Meta-analysis/systematic review (Red)
Read on for our highlighted selection of Covid-related meta-analyses and systemic reviews from the scientific press for March 2022:
- Trends in Stroke Presentations before and during the COVID-19 Pandemic: A Meta-Analysis
- Psychological impacts of COVID-19 pandemic on individuals living with multiple sclerosis: A rapid systematic review
Trends in Stroke Presentations before and during the COVID-19 Pandemic: A Meta-Analysis
There are reports of decline in the rates of acute emergency presentations during coronavirus disease 2019 (COVID-19) pandemic including stroke. In this article the authors performed a meta-analysis of the impact of COVID-19 pandemic on rates of stroke presentations and on rates of reperfusion therapy. Following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, they systematically searched the literature for studies reporting changes in stroke presentations and treatment rates before and during the COVID-19 pandemic. Aggregated data were pooled using meta-analysis with random-effect models. 37 observational studies (n=375,657) were identified. Pooled analysis showed decline in rates of all strokes (26.0%; 95% confidence interval [CI], 22.4 to 29.7) and its subtypes; ischemic (25.3%; 95% CI, 21.0 to 30.0), hemorrhagic (27.6%; 95% CI, 20.4 to 35.5), transient ischemic attacks (41.9%; 95% CI, 34.8 to 49.3), and stroke mimics (45.6%; 95% CI, 33.5 to 58.0) during months of pandemic compared with the pre-pandemic period. The decline was most evident for mild symptoms (40% mild vs. 25%-29% moderate/severe). Although rates of intravenous thrombolytic (IVT) and endovascular thrombectomy (EVT) decreased during pandemic, the likelihood of being treated with IVT and EVT did not differ between the two periods, both in primary and in comprehensive stroke centers (odds ratio [OR], 1.08; 95% CI, 0.94 to 1.24 and OR, 0.95; 95% CI, 0.83 to 1.09, respectively). The authors concluded that the rates of all strokes types decreased significantly during pandemic. It is of paramount importance that general population should be educated to seek medical care immediately for stroke-like symptoms during COVID-19 pandemic. Whether delay in initiation of secondary prevention would affect eventual stroke outcomes in the long run needs further study.
Ishaque N, Butt AJ, Kamtchum-Tatuene J, Nomani AZ, Razzaq S, Fatima N, Vekhande C, Nair R, Akhtar N, Khan K, Saqqur M, Shuaib A. Trends in Stroke Presentations before and during the COVID-19 Pandemic: A Meta-Analysis. J Stroke. 2022 Jan;24(1):65-78. doi: 10.5853/jos.2021.01571.
Psychological impacts of COVID-19 pandemic on individuals living with multiple sclerosis: A rapid systematic review
The global spread of COVID-19 has raised concerns about its possible impact on mental health. People living with multiple sclerosis (PwMS) are considered potentially vulnerable to the mental health effects of the pandemic, as they may be subject to increased social isolation. The aim of this study was to systematically review the current evidence on the impact of the COVID-19 pandemic on mental health outcomes among PwMS. The authors searched four major databases (Medline, EMBASE, PsychInfo and Scopus) and the WHO Global Health COVID-19 research database including peer-reviewed primary research studies using validated health-related quality of life (HRQOL) and psychometric screening tools to evaluate mental health outcomes among PwMS during the COVID-19 pandemic. Studies reporting data on the prevalence of mental health disorders, severity of psychological symptoms and contributing demographic and clinical factors for PwMS during the COVID-19 pandemic were included. The initial search yielded 268 records; 19 studies (13 cross-sectional, 6 longitudinal) were included. Most were conducted during a peak in the pandemic in the host country via an online platform. The main mental health outcomes were depression, anxiety, stress, sleep quality and HRQOL. The included studies used a variety of outcome assessment tools and study designs. The prevalence of mental health issues such as depression, anxiety and stress were high among PwMS during the pandemic. In addition, compared to control populations, PwMS experienced more severe symptoms of depression and stress during the COVID-19 outbreak. However, results from longitudinal studies demonstrate that the severity of mental health symptoms among PwMS during the pandemic were not significantly different compared with the pre-pandemic period. The authors concluded that although mental health issues such as anxiety and depression were common among PwMS during the pandemic, current evidence suggests that mental health among PwMS has not been significantly affected by pandemic-related restrictive measures. Instead, the observed differences may be the result of pre-pandemic differences in prevalence and severity. Where possible, future studies should seek to address the methodological issues identified in the included studies to ensure that data collected during the pandemic can be synthesized into recommendations for policy and practice.
Zarghami A, Hussain MA, Campbell JA, Ezegbe C, van der Mei I, Taylor BV, Claflin SB. Psychological impacts of COVID-19 pandemic on individuals living with multiple sclerosis: A rapid systematic review. Mult Scler Relat Disord. 2022 Jan 25;59:103562. doi: 10.1016/j.msard.2022.103562.