In tropical areas, absence or poor growth of potatoes and grains makes cassava a common food. However, presence of goitrogenic compounds make cassava unfit for human consumption hindering its contribution to curb food security. The study is aimed at providing evidence based relationship between goitre prevalence and cassava consumption in Kilifi County. A longitudinal retrospective quantitative study design was conducted in six randomly selected hospitals

The aim of this review was to evaluate the risk of COVID-19 cytokine release syndrome (CRS) with HIV infection and meta-regress for indicator covariates. Electronic databases, including Google Scholar, Cochrane Library, Web of Sciences (WOS), EMBASE, Medline/PubMed, COVID-19 Research Database, and Scopus, were systematically searched till February 30, 2022. All human studies were included, irrespective of publication date or region. Eleven studies, with a total of 2,005,274 detailing cytokine release syndrome defined by specific parameters, were included. To pool the estimate, a random-effects model with risk ratio (RR) as the effect measure was used. Moreover, publication bias and sensitivity analysis were evaluated followed by meta-regression analysis to account for any possible covariates. This systematic review, metaanalysis, and meta-regression trial was registered (CRD42021264761) on the PROSPERO register. HIV infection showed an increased risk for COVID-19 cytokine release syndrome (RR= 1.48, 95% CI (1.16, 1.88) (P=0.002)) with substantial heterogeneity (I 2 > 80%) and a 4.6% cumulative incidence. The true effects size in 95% of all the comparable populations (prediction interval) fell between 0.67 to 3.29. HIV infection further showed an increased risk for intensive care unit (ICU) admission ((P<0.0001) (I² = 0%)] and mechanical ventilation (MV) ((P=0.04) (I² = 0%)) as the key indicators of cytokine release syndrome. Metaregression analysis demonstrated that COVID-19 cytokine release syndrome was influenced by the year a study was published (R² = 0.55) and the region from where the study was conducted (R² = 0.11). On metaregression analysis, the combined impact of all covariates in the model explained at least some of the variance in effect size (Q = 16.21, df = 6, P= 0.0127), and the proportion of variance explained by covariates on comparing the model with and without the covariates was 73 % and highly significant (Tau² = 0.1100, Tau = 0.3317, I² = 86.5%, Q = .99, df = 10, P<0.0001) (R² = 0.73). Our updated meta-analysis indicated that HIV infection was significantly associated with an increased risk for COVID-19 cytokine release syndrome, which, in addition, might be moderated by the year a study was published and the region in which the study was conducted. Further, the risk for intensive care unit (ICU) admission and mechanical ventilation (MV) were identified as the key indicators of cytokine release syndrome. We believe the updated data anchoring cytokine release syndrome will contribute to more substantiation of the findings reported by similar earlier studies.

IntroductionEstablished predictors for COVID 19 related mortalities are diverse. The impact of these several risk factors on coronavirus mortality have been previously reported in several meta-analyses limited by small sample sizes and premature data. The objective of this systematic review and meta-analysis coupled with meta-regression was to evaluate the updated evidence on the risk of COVID 19 related mortality by HIV serostatus using published data, and account for possible moderators.MethodElectronic databases including Google Scholar, Cochrane Library, Web of Sciences (WOS), EMBASE, Medline/PubMed, COVID 19 Research Database, and Scopus, were systematically searched till 30th February, 2022. All human studies were included irrespective of publication date or region. Twenty-two studies with a total of 19,783,097 patients detailing COVID 19 related mortality were included. To pool the estimate, a random effects model with risk ratio as the effect measure was used. Moreover, publication bias and sensitivity analysis were evaluated followed by meta-regression. The trial was registered (CRD42021264761) on the PROSPERO register.ResultsThe findings were consistent in stating the contribution of HIV infection for COVID-19 related mortality. The cumulative COVID-19 related mortality was 110270 (0.6%) and 48863 (2.4%) with total events of 2010 (3.6%), 108260 (0.5%) among HIV-positive and negative persons respectively. HIV infection showed an increased risk of COVID-19 related mortality [RR=1.19, 95% CI (1.02, 1.39) (P=0.00001)] with substantial heterogeneity (I squared > 80%). The true effects size in 95% of all the comparable populations fell between 0.64 to 2.22. Multiple Centre studies and COVID-19 mortality with HIV infection showed a significant association [RR = 1.305, 95% CI (1.092, 1.559) (P = 0.003)], similar to studies conducted in America (RR=1.422, 95% CI 1.233, 1.639) and South Africa (RR=202;1.123, 95% CI 1.052, 1.198). HIV infection showed a risk for ICU admission [(P=0.00001) (I squared = 0%)] and mechanical ventilation [(P=0.04) (I squared = 0%)] which are predictors of COVID-19 severity prior to death. Furthermore, risk of COVID 19 related mortality is influenced by the region of study (R squared = 0.60). The variance proportion explained by covariates was significant (I squared = 87.5%, Q = 168.02, df = 21, p = 0.0000) (R squared = 0.67).ConclusionOur updated meta-analysis indicated that HIV infection was significantly associated with an increased risk for both COVID 19 mortality, which might be modulated by the regions. We believe the updated data further will contribute to more substantiation of the findings reported by similar earlier studies (Dong et al., 2021; K. W. Lee et al., 2021; Massarvva, 2021; Mellor et al., 2021; Ssentongo et al., 2021)