-
PloS One 2023Research on the long-term impact on COVID-19 in children and young people (CYP) has been published at pace. We aimed to update and refine an earlier systematic review... (Meta-Analysis)
Meta-Analysis
Persistent symptoms are associated with long term effects of COVID-19 among children and young people: Results from a systematic review and meta-analysis of controlled studies.
BACKGROUND
Research on the long-term impact on COVID-19 in children and young people (CYP) has been published at pace. We aimed to update and refine an earlier systematic review and meta-analysis to assess the current evidence for Post-COVID-19 Condition in CYP.
METHODS
Studies from the previous systematic review were combined with studies from a systematic search from July 2021 to November 2022 (registration PROSPERO CRD42021233153). Eligible studies included CYP aged ≤19 years with confirmed or probable SARS-CoV-2 infection and symptoms persisting at least 12 weeks.
FINDINGS
55 studies (n = 1,139,299 participants) were included. Over two-hundred symptoms were associated with Post COVID-19 Condition. Gastrointestinal problems, headaches, cough and fever were among the most prevalent symptoms with rates of 50.2%, 35.6%, 34.7% and 25.8% respectively. Twenty-one symptoms from 11 studies were suitable for meta-analysis. There were significantly higher pooled estimates of proportions of symptoms for altered / loss of smell or taste, dyspnoea, fatigue, and myalgia in CYP with confirmed SARS-CoV-2 infection. Heterogeneity was high suggesting substantial variation amongst the included studies.
CONCLUSIONS
Many CYP continue to experience symptoms after SARS-CoV-2 infection. Efforts to aid early identification and intervention of those most in need is warranted and the consequences of COVID-19 for CYP call for long-term follow-up.
Topics: Child; Humans; Adolescent; COVID-19; SARS-CoV-2; Headache; Research Design; Gastrointestinal Diseases; Post-Acute COVID-19 Syndrome
PubMed: 38153928
DOI: 10.1371/journal.pone.0293600 -
PloS One 2023Olfactory dysfunction is a common manifestation in COVID-19 patients and can significantly impact their quality of life. Corticosteroids have been proposed as a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Olfactory dysfunction is a common manifestation in COVID-19 patients and can significantly impact their quality of life. Corticosteroids have been proposed as a potential treatment, but their efficacy remains controversial. This systematic review and meta-analysis aims to comprehensively analyze the efficacy of corticosteroid therapy for treating COVID-19-related olfactory dysfunction.
METHODS
A literature search was conducted in PubMed, Cochrane Library, and Embase databases up to March 1, 2023. Randomized controlled trials investigating the effects of corticosteroids on olfactory dysfunction in patients with COVID-19 were included. The primary outcome was the olfactory score at the end of follow-up, and the secondary outcomes were the duration and the rate of recovery from olfactory dysfunction.
RESULTS
Seven randomized controlled trials with 999 participants were included in the meta-analysis. Compared with the control group, corticosteroid treatment resulted in a statistically significant improvement in olfactory score with a standardized mean difference of 0.55 (95% CI: 0.15 to 0.95). Topical corticosteroids were found to be effective, but systemic corticosteroids were not. In addition, longer durations and higher dosages of corticosteroids treatment may also be associated with significant improvements in olfactory scores. No significant effect was observed on the duration or recovery rate of olfactory dysfunction.
CONCLUSIONS
Our findings suggest that topical corticosteroid treatment is a viable option for improving COVID-19-related olfactory dysfunction, but further research is needed to investigate optimal treatment protocols and safety profiles.
Topics: Humans; Quality of Life; COVID-19; Randomized Controlled Trials as Topic; Adrenal Cortex Hormones; Glucocorticoids; Olfaction Disorders
PubMed: 38127940
DOI: 10.1371/journal.pone.0289172 -
Healthcare (Basel, Switzerland) Oct 2023Work-related stress is a significant problem in many work environments and can have negative consequences for both employees and organisations. This review aimed to... (Review)
Review
Work-related stress is a significant problem in many work environments and can have negative consequences for both employees and organisations. This review aimed to identify which elements of biophilic design in the workplace affect workers' stress response. To enable this, a literature search was conducted using PsycINFO, Scopus, and Medline. The search was limited to articles published from 2012 to June 2023. This review only integrated quantitative data, incorporating twelve records for qualitative synthesis. The selected studies suggest that strategies such as access to outdoor environments or the creation of outdoor areas are effective in reducing stress in the workplace. If these are not feasible, the examined research advocates the use of virtual means to recreate such relaxation or break spaces. Furthermore, aspects of interest for future research were identified, such as multisensory stimulation, including the sense of smell, the exploration of views with natural elements, the creation of shelters, or the study of biomorphic forms.
PubMed: 37957983
DOI: 10.3390/healthcare11212838 -
Canadian Journal of Respiratory Therapy... 2023Inhaled hypertonic saline (HS) is an effective mucolytic agent in patients with cystic fibrosis (CF). However, adverse events can impair the clinical utility of...
The effectiveness of hyaluronic acid in reducing adverse effects associated with inhaled hypertonic saline therapy in patients with cystic fibrosis: A systematic review and meta-analysis.
BACKGROUND
Inhaled hypertonic saline (HS) is an effective mucolytic agent in patients with cystic fibrosis (CF). However, adverse events can impair the clinical utility of hypertonic saline (HS) in this patient population. In this study, we aimed to investigate the effectiveness of hyaluronic acid (HA) in reducing these adverse events.
METHODS
A literature search was conducted across three electronic databases (Medline, Cochrane Central, and EMBASE) from inception through February 2023. Randomized controlled trials (RCTs) assessing the impact of hyaluronic acid (HA) in reducing adverse events in patients taking hypertonic saline (HS) for CF were included in the analysis. Outcomes of interest included cough, throat irritation, unpleasant taste, and FEV1. Evaluations were reported as risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CI). The Cochrane Risk of Bias Tool (CRBT) was employed to assess the quality of RCTs. The New Castle Ottawa Scale was used to assess the quality of observational studies.
RESULTS
From the 1960 articles retrieved from the initial search, five relevant studies (n=236 patients) were included in the final analysis. Compared with patients only on HS, patients with HS and HA were significantly less likely to experience cough (RR: 0.45; 95% CI, 0.28-0.72, =0.001), throat irritation (RR: 0.43; 95% CI, 0.22-0.81, = 0.009), and unpleasant smell (RR: 0.43; 95% CI, 0.23 - 0.80, =0.09). In addition, patients with HS with HA had significantly less forced expiratory volume (FEV1) (MD: -2.97; 95% CI, -3.79-2.15, =0.52) compared to patients only on HS.
DISCUSSION
The addition of HA to HS was linked to a better tolerability profile. When HS was coupled with HA, there was a reduction in all side effects. This may permit tolerance of the medication in otherwise difficult patients, improve adherence to patients receiving frequent inhalations, and improve therapeutic outcomes.
CONCLUSION
The addition of HA is advantageous in CF patients who require continuous HS therapy and have previously shown poor tolerance to therapy.
PubMed: 37927455
DOI: 10.29390/001c.89093 -
The Journal of Allergy and Clinical... Feb 2024Increasing evidence supports the united airway disease concept for the management of upper and lower respiratory tract diseases, particularly in patients with asthma and...
BACKGROUND
Increasing evidence supports the united airway disease concept for the management of upper and lower respiratory tract diseases, particularly in patients with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). However, evidence for a combined approach in asthma and CRSwNP is scarce.
OBJECTIVE
In this systematic review, we focused on the role of biologics in the lung function and quality of life in patients with severe asthma and CRSwNP.
METHODS
We conducted a systematic search of 3 electronic databases using 2 search strategies to identify studies published from January 2010 to March 2022. Quality assessment was performed with the Critical Appraisal Skills Programme.
RESULTS
Of 1030 studies identified, 48 original studies reporting data of benralizumab (12), dupilumab (14), mepolizumab (10), omalizumab (13), and reslizumab (2) were analyzed. Primary diagnosis was mostly asthma or CRSwNP, with only 15 studies, mainly observational, performed in populations with united airway disease. In total, 18 studies reported data on quality of life (mostly 22-item Sino-Nasal Outcome Test score), 8 on lung function (mostly FEV), and 22 on both outcomes. Significant FEV and 22-item Sino-Nasal Outcome Test score improvements were consistently observed after 24-week treatment, and thereafter, mostly in real-world studies that included variable proportions of patients with asthma/CRSwNP.
CONCLUSIONS
The use of biologics in patients with severe asthma and CRSwNP was overall associated with significant improvements in lung function and quality of life. However, we observed a high heterogeneity of populations and outcome measurements across studies. Notwithstanding the need of larger studies, our results reinforce the joint management of asthma and CRSwNP as united airway disease in clinical practice.
PubMed: 37915724
DOI: 10.1016/j.jacig.2023.100174 -
Physiology & Behavior Jan 2024Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce... (Meta-Analysis)
Meta-Analysis Review
Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce changes in chemosensory perception, as often observed in non-human animals. However, empirical behavioral research on pregnancy-related olfactory or gustatory changes has not yet reached a consensus. This PROSPERO pre-registered systematic review and meta-analysis evaluated published data of olfactory and gustatory changes in pregnant individuals, across the three pregnancy trimesters and postpartum period. Our comprehensive search strategy identified 20 relevant studies, for inclusion in the meta-analysis. The meta-analysis revealed that pregnant individuals, regardless of trimester, performed significantly poorer in terms of odour identification, however, no difference was detected between non-pregnant controls and women postpartum. Additionally, pregnant women in the second and third trimester rated olfactory stimuli to be more intense. A slight decline in odour pleasantness ratings was observed amongst those in the second trimester. No major difference was observed between pregnant and non-pregnant subjects in terms of gustatory functions, except the first trimester appeared to be associated with increased pleasantness for the sweet taste. Post-hoc meta-regression analyses revealed that pregnancy stage was a significant predictor for observed effect size for odour intensity ratings, but not for odour identification scores. These findings provide valuable insights into the interplay between pregnancy and chemosensory perception, highlighting systematic physiological changes due to pregnancy. Healthcare providers can also utilize the knowledge of sensory shifts to better support pregnant women in making appropriate dietary choices, managing sense-related discomfort, and leading to potential sensory interventions. Overall, this research enhances our comprehension of sensory shifts during pregnancy, benefiting maternal health and pregnancy-related care.
Topics: Pregnancy; Female; Humans; Postpartum Period; Smell; Taste Perception; Diet; Odorants
PubMed: 37890603
DOI: 10.1016/j.physbeh.2023.114388 -
World Journal of Oncology Oct 2023To date, early cancer detection is considered vital to reduce the global cancer burden through low-cost, but accurate screening modalities. The anatomical positioning of...
BACKGROUND
To date, early cancer detection is considered vital to reduce the global cancer burden through low-cost, but accurate screening modalities. The anatomical positioning of prostate cancer (PCa) created a potentially distinctive diagnostic method through the identification of volatile organic compounds (VOCs) in urine, which might be detectable not by humans but by canine species. This review aimed to capture the potential of the medical detection canine (MDC) to detect PCa by providing its diagnostic accuracy estimation on urine odor testing.
METHODS
Databases, e.g., MEDLINE, Cochrane, ScienceDirect, and ProQuest, were searched to identify the studies. We focused on accessible original research, comparing the diagnostic utility of trained female MDC and histopathology examination as the gold standard for PCa diagnosis. The statistical analysis was performed in Meta-DiSc 1.4 and presented in diagnostic values, i.e., sensitivity (Sn), specificity (Sp), positive or negative likelihood ratio (LR+ or LR-), diagnostic odd ratio (DOR), and area under the curve (AUC) value, to conclude the Sn-Sp in a single outcome.
RESULTS
Female German Shepherds were the most commonly utilized MDC from the five studies included in the final analysis. We estimate the pooled diagnostic value of eight different MDCs, with the findings as follows: Sn (0.95 (0.94 - 0.97)), Sp (0.92 (0.90 - 0.93)), LR+ (4.48 (1.90 - 10.58)), LR- (0.12 (0.01 - 1.42)), DOR (35.39 (2.90 - 432.53)), and an AUC value of 0.9232.
CONCLUSIONS
MDC's olfaction ability holds considerable potential on its diagnostic accuracies to distinguish the urine of PCa individuals by identifying its volatilome property.
PubMed: 37869239
DOI: 10.14740/wjon1635 -
Canadian Journal of Respiratory Therapy... 2023More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management...
BACKGROUND
More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management of severe COVID-19 and post-acute COVID-19 symptoms. This study synthesizes current evidence of the effectiveness of inhaled corticosteroids (ICS) on mortality, hospital length-of-stay (LOS), and improvement of smell scores in patients with COVID-19.
METHODS
We searched Embase, Web of Science, PubMed, Cochrane Library, and Scopus until Aug 2022. The Cochrane risk of bias tool was used to assess the quality of studies. We evaluated the effectiveness of ICS in COVID-19 patients through measures of mortality, LOS, alleviation of post-acute COVID-19 symptoms, time to sustained self-reported cure, and sense of smell (visual analog scale (VAS)).
RESULTS
Ten studies were included in the meta-analysis. Our study showed a significant decrease in the LOS in ICS patients over placebo (MD = -1.52, 95% CI [-2.77 to -0.28], = 0.02). Patients treated with intranasal corticosteroids (INC) showed a significant improvement in VAS smell scores from week three to week four (MD =1.52, 95% CI [0.27 to 2.78], = 0.02), and alleviation of COVID-related symptoms after 14 days (RR = 1.17, 95% CI [1.09 to 1.26], < 0.0001). No significant differences were detected in mortality (RR= 0.69, 95% CI [0.36 to 1.35], = 0.28) and time to sustained self-reported cure (MD = -1.28, 95% CI [-6.77 to 4.20], = 0.65).
CONCLUSION
We concluded that the use of ICS decreased patient LOS and improved COVID-19-related symptoms. INC may have a role in improving the smell score. Therefore, using INC and ICS for two weeks or more may prove beneficial. Current data do not demonstrate an effect on mortality or time to sustained self-reported cure. However, the evidence is inconclusive, and more studies are needed for more precise data.
PubMed: 37781348
DOI: 10.29390/001c.84260 -
Ear, Nose, & Throat Journal Sep 2023Olfactory dysfunction can negatively impact the quality of life and increase the risk of danger from warning odors. Various factors can cause olfactory dysfunction,...
Olfactory dysfunction can negatively impact the quality of life and increase the risk of danger from warning odors. Various factors can cause olfactory dysfunction, including COVID-19 infection, which has increased anosmia cases. No medications are approved; however, recent studies have suggested that intranasal insulin could effectively treat olfactory dysfunction. To comprehensively evaluate the effectiveness and safety of intranasal insulin in treating olfactory dysfunction. PubMed, Google Scholar, and CENTRAL databases were searched using specific keywords, and the outputs were screened using the Rayyan AI system. Original research articles published without time frame limitations that reported the relevant outcomes were included. The reviewers performed the screening and data extraction, and any disagreements were resolved by a third senior author. This systematic review identified 66 references from 3 databases, with 45 articles meeting the criteria for review after duplicates were removed. Six articles met the inclusion criteria and were selected, including 177 subjects. The selected studies consisted of various study designs, including pilot studies, placebo-controlled trials, crossover studies, and randomized clinical trials. The findings showed that intranasal insulin therapy had beneficial effects on olfactory function. Specifically, improvements were observed in olfactory detection and discrimination in patients with post-COVID-19 anosmia, olfactory threshold performance in healthy participants, and odor identification in hyposmic patients. However, there were variations in the observed effects based on different doses of insulin administered and gender differences. It also shows that using insulin provides good outcomes. Using it intranasally was safe and did not cause any complications. Intranasal insulin has shown promising results as a potentially safe treatment for olfactory dysfunction. Studies suggest that it can improve olfactory thresholds. Further studies are needed to investigate optimal doses and potential gender differences in response.
PubMed: 37776014
DOI: 10.1177/01455613231201028 -
Frontiers in Aging Neuroscience 2023There are discrepancies of olfactory impairment between Alzheimer's disease (AD) and other neurodegenerative disorders. Olfactory deficits may be a potential marker for...
BACKGROUND
There are discrepancies of olfactory impairment between Alzheimer's disease (AD) and other neurodegenerative disorders. Olfactory deficits may be a potential marker for early and differential diagnosis of AD. We aimed to assess olfactory functions in patients with AD and other neurodegenerative disorders, to further evaluate the smell tests using subgroup analysis, and to explore moderating factors affecting olfactory performance.
METHODS
Cross-sectional studies relating to olfactory assessment for both AD and other neurodegenerative disorders published before 27 July 2022 in English, were searched on PubMed, Embase and Cochrane. After literature screening and quality assessment, meta-analyses were conducted using stata14.0 software.
RESULTS
Forty-two articles involving 12 smell tests that evaluated 2,569 AD patients were included. It was revealed that smell tests could distinguish AD from mild cognitive impairment (MCI), Lewy body disease (LBD), depression, and vascular dementia (VaD), but not from diseases such as frontotemporal dementia (FTD). Our finding indicated that in discriminating AD from MCI, the University of Pennsylvania Smell Identification Test (UPSIT) was most frequently used (95%CI: -1.12 to -0.89), while the Brief Smell Identification Test (B-SIT), was the most widely used method in AD vs. LBD group. Further subgroup analyses indicated that the methods of smell test used contributed to the heterogeneity in olfactory threshold and discrimination scores in group AD vs. MCI. While the moderating variables including age, MMSE scores, education years in AD vs. LBD, were account for heterogeneity across studies.
CONCLUSION
Our finding suggests smell tests have potential value in early differential diagnosis of AD. UPSIT and its simplified variant, B-SIT, are widely used methods in the analyses.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php? RecordID = 357970 (PROSPERO, registration number CRD42022357970).
PubMed: 37744388
DOI: 10.3389/fnagi.2023.1249512