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Progress in Cardiovascular Diseases 2020Evidence about COVID-19 on cardiac injury is inconsistent. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Evidence about COVID-19 on cardiac injury is inconsistent.
OBJECTIVES
We aimed to summarize available data on severity differences in acute cardiac injury and acute cardiac injury with mortality during the COVID-19 outbreak.
METHODS
We performed a systematic literature search across Pubmed, Embase and pre-print from December 1, 2019 to March 27, 2020, to identify all observational studies that reported cardiac specific biomarkers (troponin, creatine kinase-MB fraction, myoglobin, or NT-proBNP) during COVID-19 infection. We extracted data on patient demographics, infection severity, comorbidity history, and biomarkers during COVID-19 infection. Where possible, data were pooled for meta-analysis with standard (SMD) or weighted (WMD) mean difference and corresponding 95% confidence intervals (CI).
RESULTS
We included 4189 confirmed COVID-19 infected patients from 28 studies. More severe COVID-19 infection is associated with higher mean troponin (SMD 0.53, 95% CI 0.30 to 0.75, p < 0.001), with a similar trend for creatine kinase-MB, myoglobin, and NT-proBNP. Acute cardiac injury was more frequent in those with severe, compared to milder, disease (risk ratio 5.99, 3.04 to 11.80; p < 0.001). Meta regression suggested that cardiac injury biomarker differences of severity are related to history of hypertension (p = 0.030). Also COVID19-related cardiac injury is associated with higher mortality (summary risk ratio 3.85, 2.13 to 6.96; p < 0.001). hsTnI and NT-proBNP levels increased during the course of hospitalization only in non-survivors.
CONCLUSION
The severity of COVID-19 is associated with acute cardiac injury, and acute cardiac injury is associated with death. Cardiac injury biomarkers mainly increase in non-survivors. This highlights the need to effectively monitor heart health to prevent myocarditis in patients infected with COVID-19.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Heart Diseases; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32305557
DOI: 10.1016/j.pcad.2020.04.008 -
Nutrients Nov 2021Vitamin D is a key micronutrient modulating function and health in skeletal muscle. Therefore, we sought to systematically review the role of vitamin D in muscle... (Meta-Analysis)
Meta-Analysis
Vitamin D is a key micronutrient modulating function and health in skeletal muscle. Therefore, we sought to systematically review the role of vitamin D in muscle recovery. A search in different databases (PubMed/MEDLINE, WOS, Google Scholar, and Scopus) was carried out following PRISMA and PICOS. The search period was from inception to April 2020. Changes in post-exercise muscle damage were quantified comparing experimental group vs. placebo in each study by using number of participants, standardized mean difference (SMD), and standard error of the SMD. Hedges's g was used to calculate the SMDs for each study group and biased by the inverse of variance that allows calculating an overall effect and the 95% confidence interval (CI). The net vitamin D supplementation effect was calculated by subtracting the placebo SMD from SMD of the experimental group. The DerSimonian and Laird method was used as a random effect model, taking into account that the effect of vitamin D on muscular damage may vary according to the dose administered and additional moderators. Six studies were selected. In conclusion, regarding circulating levels of muscle biomarkers and additional limitations of the studies, it cannot be concluded that vitamin D supplementation exerts an effect in post-exercise muscle recovery. Likely, the anti-inflammatory action of vitamin D is quicker than the recovery of tissue structure and function. This aspect is pending verification in future research.
Topics: Creatine Kinase; Databases, Factual; Dietary Supplements; Humans; L-Lactate Dehydrogenase; Muscle, Skeletal; Muscles; Myoglobin; Vitamin D
PubMed: 34836268
DOI: 10.3390/nu13114013 -
European Journal of Medical Research Aug 2020More severe cases of COVID- 19 are more likely to be hospitalized and around one-fifth, needing ICU admission. Understanding the common laboratory features of COVID-19... (Meta-Analysis)
Meta-Analysis
BACKGROUND
More severe cases of COVID- 19 are more likely to be hospitalized and around one-fifth, needing ICU admission. Understanding the common laboratory features of COVID-19 in more severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. This systematic review and meta-analysis aimed to compare the laboratory test findings in severe vs. non-severe confirmed infected cases of COVID-19.
METHODS
Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar from the beginning of 2019 to 3rd of March 2020. Heterogeneity across included studies was determined using Cochrane's Q test and the I statistic. We used the fixed or random-effect models to pool the weighted mean differences (WMDs) or standardized mean differences and 95% confidence intervals (CIs).
FINDINGS
Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapore) with 3396 ranging from 12 to1099 patients were included. Our meta-analyses showed a significant decrease in lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein ratio (LCR), leukocyte to C-reactive protein ratio (LeCR), leukocyte to IL-6 ratio (LeIR), and an increase in the neutrophil, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen, prothrombin time (PT), D-dimer, glucose level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. No significant changes in white blood cells (WBC), Creatine Kinase (CK), troponin I, myoglobin, IL-6 and K between the two groups were observed.
INTERPRETATION
This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 based on laboratory test results at the time of ICU admission. Future well-methodologically designed studies from other populations are strongly recommended.
Topics: Asia; Asian People; Betacoronavirus; Blood Coagulation; Blood Glucose; Blood Sedimentation; C-Reactive Protein; COVID-19; China; Clinical Laboratory Techniques; Coronavirus Infections; Disease Progression; Fibrin Fibrinogen Degradation Products; Hospitalization; Humans; Inflammation; Interleukin-6; L-Lactate Dehydrogenase; Lymphocytes; Neutrophils; Pandemics; Pneumonia, Viral; SARS-CoV-2; Singapore; Treatment Outcome; Troponin I
PubMed: 32746929
DOI: 10.1186/s40001-020-00432-3 -
Medical Ultrasonography Mar 2020Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important...
Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important to diagnose rhabdomyolysis as soon as possible and start the treatment according to severity, as it is a state that significantly increases the mortality of the patients. The current gold standard of rhabdomyolysis diagnosis is the creatine kinase plasma concentration test, but it can be also diagnosed with imaging techniques, such as ultrasound (US). This review aims to gather previously published information regarding sonographic appearance of rhabdomyolysis. We searched through PubMed and ScienceDirect databases for studies using designed queries. After the selection process we were left with 13 studies containing a description of US appearance of rhabdomyolysis confirmed with a CK plasma level test. Findings described in the majority of the cases were muscle thickening, ground glass opacity, traits of edema and anechoic areas. Other than these, there were several less often reported findings. As a conclusion, rhabdomyolysis seems to have its own US appearance, but for now it cannot be precisely specified and needs further research for clarification.
Topics: Humans; Rhabdomyolysis; Ultrasonography
PubMed: 32096794
DOI: 10.11152/mu-2285 -
European Journal of Sport Science May 2023Previous research has explored the demands of amateur boxing-specific activity; however, no holistic review of the acute responses to such activity currently exists.... (Meta-Analysis)
Meta-Analysis
Previous research has explored the demands of amateur boxing-specific activity; however, no holistic review of the acute responses to such activity currently exists. This paper aimed to provide a systematic review of the available literature on the acute physiological, endocrine, biochemical, and performance responses to amateur boxing-specific activity. Following a search of EBSCOhost, SPORTDiscus, PubMed and Google Scholar databases, 25 studies were identified as meeting the inclusion criteria for the review. The methodological quality of the included studies was assessed via a modified Downs and Black checklist. Random-effects meta-analysis of standardised mean differences (SMD) revealed large (SMD = 4.62) increases in pre-post blood lactate (BLa), cortisol (SMD = 1.33), myoglobin (Mb) (SMD = 1.43), aspartate transaminase (AST) (SMD = 1.37), and alanine aminotransferase (ALT) (SMD = 0.97), in addition to moderate increases in creatine kinase (CK) (SMD = 0.65). Small pre-post increases in counter-movement jump (CMJ) height (SMD = 0.33) were observed. Consistently greater pre-post alterations were observed in competitive bouts, followed by sparring, and less so in boxing-specific simulations. Considerable physiological, endocrine, and biochemical responses are elicited following amateur boxing. Interestingly, neuromuscular and task-specific performance may not deteriorate following boxing-specific activity. The findings of the review may assist in the designing and periodising of boxing-specific training, dependent on the desired physical adaptations, training phase, and recovery status of the amateur boxer.Amateur boxing elicits a considerable acute physiological, hormonal, and biochemical response.Such responses are typically greater in competitive bouts, followed by sparring, and less so in simulated activity.The considerable demands of amateur boxing-specific activity do not appear to negatively affect neuromuscular or task-specific performance.Amateur boxers may be conditioned to preserve performance despite the acute demands of the sport, or the lack of performance decrement may reflect the short duration of amateur boxing.
Topics: Humans; Boxing; Athletes; Physical Examination; Movement; Task Performance and Analysis
PubMed: 35380916
DOI: 10.1080/17461391.2022.2063072 -
PloS One 2022The aim of this review was to (1) characterize the time-course of markers of exercise-induced muscle damage (EIMD) based on the level of maximal voluntary contraction... (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this review was to (1) characterize the time-course of markers of exercise-induced muscle damage (EIMD) based on the level of maximal voluntary contraction torque loss at 24-48h post-exercise (MVCloss24-48h), (2) identify factors (e.g., exercise and population characteristics) affecting the level of MVCloss24-48h, and (3) evaluate the appropriateness of EIMD markers as indicators of MVCloss24-48h.
METHODS
Magnitude of change of each EIMD markers was normalized using the standardized mean differences method to compare the results from different studies. Time-course of EIMD markers were characterized according to three levels of MVCloss24-48h based on a clustering analysis of the 141 studies included. Association between MVCloss24-48h levels and participant´s characteristics or exercise type/modalities were assessed. Meta-regressions were performed to investigate the associations between MVCloss24-48h and EIMD markers changes at <6h, 24h, 48h, 72h and >96h after exercise.
RESULTS
Time-course of EIMD markers recovery differs between levels of MVCloss24-48h. Training status and exercise type/modality were associated with MVCloss24-48h level (p<0.05). MVCloss24-48h was correlated to changes in myoglobin concentration (<6h), jump height (24h) and range of motion (48h) (p<0.001).
CONCLUSION
As the exercise could differently affect markers as function of the EIMD severity (i.e., MVCloss24-48h levels), different markers should be used as function of the timing of measurement. Mb concentration should be used during the first hours after the exercise (<6h), whereas jump height (24h) and range of motion (48h) could be used as surrogate for maximal voluntary contraction later. Moreover, training status and exercise type/modality could influence the magnitude of MVCloss24-48h.
Topics: Biomarkers; Exercise; Humans; Lower Extremity; Muscle Contraction; Muscle, Skeletal; Myalgia; Torque
PubMed: 35834532
DOI: 10.1371/journal.pone.0271233