The administration of intravenous vitamin C (IV‐VC) in treating patients with coronavirus disease 2019 (COVID‐19) is still highly controversial. There have been no previous studies on the effect of IV‐VC on the severity and mortality of COVID‐19. Hence, we conducted a systematic review and meta‐analysis to compare the disease severity and mortality in patients with COVID‐19 who promptly received IV‐VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta‐analysis showed that IV‐VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV‐VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta‐analysis revealed that the use of IV‐VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta‐analysis demonstrated that short‐term IV‐VC treatment did not reduce the risk of severity and mortality in patients with COVID‐19.
Data on the prognosis of patients treated with oral anticoagulation (OAC) prior to hospital admission for COVID-19 remains controversial and insufficient. Therefore, we endeavored to perform a systematic review and meta-analysis to evaluate the effect of chronic use of OAC prior to the diagnosis of COVID-19 on intensive care unit (ICU) admission and mortality. An electronic search of the Pubmed, Embase, Cochrane library databases was conducted. Meta-analysis and statistical analyses were completed with using the RevMan 5.3 and Stata 12.0. A total of 13 articles representing data from 1,266,231 participants were included in this study. The meta-analysis of unadjusted results showed no decrease in mortality (OR = 1.31, 95%CI: 0.99 to 1.73, P = 0.059) or ICU admission rate (OR = 0.71, 95%CI: 0.29 to 1.77, P = 0.46) in COVID-19 patients with prior OAC therapy at hospital admission compared to patients without prior use of OAC. Moreover, the meta-analysis of adjusted results showed no lower risk of mortality (OR = 1.08, 95%CI: 0.90 to 1.30, P = 0.415) or ICU admission (OR = 1.50, 95%CI: 0.72 to 3.12, P = 0.284) in patients with prior OAC use compared to patients without previous OAC use. In conclusion, the results of this study revealed that the use of OAC prior to hospital admission appeared to be ineffective in reducing the risk of intensive care need and mortality in COVID-19 patients. Randomized controlled trials are needed to evaluate and optimize the use of OAC in COVID-19 infection.
<b><i>Introduction:</i></b> Premature infants are exceptionally vulnerable to nutrition-related diseases, and the utilization of standardized feeding guidelines may reduce nutritional practice variation, which can promote growth. Nutritional risk screening is the first step for standardized nutrition advice. However, risk screening tools specific for following up preterm infants are scarce. Hence, our study aimed to develop and evaluate a standardized Nutritional Risk Screening Tool for Preterm Infants (NRSP subscale 1) from birth to corrected age four months old . <b><i>Methods:</i></b> This study was a two-phase (the development phase and evaluation phase) study. Initially, we used the Delphi expert consultation method to create NRSP subscale 1. Then, a professional panel interviewed the participated preterm infants using the screening tool, measured anthropometric parameters, and conducted an intellectual development test on the interview day and remeasured anthropometric parameters 2 weeks or 1 month after the first interview. In the development phase, we cross-tabulated the responses to the screening tool with the classifications of <i>z</i>-scores of the body weight, length, or head circumference to identify significant predictors of underweight, stunting, or microcephaly. We then combined significant predictors to produce models for predicting underweight, stunting, or microcephaly by multivariate logistic regression analysis. In the evaluation phase, the area under the curve (AUC), sensitivity, specificity, and correlation coefficient by Spearman’s correlation analysis (<i>r</i><sub>s</sub>) between the risk classifications by NRSP subscale 1 and the classifications of the <i>z</i>-scores of the body weight, length, or head circumference were calculated to assess the validity of the screening tool. Intellectual development levels between high and low nutritional risk infants were statistically compared. <b><i>Results:</i></b> A total of 219 and 244 preterm infants were included to two phases, respectively. AUC was 0.936 (95% CI: 0.860–1.000, <i>p</i> < 0.001), sensitivity was 0.667, specificity was 0.941, <i>r</i><sub>s</sub> = 0.407 (<i>p</i> < 0.001); AUC was 0.794 (95% CI: 0.638–0.951, <i>p</i> = 0.002), sensitivity was 0.500, specificity was 0.953, <i>r</i><sub>s</sub> = 0.339 (<i>p</i> < 0.001); AUC was 0.831 (95% CI: 0.737–0.925, <i>p</i> = 0.001), sensitivity was 0.889, specificity was 0.643, <i>r</i><sub>s</sub> = 0.215 (<i>p</i> = 0.001) in predicting underweight, stunting, and microcephaly on the interview day, respectively. AUC was 0.905 (95% CI: 0.826–0.984, <i>p</i> = 0.006), sensitivity was 0.500, specificity was 0.905, <i>r</i><sub>s</sub> = 0.504 (<i>p</i> < 0.001); AUC was 0.738 (95% CI: 0.515–0.960, <i>p</i> = 0.034), sensitivity was 0.429, specificity was 0.848, <i>r</i><sub>s</sub> = 0.382 (<i>p</i> < 0.001); AUC was 0.664 (95% CI: 0.472–0.856, <i>p</i> = 0.071), sensitivity was 0.455, specificity was 0.809, <i>r</i><sub>s</sub> = 0.169 (<i>p</i> = 0.037) in predicting underweight, stunting, and microcephaly 2 weeks or 1 month after the first interview, respectively. Gross motor development quotients (DQs) (95.85 [32.87] vs. 86.29 [17.19], <i>p</i> = 0.022), fine motor DQs (115.77 [46.03] vs. 102.12 [20.27], <i>p</i> = 0.010), and verbal DQs (110.73 [35.27] vs. 100.63 [21.28], <i>p</i> = 0.042) were higher in low nutritional risk infants than high-risk ones. <b><i>Conclusion:</i></b> NRSP subscale 1 was acceptable and reliable in predicting underweight, but the validity in predicting stunting or microcephaly was slightly mild. Further investigations are required to authenticate NRSP subscale 1’s effectiveness.
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