Background
Vitamin-D is an immune-modulator which might be linked to disease severity by SARS-CoV-2.
Methods
Meta-analysis of RCTs and quasi-experimental studies, evaluating the role of vitamin-D supplementation in COVID patients was done.
Results
Total 5 studies (3 RCTs and 2 Quasi-experimental) including n = 467 patients were included. Vitamin D didn't reduce mortality (RR 0.55, 95%CI 0.22 to 1.39, p = 0.21), ICU admission rates (RR 0.20, 95% CI 0.01–4.26, p = 0.3) and need for invasive ventilation (RR 0.24, 95% CI 0.01–7.89, p = 0.42).
Conclusion
No significant difference with vitamin-D supplementation on major health related outcomes in COVID-19. Well-designed RCTs are required addressing this topic.
Background
Sedation and analgesia are the integral components of modern-day upper gastrointestinal (GI) endoscopic procedures. Irrespective of the sedative agent, hypoxia is the most commonly encountered unwarranted event with sedation. The current study intends to scrutinize whether high-flow nasal oxygen (HFNO) is advantageous for providing respiratory support during upper GI endoscopic procedures over other conventional low-flow oxygen delivery modalities, e.g. nasal cannula, facemask, etc.
Methods
An extensive screening of electronic databases was done till July 31, 2022, after enlisting in International prospective register of systematic reviews (PROSPERO) (CRD42021245409). Randomized controlled trials (RCT), comparative cohort studies, case series, cross-sectional studies and case–control studies evaluating the utility of HFNO during upper GI endoscopy under sedation were included in this meta-analysis.
Results
We retrieved eight randomized control studies and one longitudinal study with 3294 patients. The application of HFNO during endoscopy led to lesser incidence of desaturation spells (odds ratio [OR] = 0.23; 95% CI 0.11–0.48;
I
2
= 71%), reduced procedural interruption (OR = 0.11; 95% CI 0.02–0.60;
I
2
= 88%), better
nadir
SpO
2
level during procedure (mean difference [MD] = 3.16; 95% CI 0.54–5.78;
I
2
= 73%), overall lesser incidence of sedation-related adverse events (OR = 0.63; 95% CI 0.42–0.93;
I
2
= 25%), with no significant impact on the duration of endoscopy (MD = 0.15; 95% CI − 0.02 to 0.31,
I
2
= 0%).
Conclusion
HFNO is a novel option for upper GI endoscopy under sedation.
Clinical trial number and registry URL
CRD42021245409 (
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021245409
).
Supplementary Information
The online version contains supplementary material available at 10.1007/s12664-022-01308-6.
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