The outbreak of coronavirus disease 2019 (COVID-19) is one of the main public health challenges currently facing the world. Because of its high transmissibility, COVID-19 has already caused extensive morbidity and mortality in many countries throughout the world. An accurate estimation of the basic reproduction number (R0) of COVID-19 would be beneficial for prevention programs. In light of discrepancies in original research on this issue, this systematic review and meta-analysis aimed to estimate the pooled R0 for COVID-19 in the current outbreak. International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched to identify studies conducted regarding the R0 of COVID-19. Articles were searched using the following keywords: "COVID-19" and "basic reproduction number" or "R0." The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to estimate R0 in this study. The mean reported R0 in the identified articles was 3.38±1.40, with a range of 1.90 to 6.49. According to the results of the random-effects model, the pooled R0 for COVID-19 was estimated as 3.32 (95% confidence interval, 2.81 to 3.82). According to the results of the meta-regression analysis, the type of model used to estimate R0 did not have a significant effect on heterogeneity among studies (p=0.81). Considering the estimated R0 for COVID-19, reducing the number of contacts within the population is a necessary step to control the epidemic. The estimated overall R0 was higher than the World Health Organization estimate.
COVID-19 is an emerging infectious disease. The study about features of this infection could be very helpful in better knowledge about this infectious disease. The current systematic review and meta-analysis were aimed to estimate the prevalence of clinical symptoms of COVID-19 in a systematic review and meta-analysis. A systematic review using Medline/PubMed, Scopus, and Google scholar has been conducted. In the current systematic review and meta-analysis, the articles published in the period January 1, 2020, to April 2, 2020, written in English and reporting clinical symptoms of COVID-19 was reviewed. To assess, the presence of heterogeneity, the Cochran’s Q statistic, the I2 index, and the tau-squared test were used. Because of significant heterogeneity between the studies the random-effects model with 95% CI was used to calculate the pooled estimation of each symptom prevalence. The most common symptoms in COVID-19 patients include: Fever 81.2% (95% CI: 77.9-84.4); Cough: 58.5% (95% CI: 54.2-62.8); Fatigue 38.5% (95% CI: 30.6-45.3); Dyspnea: 26.1% (95% CI: 20.4-31.8); and the Sputum: 25.8% (95% CI: 21.1-30.4). Based on the meta-regression results, the sample size used in different studies did not have a significant effect on the final estimate value (P > 0.05). Considering the main symptoms of COVID-19 such as Fever, Cough, Fatigue, and Dyspnea can have a key role in early detection of this disease and prevent the transmission of the disease to other people.
Objective: The ongoing novel coronavirus disease 2019 (COVID-19) is the main cause of morbidity and mortality due to its contagious nature and absence of vaccine and treatment. Although there are considerable primary studies that reported extremely variable case fatality rate (CFR) of COVID-19, there is no review study that attempted to estimate CFR of COVID-19. The current systematic review and meta-analysis was aimed to estimate the pooled CFR of COVID-19. Methods: Electronic databases: PubMed, Science Direct, Scopus and Google Scholar were searched to retrieve the eligible primary studies that reported CFR of COVID-19. Keywords: ("COVID-19"OR "COVID-2019" OR "severe acute respiratory syndrome coronavirus 2"OR "severe acute respiratory syndrome coronavirus 2" OR "2019-nCoV" OR "SARS-CoV-2" OR "2019nCoV" OR (("Wuhan" AND ("coronavirus" OR "coronavirus")) AND (2019/12[PDAT] OR 2020[PDAT]))) AND ("mortality "OR "mortality" OR ("case" AND "fatality" AND "rate") OR "case fatality rate") were used as free text and MeSH term in searching process. Random-effects model used to estimate the CFR in this study. I2 statistic, Cochran’s Q test and T2 were used to assess the available heterogeneity between included studies. Results: The overall pooled CFR of COVID 19 was 10.0 %( 95% CI: 8.0-11.0); P<0.001; I2 = 99.7). The pooled CFR of COVID 19 in general population was 1.0% (95% CI: 1.0–3.0); P<0.001; I2 = 94.3), while in hospitalized patients was 13.0 % (95% CI: 9.0–17.0); P<0.001, I2 = 95.6). The pooled CFR in patients admitted in intensive care unit (ICU) was 37.0 % (95% CI: 24.0–51.0); P<0.001, I2 = 97.8) and in patients older than 50 years was 19.0 % (95% CI: 13.0–24.0); P<0.001; I2 = 99.8). Conclusion: The present review results highlighted the need of transparency in testing and reporting policies and denominators used in CFR estimation. It is also necessary reporting the cases age, sex and the comorbidity distribution of all patients which important in comparing the CFR among different segments of population.
2 October 2015 in Journal of the American College of Nutrition
Nonalcoholic fatty liver disease (NAFLD) is a condition defined by exceeding triglycerides accumulation in the liver. The condition can develop into fibrosis, cirrhosis, and hepatocellular carcinoma. Considering the ever-increasing prevalence of NAFLD, the aim of the present study was to investigate the effects of probiotic supplementation on glycemic and inflammatory indices in patients with NAFLD. This randomized clinical trial was conducted on 42 patients with NAFLD who had been referred to a gastroenterology clinic. Subjects in the intervention and control groups consumed 2 capsules/day probiotic or placebo, respectively, for 8 weeks. Fasting blood sugar (FBS), insulin, insulin resistance, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) were measured at baseline and at the end of the study. Means of FBS, insulin, insulin resistance, and IL-6 were significantly different between groups after intervention (p < 0.05), whereas TNF-α was not significantly modified (p > 0.05). In the probiotic group, insulin, insulin resistance, TNF-α, and IL-6 decreased significantly at the end of the study compared to the beginning of study. Considering the effects of probiotic supplementation on the reduction of glycemic and inflammatory indices in patients with NAFLD, consumption of probiotics is recommended as a complementary therapy in these patients.
Background: Given the wide range of depressive disorders, suicidal ideation and suicide attempts in various military studies around the world, determining the exact prevalence of these disorders in line with health planning as well as care and treatment service designing for military forces can be useful. The aim of the present meta-analysis was to determine the pooled prevalence of depressive disorders, suicide thoughts, and attempts in the military. Methods: The present systematic review and meta-analysis study was performed based on PRISMA criteria in 5 steps of the search strategy, screening and selection of articles, data extraction, evaluation of article quality and meta-analysis. International databases (PubMed (Medline), Scopus, Web of science, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) were searched using related keywords extracted from Mesh and Emtree. After screening and final selection of articles, data were extracted and qualitative evaluation was performed using the NOS checklist. Results: The results of meta-analysis showed that the prevalence of depression in active military forces and veterans was 23% (%95 CI: 20–26%) and 20% (%95 CI: 18–22%), respectively. In addition, the prevalence of suicidal ideation and attempts in the military was 11% (%95 CI: 10–13%) and 11% (%95 CI: 9–13%), respectively. The prevalence of suicide ideation and attempts in drug-using military was 18% (%95 CI: 7–33%) and 30% (%95 CI: 23–36%), respectively. The prevalence of suicidal ideation and attempts in military consuming alcohol were 9% (%95 CI: 4–13%) and 8% (%95 CI: 7–10%), respectively. In militaries with AIDS / HIV, the prevalence of suicide attempts was 5% (%95 CI: 4–8%). Conclusion: Therefore, it is necessary to develop and design training and intervention programs in order to increase the awareness of the military, especially veterans, to prevent the occurrence of suicide and depression.