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Zyoud SH. Global landscape of COVID-19 research: a visualization analysis of randomized clinical trials. Clin Exp Med 2024; 24:14. [PMID: 38252392 PMCID: PMC10803477 DOI: 10.1007/s10238-023-01254-3] [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: 05/16/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
The emergence of COVID-19 in 2019 has resulted in a significant global health crisis. Consequently, extensive research was published to understand and mitigate the disease. In particular, randomized controlled trials (RCTs) have been considered the benchmark for assessing the efficacy and safety of interventions. Hence, the present study strives to present a comprehensive overview of the global research landscape pertaining to RCTs and COVID-19. A bibliometric analysis was performed using the Scopus database. The search parameters included articles published from 2020 to 2022 using keywords specifically related to COVID-19 and RCTs. The data were analyzed using various bibliometric indicators. The volume of publications, contributions of countries and institutions, funding agencies, active journals, citation analysis, co-occurrence analysis, and future research direction analysis were specifically analyzed. A total of 223,480 research articles concerning COVID-19 were published, with 3,727 of them related to RCTs and COVID-19. The ten most productive countries collectively produced 75.8% of the documents, with the United States leading the way by contributing 31.77%, followed by the UK with 14.03% (n = 523), China with 12.96% (n = 483) and Canada with 7.16% (n = 267). Trials (n = 173, 4.64%), BMJ Open (n = 81, 2.17%), PLOS One (n = 73, 1.96%) and JAMA Network Open (n = 53, 1.42%) were the most active journals in publishing articles related to COVID-19 RCTs. The co-occurrence analysis identified four clusters of research areas: the safety and effectiveness of COVID-19 vaccines, mental health strategies to cope with the impact of the pandemic, the use of monoclonal antibodies to treat patients with COVID-19, and systematic reviews and meta-analyses of COVID-19 research. This paper offers a detailed examination of the global research environment pertaining to RCTs and their use in the context of the COVID-19 pandemic. The comprehensive body of research findings was found to have been generated by the collaborative efforts of multiple countries, institutions, and funding organizations. The predominant research areas encompassed COVID-19 vaccines, strategies for mental health, monoclonal antibodies, and systematic reviews. This information has the potential to aid researchers, policymakers, and funders in discerning areas of weakness and establishing areas of priority.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Qin G, Li H, Qin Y, Liu B. Is the COVID-19 epidemic affecting the body mass of Chinese teenagers? - A longitudinal follow-up study. Front Public Health 2023; 11:1269076. [PMID: 38074753 PMCID: PMC10701275 DOI: 10.3389/fpubh.2023.1269076] [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: 07/29/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background After the spread and outbreak of COVID-19 worldwide, the learning, lifestyle, and health level of young individuals have been immensely impacted. With regard to the existing studies, the development trend of adolescents' body shape in the late COVID-19 period is not sufficiently analyzed, and relevant targeted investigation is lacking. This study aimed to explore the body mass index (BMI) changes of 6-14 years-old adolescents before and after the COVID-19 epidemic, and to provide a reference for promoting the continuous enhancement of adolescent health. Methods The BMI and related data pertaining to 93,046 individuals from 2019 to 2022 were collected by cluster sampling, and changes in the BMI Z score and detection rate of overweight and obese adolescents before and after the epidemic were analyzed. Furthermore, the trend of obesity rates among adolescents in Jinan from 2019 to 2022 was analyzed using a logistic regression analysis model. Results The one-way ANOVA models indicated that the BMI Z score of 6-14 years-old adolescents in 2020 significantly increased compared to 2019 (p < 0.01), and decreased in 2021 and 2022; in 2020, the obesity rate of adolescents exhibited a significant increase; however, the rate decreased after being controlled in 2021 and 2022. The normal-body size proportion continued to rise (p < 0.01), and adolescents of different age groups and genders exhibited similar development trends; the results of the logistic regression analysis indicate that there was a significant increase in obesity rates in 2020, adolescents of different age groups and genders exhibited similar development trends (p < 0.05). Conclusion This study demonstrated that the COVID-19 epidemic impacts the BMI and obesity detection rate of adolescents. Adolescents from different age groups and genders exhibited similar development trends.
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Affiliation(s)
- Guoyang Qin
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Hui Li
- Physical Education Teaching and Research Group, Shandong Water Conservancy Vocational College, Rizhao, China
| | - Yong Qin
- Physical Education Teaching and Research Office, Lixia District Bureau of Education and Sports of Jinan City, Jinan, China
| | - Bin Liu
- Physical Education Teaching and Research Group, Jinan Licheng No.2 High School, Jinan, China
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Cappelletti P, Gallo G, Marino R, Palaniappan S, Corbo M, Savoia C, Feligioni M. From cardiovascular system to brain, the potential protective role of Mas Receptors in COVID-19 infection. Eur J Pharmacol 2023; 959:176061. [PMID: 37775018 DOI: 10.1016/j.ejphar.2023.176061] [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: 07/13/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has been declared a new pandemic in March 2020. Although most patients are asymptomatic, those with underlying cardiovascular comorbidities may develop a more severe systemic infection which is often associated with fatal pneumonia. Nonetheless, neurological and cardiovascular manifestations could be present even without respiratory symptoms. To date, no COVID-19-specific drugs are able for preventing or treating the infection and generally, the symptoms are relieved with general anti-inflammatory drugs. Angiotensin-converting-enzyme 2 (ACE2) may function as the receptor for virus entry within the cells favoring the progression of infection in the organism. On the other hand, ACE2 is a relevant enzyme in renin angiotensin system (RAS) cascade fostering Ang1-7/Mas receptor activation which promotes protective effects in neurological and cardiovascular systems. It is known that RAS is composed by two functional countervailing axes the ACE/AngII/AT1 receptor and the ACE/AngII/AT2 receptor which counteracts the actions mediated by AngII/AT1 receptor by inducing anti-inflammatory, antioxidant and anti-growth functions. Subsequently an "alternative" ACE2/Ang1-7/Mas receptor axis has been described with functions similar to the latter protective arm. Here, we discuss the neurological and cardiovascular effects of COVID-19 highlighting the role of the stimulation of the RAS "alternative" protective arm in attenuating pulmonary, cerebral and cardiovascular damages. In conclusion, only two clinical trials are running for Mas receptor agonists but few other molecules are in preclinical phase and if successful these drugs might represent a successful strategy for the treatment of the acute phase of COVID-19 infection.
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Affiliation(s)
- Pamela Cappelletti
- Department of Neuro-Rehabilitation Sciences, Casa di Cura Igea, Milan, Italy.
| | - Giovanna Gallo
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rachele Marino
- European Brain Research Institute (EBRI) Rita Levi Montalcini Foundation, Rome, Italy
| | | | - Massimo Corbo
- Department of Neuro-Rehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Carmine Savoia
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Feligioni
- Department of Neuro-Rehabilitation Sciences, Casa di Cura Igea, Milan, Italy; European Brain Research Institute (EBRI) Rita Levi Montalcini Foundation, Rome, Italy.
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Lamb MM, DeHority K, Russel SM, Kim S, Stack T, Mohammad I, Zeatoun A, Klatt-Cromwell C, Ebert CS, Baratta JM, Senior BA, Kimple AJ. Characteristics of olfactory dysfunction in patients with long-haul covid-19. RHINOLOGY ONLINE 2023; 6:30-37. [PMID: 37711977 PMCID: PMC10501207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Background A subset of individuals suffering from Coronavirus Disease 2019 (COVID-19) will experience ongoing symptoms that last longer than three months (i.e., long-haul COVID). This includes olfactory dysfunction (OD), which is currently estimated to occur in 1-63.5% of patients at one-year post-infection. However, OD in individuals with long-haul COVID-19 is poorly understood, and there is little information regarding how initial SARS-CoV-2 variants correlate with long-haul symptoms. In this study, we investigated the prevalence and severity of OD in patients with long-haul COVID-19 and investigated how OD severity varied with SARS-CoV-2 variants. Methods Patients were recruited from the University of North Carolina-Chapel Hill COVID Recovery Clinic. Each patient completed the University of Pennsylvania Smell Identification Test (UPSIT). The dominant strain at the time of infection was determined using the date of COVID-19 diagnosis, and Centers for Disease Control and Prevention, World Health Organization, and North Carolina Department of Health and Human Services databases. Results Nearly 85% of patients with long-haul COVID-19 reported some degree of OD, which persisted in some patients for two or more years from the date of the initial infection. There was no association between the time since COVID-19 infection and severity of OD. No difference was detected between OD in patients with long-haul COVID-19 based on the dominant variant at the time of infection (p=0.0959). Conclusion A vast majority of patients with long-haul COVID-19 had some degree of ongoing olfactory complications, although the severity of symptoms was not dependent on the dominant SARS-CoV-2 variant at the time of infection.
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Affiliation(s)
- Meredith M. Lamb
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Kaitlyn DeHority
- Department Physical Medicine & Rehabilitation, The University of North Carolina, Chapel Hill, NC
| | - Sarah M. Russel
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Sulgi Kim
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Taylor Stack
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Ibtisam Mohammad
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Abdullah Zeatoun
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Cristine Klatt-Cromwell
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Charles S. Ebert
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - John M. Baratta
- Department Physical Medicine & Rehabilitation, The University of North Carolina, Chapel Hill, NC
| | - Brent A. Senior
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
| | - Adam J. Kimple
- Department of Otolaryngology – Head and Neck Surgery, The University of North Carolina, Chapel Hill, NC
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Cinconze E, Rosillon D, Rappuoli R, Vadivelu K, Bekkat-Berkani R, Abbing-Karahagopian V. Challenges in synthesis of real-world vaccine effects on meningococcal serogroup B disease for 4CMenB vaccine post-licensure effectiveness studies: A systematic review. Vaccine 2023; 41:4347-4358. [PMID: 37321895 DOI: 10.1016/j.vaccine.2023.05.025] [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: 06/17/2022] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Real-world studies on vaccine effects are diverse in terms of objectives, study setting and design, data type and scope, and analysis methods. In this review, we describe and discuss four-component meningococcal serogroup B vaccine (4CMenB vaccine, Bexsero) real-world studies with the aim of synthesizing their findings with application of standard methods. METHODS We performed a systematic literature review of all real-world studies on 4CMenB vaccine effects on meningococcal serogroup B disease, with no restriction for population age, vaccination schedule and/or type of vaccine effect evaluated (vaccine effectiveness [VE] and vaccine impact [VI] outcomes) published since its licensure in 2013 (from January 2014 until July 2021) in PubMed, Cochrane and the grey literature. We then aimed to synthesize the findings of the identified studies through application of standard synthesis methods. RESULTS According to reported criteria we retrieved five studies presenting estimates on 4CMenB vaccine effectiveness and impact. These studies showed great diversity in population, vaccination schedule and analysis methods mainly due to diversity in vaccine strategies and recommendations in the study settings. Directed by this diversity, no quantitative pooling methods to synthesize findings could be applied; instead we descriptively assessed study methods. We report VE estimates ranging from 59% to 94% and VI estimates ranging from 31% to 75%, representing diverse age groups, vaccination schedules and analysis methods. CONCLUSION Both vaccine outcomes showed real-life effectiveness of 4CMenB vaccine despite differences in study methodologies and vaccination strategies. Based on appraisal of study methods, we highlighted the need for an adapted tool which facilitates synthesis of heterogenic real-world vaccine studies when quantitative pooling methods are not applicable.
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Affiliation(s)
| | | | - Rino Rappuoli
- GSK, Siena, Italy; Fondazione Biotecnopolo di Siena, Italy
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Nassar M, Abosheaishaa H, Singh AK, Misra A, Bloomgarden Z. Noninsulin-based antihyperglycemic medications in patients with diabetes and COVID-19: A systematic review and meta-analysis. J Diabetes 2023; 15:86-96. [PMID: 36690377 PMCID: PMC9934962 DOI: 10.1111/1753-0407.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patients with diabetes are more likely to suffer COVID-19 complications. Using noninsulin antihyperglycemic medications (AGMs) during COVID-19 infection has proved challenging. In this study, we evaluate different noninsulin AGMs in patients with COVID-19. METHODS We searched Medline, Embase, Web of Science, and Cochrane on 24 January 2022. We used the following keywords (COVID-19) AND (diabetes mellitus) AND (antihyperglycemic agent). The inclusion criteria were studies reporting one or more of the outcomes. We excluded non-English articles, case reports, and literature reviews. Study outcomes were mortality, hospitalization, and intensive care unit (ICU) admission. RESULTS The use of metformin rather than other glucose-lowering medications was associated with statistically significant lower mortality (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.47, 0.77, p < .001). Dipeptidyl peptidase-4 inhibitor (DPP-4i) use was associated with statistically significantly higher hospitalization risk (RR: 1.44, 95% CI: 1.23, 1.68, p < .001) and higher risk of ICU admissions and/or mechanical ventilation vs nonusers (RR: 1.24, 95% CI: 1.04, 1.48, p < .02). There was a statistically significant decrease in hospitalization for SGLT-2i users vs nonusers (RR: 0.89, 95% CI: 0.84-0.95, p < .001). Glucagon-like peptide-1 receptor agonist (GLP-1RA) use was associated with a statistically significant decrease in mortality (RR: 0.56, 95% CI: 0.42, 073, p < 0.001), ICU admission, and/or mechanical ventilation (RR: 0.79, 95% CI: 0.69-0.89, p < .001), and hospitalization (RR: 0.73, 95% CI: 0.54, 0.98, p = .04). CONCLUSIONS AGM use was not associated with increased mortality. However, metformin and GLP-1RA use reduced mortality risk statistically significantly. DPP-4i use was associated with a statistically significant increase in the risk of hospitalization and admission to the ICU.
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Affiliation(s)
- Mahmoud Nassar
- Department of MedicineIcahn School of Medicine at Mount Sinai/NYC Health+Hospitals/QueensNew York CityNew YorkUSA
| | - Hazem Abosheaishaa
- Department of MedicineIcahn School of Medicine at Mount Sinai/NYC Health+Hospitals/QueensNew York CityNew YorkUSA
| | - Awadhesh Kumar Singh
- Department of Diabetes & EndocrinologyGD Hospital & Diabetes InstituteKolkataIndia
| | - Anoop Misra
- Chairman, Fortis‐C‐DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Diabetes Foundation (India), and National Diabetes Obesity and Cholesterol Foundation (NDOC)New DelhiIndia
| | - Zachary Bloomgarden
- Department of Medicine, Division of Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Choi GJ, Kang H. Introduction to Umbrella Reviews as a Useful Evidence-Based Practice. J Lipid Atheroscler 2023; 12:3-11. [PMID: 36761061 PMCID: PMC9884555 DOI: 10.12997/jla.2023.12.1.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023] Open
Abstract
The umbrella review (UR) is a novel methodological approach that has been established to address the ever-expanding research volume of published systematic reviews. In this study, we examined the rationale underlying URs, the concepts and goals of URs, and their applicability in clinical settings. Additionally, we briefly assessed the process of conducting URs and discussed the current challenges in this regard. URs are used to integrate, evaluate, and synthesize the findings of related systematic reviews. By organizing and summarizing the abundant information in accordance with the level of evidence, URs can serve as a useful methodological tool and provide appropriate entry points to clinicians or decision-makers in the medical field. Considering the availability of many suitable interventions for specific conditions in a broad field, URs can enable evidence-based decision-making and offer a broad perspective for the resolution of issues in healthcare by summarizing the evidence and providing directions on a variety of topics. URs are clearly contributing to the management of the deluge of evidence in evidence-based medicine. However, despite the availability of several directions for conducting URs, some points of confusion persist, especially when determining the certainty of evidence. Therefore, advanced guidelines for the appropriate performance of URs are required to provide more reliable evidence through URs.
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Affiliation(s)
- Geun Joo Choi
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyun Kang
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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Nassar M, Misra A, Bloomgarden Z. COVID-19 Vaccination in Persons with Diabetes: How they Work. CONTEMPORARY ENDOCRINOLOGY 2023:195-206. [DOI: 10.1007/978-3-031-28536-3_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
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Cancarevic I, Nassar M, Medina L, Sanchez A, Parikh A, Hosna A, Devanabanda B, Vest M, Ayotunde F, Ghallab M, Omran I. Nephrotic Syndrome in Adult Patients With COVID-19 Infection or Post COVID-19 Vaccine: A Systematic Review. Cureus 2022; 14:e29613. [DOI: 10.7759/cureus.29613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
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Cancarevic I, Nassar M, Daoud A, Ali H, Nso N, Sanchez A, Parikh A, Ul Hosna A, Devanabanda B, Ahmed N, Soliman KM. Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis: A systematic review and meta-analysis. World J Virol 2022; 11:352-361. [PMID: 36188740 PMCID: PMC9523330 DOI: 10.5501/wjv.v11.i5.352] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/20/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been the most talked-about disease of the past few years. Patients with significant comorbidities have been at particular risk of adverse outcomes. This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease, a group of patients known to be particularly susceptible to infectious complications.
AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.
METHODS We searched PubMed/MEDLINE, EMBASE, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Web of Science databases for relevant terms and imported the results into the Covidence platform. From there, studies were assessed in two stages for relevance and quality, and data from studies that satisfied all the requirements were extracted into a spreadsheet. The data was then analyzed descriptively and statistically.
RESULTS Of the 920 studies identified through the initial database search, only 17 were included in the final analysis. The studies included in the analysis were mostly carried out during the first wave. We found that COVID-19 incidence among patients on hemodialysis was significant, over 10% in some studies. Those who developed COVID-19 infection were most likely going to be hospitalized, and over 1 in 5 died from the infection. Intensive care unit admission rate was lower than the infection lethality rate. Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.
CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections, and a significant proportion was infected during the first wave. Their prognosis is overall much worse than in the general population, and every effort needs to be made to decrease their exposure.
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Affiliation(s)
- Ivan Cancarevic
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Ahmed Daoud
- Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt
| | - Hatem Ali
- Department of Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Angelica Sanchez
- Department of Medicine, Universidad Autonoma de Santo Domnigo, Santo Domingo 10105, Dominican Republic
| | - Avish Parikh
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Asma Ul Hosna
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Bhavana Devanabanda
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Nazakat Ahmed
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States
| | - Karim M Soliman
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
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Mularczyk-Tomczewska P, Zarnowski A, Gujski M, Jankowski M, Bojar I, Wdowiak A, Krakowiak J. Barriers to accessing health services during the COVID-19 pandemic in Poland: A nationwide cross-sectional survey among 109,928 adults in Poland. Front Public Health 2022; 10:986996. [PMID: 36159267 PMCID: PMC9495711 DOI: 10.3389/fpubh.2022.986996] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/22/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction The COVID-19 pandemic has significant socio-economic implications for numerous industries, including healthcare. Disruptions of essential health services were reported by nearly all countries around the world. A detailed assessment of the healthcare uptake is necessary to estimate the potential health effects of the COVID-19 pandemic on the population. This study aimed to assess the prevalence of barriers to accessing health services during the COVID-19 pandemic in Poland as well as to identify factors associated with the disturbed access to healthcare during the pandemic. Methods This cross-sectional survey was carried out among Internet users in Poland using the computer-assisted web interview technique. Data were collected between October and December 2021. The questionnaire included 32 questions on sociodemographic characteristics, the COVID-19 pandemic, health status, daily habits as well as the use of healthcare during the COVID-19 pandemic. Results Data were obtained from 102928 adults, the mean age was 48.0 ± 14.2 years, and 57.2% were females. Most of the respondents had visited a doctor during the past 12 months (70.4%). Almost half of adults in Poland (49.7%) reported barriers to access health services in the past 12 months. Out of 51,105 respondents who had experienced barriers to accessing health services during the COVID-19 pandemic, only 54.3% had visited a doctor in the past 12 months. Long waiting time (39.5%) and temporary closure of healthcare facilities/transformation into a COVID-19 dedicated center (28.8%) were the most common barriers indicated by the respondents. In multivariable logistic regression, female gender, age 18-49 years, lack of higher education, living in cities between 51,000 and 200,000 residents or above 500,000 residents, and having at least one chronic disease were significantly (p < 0.05) associated with higher odds of experiencing barriers to accessing health services during the COVID-19 pandemic. Conclusions This study confirmed that the COVID-19 pandemic has worsened access to health services in Poland. During the pandemic, new barriers to accessing health services, such as the temporary closure of healthcare facilities for non-COVID patients were revealed. Findings from this study provided patients' perspectives on barriers to accessing health services in Poland that may be used by policymakers to reduce health inequalities.
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Affiliation(s)
| | - Adam Zarnowski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland,*Correspondence: Mateusz Jankowski
| | - Iwona Bojar
- Department of Women's Health, Institute of Rural Health in Lublin, Lublin, Poland
| | - Artur Wdowiak
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Jan Krakowiak
- Department of Social Medicine, Medical University of Lodz, Lodz, Poland
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Diagnostic Role of Bronchoalveolar Lavage in Patients with Suspected SARS-CoV-2 Pneumonia and Negative Upper Respiratory Tract Swab: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11164656. [PMID: 36012892 PMCID: PMC9409822 DOI: 10.3390/jcm11164656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 08/05/2022] [Indexed: 12/01/2022] Open
Abstract
The added role of bronchoalveolar lavage (BAL) in SARS-CoV-2 detection in hospitalized patients with suspected COVID-19 pneumonia and at least one negative nasopharyngeal swab (NPS) has yet to be definitively established. We aimed to provide a systematic review and meta-analysis to summarize data from the literature on the diagnostic yield of BAL in this context. We searched Medline and Embase for all studies reporting outcomes of interest published up to October 2021. Two authors reviewed all titles/abstracts and retrieved the selected full texts according to predefined selection criteria. The summary estimate was derived using the random-effects model. Thirteen original studies, involving 868 patients, were included. The summary estimate of proportions of SARS-CoV-2 positivity in BAL fluid in patients with at least one previous negative NPS was 20% (95% confidence interval [CI]; 11–30%). Moreover, microbiological tests of BAL fluid led to the identification of other pathogens, mainly bacteria, in up to two-thirds of cases. BAL plays a crucial role in the diagnostic work-up of patients with clinical suspicion of COVID-19 and previous negative NPS, as it allowed to detect the infection in a significant proportion of subjects, who would have been otherwise misclassified, with relevant implications in the prevention of disease spread, especially in hospital settings.
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Tocilizumab Treatment Reduces Mortality in Hospitalized Patients With COVID-19: A Retrospective Cohort Study at a New York City Hospital. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Shafiee A, Teymouri Athar MM, Nassar M, Seighali N, Aminzade D, Fattahi P, Rahmannia M, Ahmadi Z. Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Syndr 2022; 16:102512. [PMID: 35660932 PMCID: PMC9135641 DOI: 10.1016/j.dsx.2022.102512] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/07/2022] [Accepted: 05/17/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS This systematic review and meta-analysis aimed to evaluate the current evidence available to investigate clinical outcomes between patients with type 1 and type 2 diabetes. METHODS MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched. Randomized controlled trials (RCTs), non-randomized trials, and observational studies were eligible for inclusion. National Institutes of Health Quality Assessment Tool was used to assess the quality. Data were pooled by the Restricted-maximum-likelihood random-effects approach. RESULTS Total 11 studies comprising 7690415 individuals were included in this study. The log OR for the pooled data for all-cause mortality rate was -0.71 (95% CI: -1.38 to -0.03). Based on the pooled results, type 1 diabetic COVID-19 patients may have a better prognosis for mortality. There were no significant differences between groups in term of ICU-admission log OR -0.22 (95% CI: -0.81 to 0.37), and hospitalization log OR -0.48 (95% CI: -1.23 to 0.27). Based on our descriptives analyses after adjusting for age and comorbidities, the high-risk group in three studies was type 2 diabetes, and in five studies was type 1. Two studies reported no significant difference between these groups in relevant outcomes. CONCLUSION There were no significant differences in disease severity between type 1 and type 2 diabetes. Based on the unadjusted data available, the mortality rate for people with type 1 diabetes was shown to be lower than that for people with type 2. As data on these subjects is scarce, and the results obtained from studies are heterogeneous, further research with adequate sample sizes is needed to precisely compare the outcomes of COVID-19 between type 1 and type 2 diabetes.
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Affiliation(s)
- Arman Shafiee
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.
| | | | - Mahmoud Nassar
- Medicine Department, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals / Queens, New York, USA
| | - Niloofar Seighali
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Dlnya Aminzade
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Fattahi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmannia
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ahmadi
- Department of Basic Sciences and New Technologies, Electronical Branch, Islamic Azad University, Tehran, Iran
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Alshamam MS, Nso N, Nassar M, Idrees Z, Ghernautan V, Khan S, Abdalazeem Y, Munira M. T-wave Inversions in Cerebellar and Occipital Lobe Infarcts in the Setting of Deep Vein Thrombosis and Pulmonary Embolism Suggestive of Paradoxical Emboli: A Case Report. Cureus 2022; 14:e24230. [PMID: 35602844 PMCID: PMC9115622 DOI: 10.7759/cureus.24230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/14/2022] Open
Abstract
Cardiological causes account for the majority of acute electrocardiographic (ECG) changes. The reason for this fear is the irreversibility of myocardial necrosis. Generally, various changes can be observed in the ECG, including ST-T changes, QTc prolongation, arrhythmias, and T-wave inversions. Even though T-wave inversions can be seen in myocardial ischemia/infarction, they are rarely seen in acute cerebrovascular accidents (CVAs). We present the case of a 66-year-old woman who initially presented at our facility with dizziness in the context of orthostatic hypotension. An initial cardiac evaluation revealed no cardiac involvement. She was treated with intravenous fluids (IVF), which improved her symptoms. The patient's mental status was markedly altered approximately four days after admission. In this instance, she was found to have abnormal ECG findings (not previously observed on the ECG that was obtained on the day of admission), elevated troponin T levels, as well as elevated pro-B-type natriuretic peptide (pro-BNP). The patient was given aspirin and clopidogrel immediately and was placed on a heparin drip for a suspected non-ST elevation myocardial infarction (NSTEMI). A non-contrast computed tomography of the head revealed an acute cerebrovascular accident (CVA), following which the heparin drip was stopped. The patient was then transferred to another acute care facility capable of performing neurosurgical interventions. Additionally, a computed tomography angiography (CTA) of the chest and lower extremities venous duplex showed bilateral pulmonary emboli and deep venous thrombosis (DVT), respectively.
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Nassar M, Daoud A, Nso N, Medina L, Ghernautan V, Bhangoo H, Nyein A, Mohamed M, Alqassieh A, Soliman K, Alfishawy M, Sachmechi I, Misra A. Diabetes Mellitus and COVID-19: Review Article. Diabetes Metab Syndr 2021; 15:102268. [PMID: 34562865 PMCID: PMC8416292 DOI: 10.1016/j.dsx.2021.102268] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS We aim to cover most of the current evidence on the mutual effect of diabetes & COVID-19 infection on each other and the management of the COVID-19 patients with diabetes. METHODS We utilized databases to review the current evidence related to diabetes mellitus and COVID-19. RESULTS We discussed the most recent evidence of diabetes milieus and COVID-19 regarding risk factors, management, complications, and telemedicine. CONCLUSION Diabetes mellitus is associated with a significant risk of complications, extended hospital stays, and mortality in COVID-19 infected patients.
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Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Ahmed Daoud
- Internal Medicine Department, Faculty of Medicine Cairo University, Cairo, Egypt.
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Luis Medina
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Victoria Ghernautan
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Harangad Bhangoo
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Andrew Nyein
- New York Institute of Technology College of Osteopathic Medicine, NYC, USA.
| | - Mahmoud Mohamed
- Medicine department, North Mississippi Medical Center, Tupelo, MS, USA.
| | - Ahmed Alqassieh
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - Karim Soliman
- Division of Nephrology, Department of Medicine and Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - Mostafa Alfishawy
- Infectious Diseases Consultants and Academic Researchers of Egypt IDCARE, Egypt.
| | - Issac Sachmechi
- Chair of Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens USA.
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, Chairman, National Diabetes, Obesity, And Cholesterol Foundation (N-DOC), President, Diabetes Foundation (India) (DFI), USA.
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Safety and Efficacy of Convalescent Plasma in COVID-19: An Overview of Systematic Reviews. Diagnostics (Basel) 2021; 11:diagnostics11091663. [PMID: 34574004 PMCID: PMC8467957 DOI: 10.3390/diagnostics11091663] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 12/27/2022] Open
Abstract
Convalescent plasma (CP) from patients recovered from COVID-19 is one of the most studied anti-viral therapies against SARS-COV-2 infection. The aim of this study is to summarize the evidence from the available systematic reviews on the efficacy and safety of CP in COVID-19 through an overview of the published systematic reviews (SRs). A systematic literature search was conducted up to August 2021 in Embase, PubMed, Web of Science, Cochrane and Medrxiv databases to identify systematic reviews focusing on CP use in COVID-19. Two review authors independently evaluated reviews for inclusion, extracted data and assessed quality of evidence using AMSTAR (A Measurement Tool to Assess Reviews) and GRADE tools. The following outcomes were analyzed: mortality, viral clearance, clinical improvement, length of hospital stay, adverse reactions. In addition, where possible, subgroup analyses were performed according to study design (e.g., RCTs vs. non-RCTs), CP neutralizing antibody titer and timing of administration, and disease severity. The methodological quality of included studies was assessed using the checklist for systematic reviews AMSTAR-2 and the GRADE assessment. Overall, 29 SRs met the inclusion criteria based on 53 unique primary studies (17 RCT and 36 non-RCT). Limitations to the methodological quality of reviews most commonly related to absence of a protocol (11/29) and funding sources of primary studies (27/29). Of the 89 analyses on which GRADE judgements were made, effect estimates were judged to be of high/moderate certainty in four analyses, moderate in 38, low in 38, very low in nine. Despite the variability in the certainty of the evidence, mostly related to the risk of bias and inconsistency, the results of this umbrella review highlight a mortality reduction in CP over standard therapy when administered early and at high titer, without increased adverse reactions.
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