Meta-analysis/systematic review (Red)
Read on for our highlighted selection of Covid-related meta-analyses and systemic reviews from the scientific press for August 2022:
- Clinical characteristics, radiological features and prognostic factors of transverse myelitis following COVID-19 vaccination: A systematic review
- Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis
Clinical characteristics, radiological features and prognostic factors of transverse myelitis following COVID-19 vaccination: A systematic review
Background: Since introducing COVID-19 vaccines, many neurological complications such as acute transverse myelitis have been reported in the literature. This study aims to identify the clinical characteristics, radiological findings, and prognostic factors in patients with COVID-19 vaccine-associated transverse myelitis (TM).
The authors systematically reviewed Scopus, Pubmed, Cochrane library, Google Scholar, and preprint databases using appropriate keywords from inception up to 8 April, 2022. A manually search of the reference lists of the included studies and relevant previous reviews was conducted.
Twenty-eight studies identifying 31 post-COVID-19 vaccination myelitis patients (17 female and 14 male) were included. The mean age of the included patients was 52±19 years. ChAdOx1 nCoV-19 vaccine (Oxford-AstraZeneca) was the most common type of vaccine in association with myelitis (12 out of 31), followed by Pfizer (8 out of 31), Moderna (7 out of 31), Sinopharm (3 out of 31), and Janssen vaccine (1 out of 31). The myelitis occurred in 24 and 7 patients after administering the first and second dose of the vaccine, respectively. Twenty-one and ten patients had good recovery (Modified Rankin Score (MRS) <3 at the follow-up) and poor recovery (MRS≥3 at the follow-up) from myelitis, respectively. Age (OR 1.09, 95%CI 1.01-1.18, pvalue 0.02) and MRS at admission (OR 17.67, 95%CI 1.46-213.76, pvalue 0.024) were two independent risk factors for poor recovery from myelitis.
The authors conclude that the patients with higher age and MRS at admission had a worse prognosis and needed timely and more aggressive therapeutic strategies.
Ostovan VR, Sahraian MA, Karazhian N, Rostamihosseinkhani M, Salimi M, Marbooti H. Clinical characteristics, radiological features and prognostic factors of transverse myelitis following COVID-19 vaccination: A systematic review. Mult Scler Relat Disord. 2022 Jul 6;66:104032. doi: 10.1016/j.msard.2022.104032. Epub ahead of print.
Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis.
The coronavirus disease 2019 (COVID-19) vaccination coverage, willingness, and safety profiles in patients with epilepsy remain poorly understood. This study aimed to summarise the available evidence of COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy.
A literature search was performed in Pubmed, EMBASE, and the Cochrane Central Register database between 1 January 2020 and 30 April 2022, including eligible studies that provided information on COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy. The association between baseline characteristics of patients with epilepsy and un-vaccination status was investigated using a fixed-effect model. The pooled overall willingness to be vaccinated against COVID-19 was calculated and the safety profiles after COVID-19 vaccination in patients with epilepsy were systematically reviewed.
Ten eligible observational studies and two case reports yielded 2589 participants with epilepsy or their caregivers. Among 2145 participants that provided the information of vaccination status, 1508 (70.3%) patients with epilepsy were not administered a COVID-19 vaccine, and 58% (95%CI 40-75%) of respondents were willing to be vaccinated against COVID-19. Seizure status (active versus inactive, OR 1.84 95%CI 1.41-2.39, I2 = 0%) rather than seizure type (focal versus non-focal, OR 1.22 95%CI 0.94-1.58, I2 = 0%) was associated with COVID-19 un-vaccination status. Vaccines were well-tolerated; epilepsy-related problems such as increase in seizure frequency and status epilepticus after COVID-19 vaccination were uncommon.
The findings suggest a low COVID-19 vaccination coverage and willingness in patients with epilepsy. According to this study, vaccination against COVID-19 appears to be well-tolerated and safe in patients with epilepsy, supporting a positive outlook toward vaccination in this population.
Lin K, Huang H, Fang S, Zheng G, Fu K, Liu N, Du H. Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis. Epilepsy Behav. 2022 Jun 29;134:108822. doi: 10.1016/j.yebeh.2022.108822. Epub ahead of print.