Coronavirus disease (COVID-19) pandemic: an overview of systematic reviews

BMC Infectious Diseases

Livia Puljak¹  Vinicius Tassoni Civile²  Alvaro Nagib Atallah²  Irena Zakarija-Grkovic³  Tina Poklepovic Pericic³  Ana Marusic³  Thilo Caspar von Groote⁴  Hebatullah Mohamed Abdulazeem⁵  Dónal P. O’Mathúna⁶  Nicola Luigi Bragazzi⁷  Ishanka Weerasekara⁸  Milena Soriano Marcolino⁹  Israel Júnior Borges do Nascimento^1,10  Santino Filoso^1,11 

[1] Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia;Cochrane Brazil, Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, Brazil;Cochrane Croatia, University of Split, School of Medicine, Split, Croatia;Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany;Department of Sport and Health Science, Technische Universität München, Munich, Germany;Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, OH, USA;School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland;Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada;School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia;Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka;University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;Medical College of Wisconsin, Milwaukee, WI, USA;Yorkville University, Fredericton, New Brunswick, Canada;

关键词: Coronavirus;    COVID-19;    SARS-Cov-2;    Evidence-based medicine;    Infectious diseases;   

DOI  :  10.1186/s12879-021-06214-4

来源: Springer

【 摘 要 】

BackgroundNavigating 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.MethodsNine 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.ResultsEighteen 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%.ConclusionsIn 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.

【 授权许可】

CC BY