No abstract

Background: the 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality.Methods: The study protocol was registered on to PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted on June 2020, to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations. Results: The prevalence of obesity was 33% (95% CI, 30.0%–35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR=2.42, 95% CI: 1.58 to 3.70; moderate certainty) and COVID-19 severity (OR=1.62, 95% CI: 1.48 to 1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR=1.75, 95% CI: 1.47 to 2.09; very low certainty), mechanical ventilation (OR=2.24, 95% CI: 1.70 to 2.94; low certainty), intensive care unit (ICU) admission (OR=1.75, 95% CI: 1.38 to 2.22; low certainty), and death (OR=1.23, 95% CI: 1.06 to 1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups. Conclusions: Obesity is associated with COVID-19 and its poor clinical outcomes. Thus, it is highly recommended to consider obesity status in prognostic scores and improvement of guidelines for the clinical care of patients with COVID-19.

No abstract

BackgroundThe association between the Vitamin D Receptor (VDR) gene polymorphism and the risk of Multiple sclerosis (MS) has been evaluated in several researches. However, the findings were inconsistent and inconclusive. Therefore, we set out a meta-analysis of all eligible published case-control studies to obtain an exact evaluation of the association between VDR gene polymorphisms and MS.MethodAll relevant studies reporting the association between the VDR gene FokI (rs2228570), or/and TaqI (rs731236) or/and BsmI (rs1544410) or/and ApaI (rs7975232) polymorphisms and susceptibility to MS published up to May, 2019 were identified by comprehensive systematic search in the electronic database of web of science, Scopus, and PubMed. After that, the strength of association between VDR gene polymorphisms and susceptibility to MS was evaluated by odds ratio (OR) and 95% confidence interval (CI).ResultsA total of 30 case–control studies were included in the meta-analysis. The overall results suggested a significant association between TaqI polymorphism and MS risk under heterozygote genetic model (OR = 1.27, 95%CI = 1.01–1.59, random effect). Moreover, the pooled results of subgroup analysis declined presence of significant association under all defined genetic model. In subgroup analysis, BsmI polymorphisms was associated with increased risk of MS under recessive model in Asian populations. On the other hand, ApaI polymorphism was associated with decreased risk of MS under recessive and aa vs. AA model in Asian populations.ConclusionThis meta-analysis suggested a significant association between TaqI polymorphism and MS susceptibility. Furthermore, BsmI polymorphism was associated with increased risk of MS in Asian populations. In contrast, ApaI polymorphism was associated with decreased risk of MS in Asian populations. Future large-scale studies on gene–environment and gene–gene interactions are required to estimate risk factors and assist early diagnosis of patients at high risk for MS.

Purpose The 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality. Methods The study protocol was registered in PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted from 31 December 2019 to 1 June 2020 to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations. Results The prevalence of obesity was 33% (95% CI 30.0%-35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR = 2.42, 95% CI 1.58-3.70; moderate certainty) and COVID-19 severity (OR = 1.62, 95% CI 1.48-1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR = 1.75, 95% CI 1.47-2.09; very low certainty), mechanical ventilation (OR = 2.24, 95% CI 1.70-2.94; low certainty), intensive care unit (ICU) admission (OR = 1.75, 95% CI 1.38-2.22; low certainty), and death (OR = 1.23, 95% CI 1.06-1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups. Conclusion Obesity is associated with COVID-19, need for hospitalization, mechanical ventilation, ICU admission, and death due to COVID-19. Level of evidence Level I, systematic reviews and meta-analyses.

Background. Several studies have reported that statins have anti-inflammatory effects. Nevertheless, results of clinical trials concerning the effect of statins on the levels of C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) have been inconsistent. Therefore, we performed a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effect of statins on CRP and hs-CRP levels in patients with cardiovascular diseases (CVDs). Methods. Literature search of the major databases was performed to find eligible RCTs assessing the effect of statins on serum levels of CRP and hs-CRP from the inception until the last week of April 2021. The effect sizes were determined for weighted mean difference (WMD) and 95% confidence intervals (CI). Results. 26 studies were identified (3010 patients and 2968 controls) for hs-CRP and 20 studies (3026 patients and 2968 controls) for CRP. Statins reduced the serum levels of hs-CRP ( WMD = − 0.97   mg / L ; 95% CI: -1.26 to -0.68 mg/L; P < 0.001 ) and CRP ( WMD = − 3.05   mg / L ; 95% CI: -4.86 to -1.25 mg/L; P < 0.001 ) in patients with CVDs. Statins decreased the serum levels of hs-CRP in patients receiving both high-intensity and moderate/low-intensity treatments with these drugs. In addition, the duration of treatment longer than 10 weeks decreased hs-CRP levels. Only high-intensity statin treatment could marginally decrease serum levels of CRP in CVDs patients. Conclusions. This meta-analysis showed the efficacy of statins to reduce the concentrations of CRP and hs-CRP in patients with different types of CVDs.

No abstract

Background: We performed a systematic review and meta-analysis of the Matrix metalloproteinases (MMP)-9 (C1562T), MMP-9 (R279Q), MMP-9 (P574R) and MMP-9 (R668Q) polymorphisms and risk of Coronary Artery Disease (CAD). Methods: After a systematic literature search, pooled odds ratio (OR) and their corresponding 95% confidence interval (CI) were used to evaluate the strength of the association. Results: We identified 40 studies with 11,792 cases and 8280 controls for C1562T, 7 case-control studies with 5525 cases and 2497 controls for R279Q, 2 studies with 1272 cases and 785 controls for P574R, and 2 studies with 1272 cases and 785 controls for R668Q. MMP-9 (C1562T) polymorphism was associated with increased risk of CAD under dominant model (OR = 1.41, P < 0.001), recessive model (OR = 1.59, P < 0.001), allelic model (OR = 1.38, P < 0.001), TT vs. CC model (OR = 1.70, P < 0.001), and CT vs. CC model (OR = 1.35, P < 0.001). Moreover, the subgroup analysis based on the continent of the study populations in this SNP indicated strong significant association in Asians but not in Europeans. Subgroup analysis was not performed in Africa, America and Oceania, due to lack of sufficient data. Conclusions: Our meta-analysis revealed that MMP-9 (C1562T) SNP conferred a susceptibility risk for CAD in the overall analysis and Asian population. The overall analysis and subgroup analysis of the other three SNPs reject the association between MMP-9 polymorphisms and the risk of CAD. Although the results should interpret with caution because of small sample size of included studies in these three SNPs.