Israel Júnior Borges do Nascimento1,2, Dónal P O'Mathúna3,4, Thilo Caspar von Groote5, Hebatullah Mohamed Abdulazeem6, Ishanka Weerasekara7,8, Ana Marusic9, Livia Puljak10, Vinicius Tassoni Civile11, Irena Zakarija-Grkovic9, Tina Poklepovic Pericic9, Alvaro Nagib Atallah11, Santino Filoso12, Nicola Luigi Bragazzi13, Milena Soriano Marcolino1. 1. University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 2. Medical College of Wisconsin, Milwaukee, WI, USA. 3. Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, OH, USA. 4. School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland. 5. Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany. 6. Department of Sport and Health Science, Technische Universität München, Munich, Germany. 7. School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia. 8. Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka. 9. Cochrane Croatia, University of Split, School of Medicine, Split, Croatia. 10. Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia. livia.puljak@gmail.com. 11. Cochrane Brazil, Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, Brazil. 12. Yorkville University, Fredericton, New Brunswick, Canada. 13. Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada.
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.
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.
Authors: Matteo Chinazzi; Jessica T Davis; Marco Ajelli; Corrado Gioannini; Maria Litvinova; Stefano Merler; Ana Pastore Y Piontti; Kunpeng Mu; Luca Rossi; Kaiyuan Sun; Cécile Viboud; Xinyue Xiong; Hongjie Yu; M Elizabeth Halloran; Ira M Longini; Alessandro Vespignani Journal: Science Date: 2020-03-06 Impact factor: 47.728
Authors: Israel Júnior Borges do Nascimento; Ana Beatriz Pizarro; Jussara M Almeida; Natasha Azzopardi-Muscat; Marcos André Gonçalves; Maria Björklund; David Novillo-Ortiz Journal: Bull World Health Organ Date: 2022-06-30 Impact factor: 13.831
Authors: Dailun Hu; Tao Wang; Jasim Uddin; Wayne K Greene; Dakang Hu; Bin Ma Journal: Front Cell Infect Microbiol Date: 2022-10-04 Impact factor: 6.073