Objectives The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID‐19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections. Results Two hundred and eighty‐five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV‐infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID‐19 outcomes, (2) more data are needed to determine COVID‐19 outcomes in patients with AIDS and (3) HIV‐infected patients presenting with COVID‐19 symptoms should be investigated for superinfections. Conclusions Our findings suggest that PLHIV with well‐controlled disease are not at risk of poorer COVID‐19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID‐19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population.
Objective We aimed to examine the literature evidence behind using extracorporeal membrane oxygenation in COVID‐19 patients in a systematic review manner. Methods We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted on Global Health Medline, EMBASE, and Cochrane databases using keywords and MeSH terms to identify articles pertaining to extracorporeal membrane oxygenation (ECMO) and Coronavirus disease 2019 (COVID‐19). A narrative synthesis was then undertaken to identify the key themes. Results A total of 25 articles met the inclusion criteria of this systematic review. Three main themes were identified following the data extraction: (a) evidence against/inconclusive regarding ECMO for COVID‐19, (b) evidence supporting ECMO for COVID‐19, and finally (c) VV‐ECMO and VA‐ECMO. After combining the data, there were 3428 patients diagnosed with COVID‐19 and 95 ECMO‐associated deaths (19.83%). Conclusion Our study highlights the paucity of evidence and the need for further data to consolidate the efficacy of ECMO in improving patient outcomes. Although ECMO has been shown to be beneficial in a selected group of patients, the recuperative effects of ECMO remain inconclusive. We must ensure that risk‐benefit analysis for each candidate is conducted thoroughly so that patients that have increased probability of survival can benefit from this scarce resource.
This systematic review aims to gather primary data from cancer institutions that have implemented changes to cancer service provision amid the COVID-19 outbreak to inform future intervention and health care facility response strategies. A comprehensive literature search was done on Global Health Medline and EMBASE using pertinent key words and MeSH terms relating to COVID-19 and Cancer service provision. A total of 72 articles were selected for inclusion in this systematic review. Following the narrative synthesis that was conducted of the literature, 6 core themes that encompassed common cancer service intervention adopted by institutions were identified: (1) Testing and Tracking, (2) Outreach and Communication, (3) Protection, (4) Social Distancing (5) Treatment Management, (6) Service Restructuring. Since cancer patients are a high-risk population amid the COVID-19 pandemic, these areas of targeted intervention can be used to inform necessary actions in institutions facing similar risks, based on previous learning from numerous cancer centers globally.
CORONAVIRUS DISEASE 2019 (COVID-19) is a contagious infection precipitated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2. It is a novel virus of which transmissability, incidence and mortality rates have made it a global emergency. While the clinical manifestations of the virus may vary in severity, it is widely known that the cardiorespiratory system is the principle infection point of the virus, with acute respiratory distress syndrome (ARDS) and shock being possibilities. 1 Although severe and critically ill patients account for 15-26% of patients, there are currently no targeted COVID-19 therapeutics. 2 At present, supportive care forms the core of disease management, with emphasis on oxygen delivery in the early stage of the disease. 3 In March 2020, the World Health Organization (WHO) published interim guidelines recommending the use of extracorporeal membrane oxygenation (ECMO) in ARDS patients unresponsive to mainstream therapies, in order to maintain cardiorespiratory function. 4 In this letter, we present a systematic review of the literature to summarize the evidence behind using ECMO in COVID-19 patients, in accordance to the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis: (PRISMA) Guidelines. We have performed a comprehensive electronic literature search using key words "COVID-19," "SARS-CoV2," "Coronavirus," "ECMO," "Extracorporeal membrane oxygenation," "VA-ECMO," "VV-ECMO," "Outcomes," "Respiratory support," and "circulatory support," either as MeSH terms or in the combined key word formats. Our results showed a total of 102 articles that were collected from the database search and through snowballing. A total of 25 articles were selected to be included, after exclusion of duplication and subsequent screening (Fig 1). A summary of each of the chosen studies was conducted as shown in Table 1. After combining the data from the studies, 3,428 patients were diagnosed with COVID-19 overall, 612 patients were diagnosed with ARDS, and 479 were placed on ECMO, with VV-ECMO being the most commonly used type. Commonly used as a form of rescue therapy, ECMO was delivered to COVID-19 patients with induced ARDS and other
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