This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

Background Even though pharmacists have devoted considerable time to ensuring patient safety during the process of preparing and dispensing chemotherapy, only a few studies have evaluated their efforts. Objective To evaluate the clinical and economic impact of pharmacists' interventions in a large volume chemotherapy preparation unit. Setting A 1600-bed tertiary hospital in Seoul, Korea. Method Pharmacist intervention records from May 2012 to April 2013 were retrospectively reviewed. The clinical significance of interventions was rated by one physician and one pharmacist. A cost-benefit analysis was conducted. The benefit from interventions was estimated through both cost avoidance based on the potential to avoid an adverse drug event (ADE) and cost savings related to reducing discarded products. Cost was estimated from the pharmacists' salary corresponding to the time spent in reviewing chemotherapy prescriptions. Main outcome measure Acceptance rate, clinical significance, net cost-benefit, and cost-benefit ratio of pharmacist interventions. Results Among 39,649 cancer chemotherapy prescriptions in 6364 patients, 631 interventions were performed for 435 patients. The acceptance rate was 72.1 %. Most cases of declined interventions were related to dosage adjustment within the range of <10 % of the prescribed dosage. More than half of the interventions were considered as clinically more than "significant" (50.4 %). The cost-benefit analysis showed a clear cost benefit with a net cost-benefit of $116,493 and a cost-benefit ratio of 3.64:1. Conclusion Pharmacists' interventions in a large volume ambulatory-based chemotherapy preparation unit provided a positive economic impact on health care budget and were effective in preventing clinically significant ADEs.

This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval (CI). Nine studies involving with 93 pregnant women with COVID-19 and 103 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 3214.7g. Fetal death, severe neonatal asphyxia, and detection of SARS-CoV-2 were observed in about 2%, whereas no neonatal death was found. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

Although hepatotoxicity induced by immune checkpoint inhibitors (ICPIs) can cause severe clinical complications, the risk factors associated with hepatotoxicity have rarely been investigated. The purpose of this study was to determine the potential risk factors for the incidence of hepatotoxicity and for time to ICPI-induced hepatotoxicity. Patients who received ICPIs (atezolizumab, nivolumab, pembrolizumab, and ipilimumab) were included in this retrospective 2-center study. Collected data included sex, age, body weight, body surface area, Eastern Cooperative Oncology Group performance status, underlying disease, liver metastasis, programmed cell death ligand-1 expression, interval from previous chemotherapy, and concomitant drug use. Among the 194 patients, patients who experienced hepatotoxicity after ICPI administration was 64.4% (n=125) in all grade and 10.8% (n=21) in grade III or higher. Multivariate analysis showed that patients aged 30–50 and 50–70 years had increased risks of hepatotoxicity by 4.9-fold (95% confidence interval, 1.3–18.0) and 2.7-fold (95% confidence interval, 1.3–5.5), respectively, compared with those older than 70 years. The use of acetaminophen increased the occurrence of hepatotoxicity by 2.1 times; the attributable risk was 53.2%. Male patients and patients younger than 65 years had around 1.5-fold increased hazard of time to reach hepatotoxicity. Patients treated with 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors had a 4.7-fold higher risk of grade III–IV hepatotoxicity compared with those without HMG-CoA reductase inhibitors; the attributable risk was 78.8%. In conclusion, close monitoring of liver function is recommended, especially in male patients, patients younger than 65 years old, and when there is concomitant use of hepatotoxic drugs including acetaminophen and HMG-CoA reductase inhibitors.

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