielded a significant mortality benefit (RR 0.37; 95% CI; 0.25-0.55). However, on subgroup analysis, only proxalutamide/enzalutamide and sabizabulin were found to significantly reduce mortality (RR 0.22, 95% CI: 0.16-0.30 and RR 0.42, 95% CI: 0.26-0.68, respectively), while aldosterone receptor antagonists and antigonadotropins did not show any benefit. No significant between-group difference was found in the early or late initiation of therapy. Antiandrogens also reduced hospitalizations and the duration of hospital stay, and improved recovery rates. Proxalutamide and sabizabulin may be effective against COVID-19, however, further large-scale trials are needed to confirm these findings.
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Affiliation(s)
- Huzaifa Ahmad Cheema
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | - Aqeeb Ur Rehman
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | | | - Aleenah Mohsin
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | - Abia Shahid
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Ehsan
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Ayyan
- Department of Medicine, Division of Infectious Diseases, King Edward Medical University, Lahore, Pakistan
| | - Heba Ismail
- Department of Internal Medicine, Limerick University Hospital, Limerick, Ireland
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Cheema HA, Sohail A, Fatima A, Shahid A, Shahzil M, Ur Rehman ME, Awan RU, Chinnam S, Nashwan AJ. Quercetin for the treatment of COVID-19 patients: A systematic review and meta-analysis. Rev Med Virol 2023; 33:e2427. [PMID: 36779438 DOI: 10.1002/rmv.2427] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/14/2023]
Abstract
Currently approved therapies for COVID-19 are mostly limited by their low availability, high costs or the requirement of parenteral administration by trained medical personnel in an in-hospital setting. Quercetin is a cheap and easily accessible therapeutic option for COVID-19 patients. However, it has not been evaluated in a systematic review until now. We aimed to conduct a meta-analysis to assess the effect of quercetin on clinical outcomes in COVID-19 patients. Various databases including PubMed, the Cochrane Library and Embase were searched from inception until 5 October 2022 and results from six randomized controlled trials (RCTs) were pooled using a random-effects model. All analyses were conducted using RevMan 5.4 with odds ratio (OR) as the effect measure. Quercetin decreased the risk of intensive care unit admission (OR = 0.31; 95% confidence interval (CI) 0.10-0.99) and the incidence of hospitalisation (OR = 0.25; 95% CI 0.10-0.62) but did not decrease the risk of all-cause mortality and the rate of no recovery. Quercetin may be of benefit in COVID-19 patients, especially if administered in its phytosome formulation which greatly enhances its bioavailability but large-scale RCTs are needed to confirm these findings.
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Affiliation(s)
- Huzaifa Ahmad Cheema
- Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Aruba Sohail
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Areej Fatima
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abia Shahid
- Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Shahzil
- Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan.,SSM Health St. Anthony Hospital, Oklahoma City, Oklahoma, USA
| | | | - Rehmat Ullah Awan
- Department of Medicine, Ochsner Rush Medical Center, Meridian, Mississippi, USA
| | - Sampath Chinnam
- Department of Chemistry, M. S. Ramaiah Institute of Technology, Bengaluru, Karnataka, India.,Visvesvaraya Technological University, Belgaum, Karnataka, India
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