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Turkish Journal of Medical Sciences Aug 2022Coronavirus disease 2019 (COVID-19) shares some clinical features with new-onset granulomatosis with polyangiitis (GPA) or GPA flare that may lead to a challenge in...
BACKGROUND
Coronavirus disease 2019 (COVID-19) shares some clinical features with new-onset granulomatosis with polyangiitis (GPA) or GPA flare that may lead to a challenge in differential diagnosis. To date, little is known whether GPA can be induced by COVID-19. Herein, we aimed to seek the frequency and mortality rates of COVID-19 in our GPA cohort, and along with the literature cases, to evaluate clinical features and treatments of GPA patients with COVID-19. We also tried to identify clinical features of COVID-19 induced GPA.
METHODS
As of July 2021, we conducted a systematic literature review using different spelling combinations of "COVID-19 and GPA" in the PUBMED database. In total, 18 cases were found in the literature, 6 of them had COVID-19 induced GPA. The remaining 12 of literature cases and 6 cases in our GPA cohort (n = 81) had a COVID-19 infection while followed-up with GPA. We grouped these 18 patients as GPA+COVID-19.
RESULTS
The frequency of COVID-19 was 7.4% in GPA cohort and mortality rate was 33% in GPA patients with COVID-19. The most common symptoms of GPA+COVID-19 patients were fever, cough, arthralgia/myalgia, and malaise. The most frequent treatments for GPA before the COVID-19 infection were steroids (72%) and rituximab (56%). Three patients who received rituximab also had COVID-19 reinfection. In the literature cases, mortality was observed in 4 (22%) of 18 patients with GPA+COVID-19. The most common symptoms of COVID-19 induced GPA were dyspnea, fever and cough.
DISCUSSION
In our GPA cohort, we observed a higher mortality rate compared to global WHO data. In patients followed up with GPA, rituximab treatment may be precarious for both COVID-19 disease and reinfection. Our study also provided some clues about the diagnostic challenge of GPA induced by COVID-19.
Topics: Humans; Granulomatosis with Polyangiitis; Rituximab; COVID-19; Reinfection; Cough
PubMed: 36326380
DOI: 10.55730/1300-0144.5389 -
Cureus Sep 2022Few studies have thoroughly evaluated the neuro-invasive effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which may contribute to a... (Review)
Review
Few studies have thoroughly evaluated the neuro-invasive effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which may contribute to a wide range of sequelae from mild long-term effects like headaches and fatigue to severe events like stroke and arrhythmias. Our study aimed to evaluate the long-term neurological effects of coronavirus disease 2019 (COVID-19) among patients discharged from the hospital. In this systematic review and meta-analysis, we assessed the long-term neurocognitive effects of COVID-19. Post-COVID-19 neurological sequelae were defined as persistent symptoms of headache, fatigue, myalgia, anosmia, dysgeusia, sleep disturbance, issues with concentration, post-traumatic stress disorder (PTSD), suicidality, and depression long after the acute phase of COVID-19. Data from observational studies describing post-COVID-19 neurocognitive sequelae and severity of COVID-19 from September 1, 2019, to the present were extracted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol with a consensus of three independent reviewers. A systematic review was performed for qualitative evaluation and a meta-analysis was performed for quantitative analysis by calculating log odds of COVID-19 neurocognitive sequelae. The odds ratio (OR) and 95% confidence interval (CI) were obtained and forest plots were created using random effects models. We found seven studies, out of which three were used for quantitative synthesis of evidence. Of the 3,304 post-COVID-19 patients identified, 50.27% were male with a mean age of 56 years; 20.20% had post-COVID-19 symptoms more than two weeks after the acute phase of infection. Among persistence symptoms, neurocognitive symptoms like headache (27.8%), fatigue (26.7%), myalgia (23.14%), anosmia (22.8%), dysgeusia (12.1%), sleep disturbance (63.1%), confusion (32.6%), difficulty to concentrate (22%), and psychiatric symptoms like PTSD (31%), feeling depressed (20%), and suicidality (2%) had a higher prevalence. In meta-analysis, COVID-19 patients with severe symptoms had higher odds of headache (pooled OR: 4.53; 95% CI: 2.37-8.65; p<0.00001; I: 0%) and myalgia (pooled OR: 3.36; 95% CI: 2.71-4.17; p<0.00001; I: 0%). Anosmia, fatigue, and dysgeusia had higher but non-significant odds following COVID-19. Although we had sufficient data for headache and fatigue to identify higher rates and associations following COVID-19, we could not establish relationships with other post-COVID-19 neurocognitive séqueles. Long-term follow-up may mitigate the neurocognitive effects among COVID-19 patients as these symptoms are also associated with a poor quality of life.
PubMed: 36321004
DOI: 10.7759/cureus.29694 -
Frontiers in Oncology 2022Taxanes-containing chemotherapy constitutes an essential backbone for both early and metastatic breast cancer (mBC). However, the two major taxane drugs-paclitaxel and...
Taxanes-containing chemotherapy constitutes an essential backbone for both early and metastatic breast cancer (mBC). However, the two major taxane drugs-paclitaxel and docetaxel-have distinct safety profiles. In this review, we summarize the safety outcome and management following treatment with both taxanes from selected clinical trials. We utilized PubMed to perform literature search before April 2021. Five phase III randomized controlled trials with reports of individual taxane adverse events (AEs) were included in this review. Grade 3/4 AEs were summarized and discussed extensively. The rates of grade 3/4 neutropenia were higher with docetaxel than with paclitaxel. For non-hematologic grade 3/4 AEs, peripheral neuropathy was more frequent with paclitaxel while fluid retention was more frequent with docetaxel. Compared to paclitaxel, docetaxel had a higher rate of grade 3/4 gastrointestinal AEs. Grade 3/4 myalgia were generally comparable between the two taxanes. Except for neutropenia, the incidence rate of grade 3/4 AEs of taxanes was generally manageable. Peripheral neuropathy was more common with paclitaxel while grade 3/4 neutropenia was more common with docetaxel.
PubMed: 36303832
DOI: 10.3389/fonc.2022.940239 -
Scientific Reports Oct 2022Statins are hypolipidaemic in human immunodeficiency virus (HIV) positive individuals. However, their effect on all-cause mortality and rate of discontinuation is... (Meta-Analysis)
Meta-Analysis
Statins are hypolipidaemic in human immunodeficiency virus (HIV) positive individuals. However, their effect on all-cause mortality and rate of discontinuation is unclear. We conducted a systematic review to evaluate the impact of statins on all-cause mortality, discontinuation rates, and risk of adverse effects among HIV patients on highly active antiretroviral therapy (HAART). We searched four electronic databases from inception until October 2021 for trials and cohort studies evaluating the effects of statin treatment versus placebo in HIV patients. Forty-seven studies involving 91,594 patients were included. Statins were associated with significantly lower risk of discontinuation (RR, 0.701; 95% CI 0.508-0.967; p = 0.031). The risk of all-cause mortality (RR, 0.994; 95% CI 0.561-1.588; p = 0.827), any adverse effects (RR, 0.780; 95% CI 0.564-1.077; p = 0.131) and, diabetes mellitus (RR, 0.272; 95% CI 0.031-2.393; p = 0.241) with statin treatment were lower but not statistically significant compared to placebo/control. Statin treatment was associated with a trend of higher but statistically insignificant risk of myalgia (RR, 1.341; 95% CI 0.770-2.333; p = 0.299), elevated creatine kinase (RR, 1.101; 95% CI 0.457-2.651; p = 0.830) and liver enzyme activities (RR, 1.709; 95% CI 0.605-4.831; p = 0.312). Clinicians should consider the nocebo effect in the effective management of PLWH on statins, who present with common adverse effects such as myalgia and, elevated levels of creatine kinase and liver enzymes.
Topics: Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; HIV Infections; Myalgia; Nocebo Effect; Creatine Kinase
PubMed: 36302940
DOI: 10.1038/s41598-022-23102-2 -
The Clinical Respiratory Journal Dec 2022The aim of this review was to combine the results of published cohort studies to determine the exact association between chronic liver disorders, and the severe form of... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The aim of this review was to combine the results of published cohort studies to determine the exact association between chronic liver disorders, and the severe form of COVID-19, and its associated complications.
METHODS
This meta-analysis employed a keyword search (COVID-19 and chronic liver disorders) using PubMed (Medline), Scopus, Web of Sciences, and Embase (Elsevier). All articles related from January 2019 to May 2022 were reviewed. The STATA software was used for analysis.
RESULTS
The risk of death in COVID-19 patients with chronic liver disorders was higher than in ones without the chronic liver disease (RR: 1.52; CI 95%: 1.46-1.57; I : 86.14%). Also, the risk of acute respiratory distress syndrome (ARDS) and hospitalization in COVID-19 patients with chronic liver disorders was higher than in ones without the chronic liver disease ([RR: 1.65; CI 95%: 1.09-2.50; I : 0.00%] and [RR: 1.39; CI 95%: 1.23-1.58; I : 0.20%]). Also, the meta-analysis showed cough, headache, myalgia, nausea, diarrhea, and fatigue were 1.37 (CI 95%: 1.20-1.55), 1.23 (CI 95%: 1.09-1.38), 1.25 (CI 95%: 1.04-1.50), 1.19 (CI 95%: 1.02-1.40), 1.89 (CI 95%: 1.30-2.75), 1.49 (CI 95%: 1.07-2.09), and 1.14 (CI 95%: 0.98-1.33), respectively, whereas the risk of all these symptoms was higher in COVID-19 patients with chronic liver diseases than ones without chronic liver disorders.
CONCLUSION
The mortality and complications due to COVID-19 were significantly different between patients with the chronic liver disease and the general population.
Topics: Humans; COVID-19; SARS-CoV-2; Liver Diseases; Cohort Studies
PubMed: 36254683
DOI: 10.1111/crj.13552 -
EClinicalMedicine Oct 2022Neuropsychiatric presentations of monkeypox (MPX) infection have not been well characterised, despite evidence of nervous system involvement associated with the related...
BACKGROUND
Neuropsychiatric presentations of monkeypox (MPX) infection have not been well characterised, despite evidence of nervous system involvement associated with the related smallpox infection.
METHODS
In this pre-registered (PROSPERO ID 336649) systematic review and meta-analysis, we searched MEDLINE, EMBASE, PsycINFO, AMED and the preprint server MedRxiv up to 31/05/2022. Any study design of humans infected with MPX that reported a neurological or psychiatric presentation was included. For eligible symptoms, we calculated a pooled prevalence using an inverse variance approach and corresponding 95% confidence intervals. The degree of variability that could be explained by between-study heterogeneity was assessed using the statistic. Risk of bias was assessed with the Newcastle Ottawa Scale and the Joanna Briggs Institute quality assessment tool.
FINDINGS
From 1705 unique studies, we extracted data on 19 eligible studies (1512 participants, 1031 with confirmed infection using CDC criteria or PCR testing) most of which were cohort studies and case series with no control groups. Study quality was generally moderate. Three clinical features were eligible for meta-analysis: seizure 2.7% (95% CI 0.7-10.2%, I 0%), confusion 2.4% (95% CI 1.1-5.2%, I 0%) and encephalitis 2.0% (95% 0.5-8.2%, I 55.8%). Other frequently reported symptoms included myalgia, headache and fatigue, where heterogeneity was too high for estimation of pooled prevalences, possibly as a result of differences in viral clades and study methodology.
INTERPRETATION
There is preliminary evidence for a range of neuropsychiatric presentations including severe neurological complications (encephalitis and seizure) and nonspecific neurological features (confusion, headache and myalgia). There is less evidence regarding the psychiatric presentations or sequelae of MPX. This may warrant surveillance within the current MPX outbreak, with prospective longitudinal studies evaluating the mid- to long-term sequelae of the virus. Robust methods to evaluate the potential causality of MPX with these clinical features are required. More evidence is necessary to explain heterogeneity in prevalence estimates.
FUNDING
UKRI/MRC (MR/V03605X/1), MRC-CSF (MR/V007181/1), MRC/AMED (MR/T028750/1) and the Wellcome Trust (102186/B/13/Z) and (102186/B/13/Z) and UCLH BRC.
PubMed: 36246957
DOI: 10.1016/j.eclinm.2022.101644 -
Nutrients Oct 2022Previous studies have shown that polyphenol consumption enhances recovery of the muscle after exercise-induced muscle damage (EIMD). However, EIMD markers have not been... (Review)
Review
Previous studies have shown that polyphenol consumption enhances recovery of the muscle after exercise-induced muscle damage (EIMD). However, EIMD markers have not been studied by sport type. The main aim of this research was to perform a systematic review to determine the efficacy of polyphenolic consumption in increasing muscle recovery for performing team sport skills. Eligible studies included, following PICOS structure, presented at least one of the following outcomes: maximal isometric voluntary contraction (MVIC); countermovement jump (CMJ); delayed onset muscle soreness (DOMS); 20 m sprint test; creatine kinase (CK); and C-reactive protein (hsCRP). A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the PEDro scale tool. The review showed a possibly positive impact of polyphenol consumption on recovery after EIMD in team sports athletes. No differences were found between sexes. Considering the limitations, there is moderate to very low certainty of polyphenol supplementation effects on recovery of team sport females and males. A dose of 60 mL/day, divided into two times per day, ingested for >7 days may present positive effects on muscle function and muscle soreness in team sport athletes. However, further investigation is required, specifically in females.
Topics: Athletes; Athletic Performance; C-Reactive Protein; Creatine Kinase; Female; Humans; Male; Muscle, Skeletal; Myalgia; Polyphenols; Team Sports
PubMed: 36235737
DOI: 10.3390/nu14194085 -
Nutrients Sep 2022Branched-chain amino acids (BCAAs) are oxidized in the muscle and result in stimulating anabolic signals-which in return may optimize performance, body composition and... (Review)
Review
Branched-chain amino acids (BCAAs) are oxidized in the muscle and result in stimulating anabolic signals-which in return may optimize performance, body composition and recovery. Meanwhile, among athletes, the evidence about BCAA supplementation is not clear. The aim of this study was to review the effects of BCAAs in athletic populations. The research was conducted in three databases: Web of Science (all databases), PubMed and Scopus. The inclusion criteria involved participants classified both as athletes and people who train regularly, and who were orally supplemented with BCAAs. The risk of bias was individually assessed for each study using the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). From the 2298 records found, 24 studies met the inclusion criteria. Although BCAAs tended to activate anabolic signals, the benefits on performance and body composition were negligible. On the other hand, studies that included resistance participants showed that BCAAs attenuated muscle soreness after exercise, while in endurance sports the findings were inconsistent. The protocols of BCAA supplements differed considerably between studies. Moreover, most of the studies did not report the total protein intake across the day and, consequently, the benefits of BCAAs should be interpreted with caution.
Topics: Amino Acids, Branched-Chain; Athletes; Dietary Supplements; Exercise; Humans; Myalgia
PubMed: 36235655
DOI: 10.3390/nu14194002 -
International Journal of Environmental... Sep 2022The coronavirus disease 2019 (COVID-19) is still in a global pandemic state. Some studies have reported that COVID-19 vaccines had a protective effect against long... (Meta-Analysis)
Meta-Analysis Review
The coronavirus disease 2019 (COVID-19) is still in a global pandemic state. Some studies have reported that COVID-19 vaccines had a protective effect against long COVID. However, the conclusions of the studies on the effect of COVID-19 vaccines on long COVID were not consistent. This study aimed to systematically review relevant studies in the real world, and performed a meta-analysis to explore the relationship between vaccination and long COVID. We systematically searched PubMed, Embase, Web of science, and ScienceDirect from inception to 19 September 2022. The PICO (P: patients; I: intervention; C: comparison; O: outcome) was as follows: patients diagnosed with COVID-19 (P); vaccination with COVID-19 vaccines (I); the patients were divided into vaccinated and unvaccinated groups (C); the outcomes were the occurrence of long COVID, as well as the various symptoms of long COVID (O). A fixed-effect model and random-effects model were chosen based on the heterogeneity between studies in order to pool the effect value. The results showed that the vaccinated group had a 29% lower risk of developing long COVID compared with the unvaccinated group (RR = 0.71, 95% CI: 0.58-0.87, < 0.01). Compared with patients who were not vaccinated, vaccination showed its protective effect in patients vaccinated with two doses (RR = 0.83, 95% CI: 0.74-0.94, < 0.01), but not one dose (RR = 0.83, 95% CI: 0.65-1.07, = 0.14). In addition, vaccination was effective against long COVD in patients either vaccinated before SARS-CoV-2 infection/COVID-19 (RR = 0.82, 95% CI: 0.74-0.91, < 0.01) or vaccinated after SARS-CoV-2 infection/COVID-19 (RR = 0.83, 95% CI: 0.74-0.92, < 0.01). For long COVID symptoms, vaccination reduced the risk of cognitive dysfunction/symptoms, kidney diseases/problems, myalgia, and sleeping disorders/problems sleeping. Our study shows that COVID-19 vaccines had an effect on reducing the risk of long COVID in patients vaccinated before or after SARS-CoV-2 infection/COVID-19. We suggest that the vaccination rate should be improved as soon as possible, especially for a complete vaccination course. There should be more studies to explore the basic mechanisms of the protective effect of COVID-19 vaccines on long COVID in the future.
Topics: COVID-19; COVID-19 Vaccines; Humans; SARS-CoV-2; Vaccination; Post-Acute COVID-19 Syndrome
PubMed: 36231717
DOI: 10.3390/ijerph191912422 -
Cureus Aug 2022The coronavirus can infect the upper respiratory tract, sinuses, and nose, and its severity manifests in its respiratory symptoms and neurological and psychological... (Review)
Review
The coronavirus can infect the upper respiratory tract, sinuses, and nose, and its severity manifests in its respiratory symptoms and neurological and psychological consequences. The majority of people who have COVID-19 present with moderate flu-like illness, and patients who are elderly with comorbid conditions, such as hypertension and diabetes, are more prone to experience severe illness and death. However, in the ongoing COVID-19 pandemic, neurological consequences have become a substantial source of morbidity and mortality. COVID-19 poses a global hazard to the nervous system because of its widespread dispersion and multiple pathogenic pathways. This review offers a critical assessment of the acute and long-term neurological effects of the COVID-19 virus. Some neurological problems include headache, dizziness, myalgia/fatigue, meningitis, ischemic/hemorrhagic stroke, and myelitis. Other people who have contracted COVID-19 also exhibit neurological features such as loss of taste and smell, reduced consciousness, and Guillain-Barré syndrome. This study seeks to help neurologists comprehend the wide range of neurologic aspects of COVID-19, as understanding neurological symptoms may help with the management and enhance the patient's outcomes.
PubMed: 36168382
DOI: 10.7759/cureus.28309