Coronavirus disease (COVID-19) pandemic: an overview of systematic reviews

Abstract

Background Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. Methods Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. Results Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as “critically low”. Identified symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8–12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. Conclusions In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was “critically low”. Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.

Perfil clínico, epidemiológico e laboratorial de pacientes portadores de Síndromes Respiratórias Agudas Graves (SRAGs) e COVID-19, admitidos em um Hospital Universitário da região do submédio do São Francisco

“…Em relação às possíveis alterações em exames laboratoriais, podem ser expressos níveis elevados de proteína C reativa, associados com linfocitopenia, lactato desidrogenase elevada, bem como aspartato e alanina aminotransferase ligeiramente elevados (Borges do Nascimento et al, 2021), além do aumento do D-dímero em pacientes com COVID-19 (Huang et al, 2020), em concordância com o exposto nos resultados deste estudo. Aumentos nas taxas de TGO, TGP e bilirrubina total podem decorrer de injúria hepática.…”

Infodemics and health misinformation: a systematic review of reviews

“…We used a published definition of systematic reviews 14 and included a systematic review or mini-reviews if: (i) the search strategy was conducted at least in two databases; (ii) the study had at least two authors; and (iii) the study comprehensively presented a methods section or description of inclusion and exclusion criteria. We only included systematic reviews that directly analysed the available evidence correlated to infodemics, misinformation, disinformation, health communication, information overload and fake news (defined as: purposefully crafted, sensational, emotionally charged, misleading or totally fabricated information that mimics the form of mainstream news).…”

“Five Keys to Safer Food” and COVID-19

“…Although cross-contamination is a principal factor in food-borne illness outbreaks [37] including in Wuhan [38] and Hong Kong's wet markets [39], the literature has not reflected this contamination implicating SARS-CoV-2, but the WHO [19] and Oakenfull and Wilson [17] indicated cross-contamination from raw meat, blood products, milk, or animal organs and suggested they should be handled with care; it should not be forgotten that two factors, intake of raw meat and humans who came into close contact with animals, have been suggested as the cause [40] for the initiation of COVID-19. The WHO [41] indicated that avoiding eating raw or undercooked animal products should be a general rule.…”