Background
Neutrophil‐to‐lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID‐19.
Objective
To evaluate the ...prognostic value of the NLR in patients diagnosed with COVID‐19.
Methods
We conducted a systematic review and meta‐analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all‐cause mortality in COVID‐19 patients were included. The quality of the studies was assessed using the Newcastle‐Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta‐analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test.
Results
We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case‐control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all‐cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005).
Conclusions
Higher values of NLR were associated with severity and all‐cause mortality in hospitalised COVID‐19 patients.
We performed a systematic review and meta-analysis to assess whether telomerase activity and telomere length are associated with breast cancer.
PubMed, Web of Science, Embase, LILACS, Scielo, Embase, ...and CNKI databases were searched to obtain relevant articles published through May 10, 2023, following PRISMA guidelines and a registered PROSPERO protocol (CRD42022335402). We included observational studies reporting telomerase activity or telomere length in patients with breast cancer compared with women with benign lesions or normal tissue (control women). The Newcastle-Ottawa Scale was used to evaluate the quality of studies. Data were expressed as odds ratios (OR) and 95 % confidence intervals (CI). Random effects and inverse variance methods were used to meta-analyze associations. The I
test was used to assess heterogeneity.
The meta-analysis of telomerase shows significantly greater activity in patients with breast cancer than in those without malignancies (OR = 23.46, 95 % CI 14.07-39.11, p < 0.00001, I
= 72 %). There were non-significant differences in relative telomere length (OR = 1.16, 95 % CI = 0.90-1.49, p = 0.26, I
= 86 %) and leukocyte telomere length (OR = 2.32, 95 % CI = 0.89-6.08, p = 0.09, I
= 98 %) between women with and without breast cancer. In subgroup analyses by world regions of studies, both telomerase activity and telomere length displayed the same trends as in their respective meta-analyses. In sensitivity analyses, variables showed their respective same trends.
Telomerase activity is higher in patients with breast cancer than in women without malignancies. There were no significant differences in either relative telomere length or leukocyte telomere length in women with and without breast cancer. PROSPERO protocol CRD42022335402.
Vaccination it is considered a vital strategy in order to mitigate monkeypox by protecting from severe disease and helping in reduction of hospitalisations. In this sense, this study aims to estimate ...the global prevalence of vaccination acceptance against monkeypox. We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention of vaccines against monkeypox from multiple continents. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. In addition, a subgroup analysis by study location and population and a sensitivity analysis was developed.Eleven cross-sectional studies were included. A total of 8045 participants were included. The pooled prevalence of monkeypox vaccination acceptance in all participants was 56.0% (95%CI: 42.0–70.0%). In the subgroup analysis of monkeypox vaccine acceptance according to continents, the prevalence of vaccine acceptance was 50.0% (95%CI: 24.0–76.0%) in Asian countries and 70.0% (95%CI: 55.0–84.0%) in European countries. The prevalence of vaccine acceptance was 43.0% (95%CI: 35.0–50.0%) in the general population, 63.0% (95%CI: 42.0–70.0%) in healthcare workers, and 84.0% (95%CI: 83.0–86.0%) in the LGBTI community. Despite the high prevalence of monkeypox vaccination acceptance in the LGBTI community found in our study, vaccination acceptance from healthcare workers and the general population are lower. Governments could use these results for planning, developing or promoting vaccination strategies and public health policies focused on these populations.
•Endometrial telomerase is increased in women with endometrial cancer.•Endometrial telomerase is increased in women with endometrial hyperplasia.•Women from different continents have similar results.
...We performed a systematic review and meta-analysis to assess whether endometrial telomerase activity is associated with endometrial cancer or hyperplasia.
PubMed, Web of Science, Embase, Scielo, LILAC, and CNKI databases were searched to obtain relevant literature for articles published through June 2022, following PRISMA guidelines and a registered PROSPERO protocol. We included observational studies reporting endometrial telomerase activity in patients with either endometrial cancer or hyperplasia compared with benign endometrial tissue (control women). The Newcastle-Ottawa Scale was used to evaluate the quality of studies. Data were expressed as the odds ratios (OR) and 95 % confidence intervals (CI). Random effects and inverse variance methods were used to meta-analyze associations. The I2 test was used to assess heterogeneity.
There were significant associations between endometrial telomerase activity and either endometrial cancer (20 studies, OR = 10.65, 95 % CI 6.39, 17.75, p = 0.00001, I2 = 21 %) or endometrial hyperplasia (nine studies, OR = 3.62, 95 % CI 1.61, 8.13, p = 0.002, I2 = 36 %) compared to women without endometrial cancer and hyperplasia. There was not a significant difference in telomerase activity in women with endometrial cancer compared to those with endometrial hyperplasia (seven studies, OR = 1.03; 95 % CI 0.31, 3.37, p = 0.96, I2 = 49 %). In subgroup analyses, there were no significant differences in telomerase activity in patients with endometrial cancer by type of observational studies and by countries of the studies.
Endometrial telomerase activity is higher in women with either endometrial cancer or endometrial hyperplasia compared to control women without those lesions.
Background and Aims. Biomarkers are necessary to stratify the risk of diabetic foot ulcers (DFUs). This systematic review and meta-analysis aimed to evaluate the association between the lipid profile ...and apolipoproteins with the risk of DFU. Methods. A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science among adult patients. Cohort and case-control studies were included. Random-effects models were used for meta-analyses, and the effects were expressed as odds ratio (OR) and their 95% confidence intervals (CIs). We evaluated publication bias through Egger’s test and funnel plot. Results. A total of 12 cohort studies and 26 case-control studies were included, with 17076 patients. We found that the higher values of total cholesterol (TC), low-density lipoprotein (LDL), triglycerides, and lipoprotein(a) (Lp(a)) were associated with a higher risk of developing DFU (OR: 1.47, OR: 1.47, OR: 1.5, OR: 1.85, respectively). Otherwise, the lower values of HDL were associated with a higher risk of developing DFU (OR: 0.49). Publication bias was not found for associations between TC, HDL, LDL, or TG and the risk of DFU. Conclusions. The high values of LDL, TC, TG, and Lp(a) and low values of HDL are associated with a higher risk of developing DFU. Furthermore, we did not find a significant association for VLDL, ApoA1, ApoB, and ApoB/ApoA1 ratio.
Vaccination represents an important strategy to mitigate COVID-19 related morbidity and mortality by protecting against severe forms of the disease and reducing hospitalization and death rates. In ...this sense, the objective of this study is to estimate the prevalence of Vaccination Intention (VI) against COVID-19 in Latin America and Caribbean (LAC).
We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention to vaccines against COVID-19 in LAC countries. The Clopper-Pearson method was used to estimate 95% Confidence Intervals. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. A subgroup analysis by study location and a sensitivity analysis were developed.
Nineteen cross-sectional studies were included. Five meta-analyzes were performed according to the target population of the included studies. The VI in the general population of LAC was 78.0% (95%CI: 74.0%–82.0%). The VI for non-pregnant women was 78.0% (95%CI: 58.0%–99.0%), for elderly population was 63.0% (95%CI: 59.0%–69.0%), for pregnant women was 69.0% (95%CI: 61.0%–76.0%) and for health-personnel was 83.0% (95% CI: 71.0%–96.0%). The sensitivity analysis for general population meta-analysis that included only low risk of bias studies showed a 77.0% VI (95%CI: 73.0%–82.0%) and for non-pregnant women, 85.0% VI (95%CI: 79.0%–90.0%).
Despite the high prevalence of VI in general population found in our study, VI prevalence from elderly people and pregnant women are lower than other population groups and overall population.
Numerous studies have found an association between vitamin deficiency and thyroid disorders (TD). The presence of anti-parietal cell antibodies is indicative of reduced ability to absorb vitamin B12. ...Thus, this study reviewed the existing studies with the objective of assessing differences in the serum levels of vitamin B12 among patients with and without TD, the frequency of vitamin B12 deficiency in patients with TD, and the presence of anti-parietal cell antibodies in patients with TD.
A meta-analysis of random-effects model was conducted to calculate pooled frequencies, mean differences (MD), and their respective 95% confidence intervals (CI). We identified 64 studies that met our inclusion criteria (n = 28597).
We found that patients with hypothyroidism had lower vitamin B12 levels than healthy participants (MD: -60.67 pg/mL; 95% CI: -107.31 to -14.03 pg/mL; p = 0.01). No significant differences in vitamin B12 levels were observed between healthy participants and patients with hyperthyroidism (p = 0.78), autoimmune thyroid disease (AITD) (p = 0.22), or subclinical hypothyroidism (SH) (p = 0.79). The frequencies of vitamin B12 deficiency among patients with hypothyroidism, hyperthyroidism, SH, and AITD were 27%, 6%, 27%, and 18%, respectively.
Patients with hypothyroidism had lower levels of vitamin B12 than healthy participants. No significant differences were observed between vitamin B12 levels and hyperthyroidism, AITD, or SH.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324422, identifier (CRD42022324422).
The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients.
...A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias.
The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), −0.27; 95% IC, −0.32 to −0.22; p < 0.001; I2 = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, −0.29; 95% IC, −0.35 to −0.24; p < 0.001; I2 = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I2 = 20%; mortality, I2 = 5%).
Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
Albumin, COVID-19, Globulin, Prognosis.
Avian influenza A H5N1 is a significant global public health threat. Although relevant, systematic reviews about its prevalence in animals are lacking.
We performed a systematic literature review in ...bibliographic databases to assess the prevalence of H5N1 in animals. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95 % confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported.
The literature search yielded 1359 articles, of which 33 studies were fully valid for analysis, including 96,909 animals. The pooled prevalence for H5N1 in birds (n = 90,045, 24 studies) was 5.0 % (95%CI: 4.0–6.0 %; I2 = 99.21); in pigs (n = 3,178, 4 studies) was 1.0 % (95%CI: 0.0–1.0 %); in cats (n = 2,911, 4 studies) was 0.0 % (95%CI: 0.0–1.0 %); and in dogs (n = 479, 3 studies) was 0.0 % (95%CI: 0.0–2.0 %).
While the occurrence of H5N1 in animals might be comparatively limited compared to other influenza viruses, its impact on public health can be substantial when it transmits to humans. This virus can potentially induce severe illness and has been linked to previous outbreaks. Therefore, it is essential to closely monitor and comprehend the factors influencing the prevalence of H5N1 in both avian and human populations to develop effective disease control and prevention strategies.
Lymphocyte-to-Monocyte ratio (LMR) has shown an association with survival outcomes in several oncological diseases. This study aimed to evaluate the association between LMR and clinical outcomes for ...cholangiocarcinoma patients. A systematic review and meta-analysis were performed to assess the association between LMR values and overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and time to recurrence (TTR) in cholangiocarcinoma patients. We used Hazard ratio (HR) and their 95% confidence interval (CI) as a measure of effect for the random effect model meta-analysis. The Newcastle–Ottawa Scale was used for quality assessment. The Egger test and funnel plot were developed for approaching publication bias. A total of 19 studies were included in this study (n = 3860). The meta-analysis showed that cholangiocarcinoma patients with low values of LMR were associated with worse OS (HR: 0.82; 95% CI: 0.71–0.96; I2 = 86%) and worse TTR (HR: 0.71; 95% CI: 0.58–0.86; I2 = 0%). DFS and RFS also were evaluated; however, they did not show statistically significant associations. Low LMR values were associated with a worse OS and TTR.
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