A Systematic Review of Systematic Reviews on the COVID-19 Pandemic

Abstract

COVID-19 a systemic inflammation involving multiple organs, affecting all age groups, with high mortality rate, severe adverse outcomes, and high economic burden need to be described. A systematic review of systematic reviews conducted. We searched PubMed, OVID Medline, Cochrane library, COVID-19 resource centers of N Engl. J Med, AHA, and LITCOVID. Certainty of evidences was evaluated by GRADE approach. Meta-analysis according to random effects model was conducted. Seventy-one eligible systematic reviews are included in the study. A total of 86.5% of them had high quality, and 13.5% had medium quality. Meta-analysis results are presented in tabular format, and the remaining results are presented in narration fashion. COVID-19 involves blood vessels, lung, heart, nervous system, liver, gastrointestinal system, kidney, eyes, and other organs and infects adult and children, neonates, pregnant women, and elderly, transmitted via air born and droplet. Comorbidities associated with COVID-19 are HTN 20.7%, CVD 9.6%, DM 9.55%, respiratory diseases 7%, and 9% of cigarette smoking. Prognostic factors for mortality among COVID-19 cases are acute cardiac injury, diagnosed CVD, DM, respiratory disease, and HTN. Prognostic factors for disease severity are CVD and HTN. Prognostic factors for disease progression were fever, shortness of breath, and smoking. There is no specific antiviral treatment. Preventive measures including physical distancing of 2 m and more, using PPE, avoiding social gatherings, quarantine, and isolation have been recommended. Encouraging telemedicine, online training, and homeschooling are highly recommended. Vaccine is approaching, and concerns exist about vaccine with a high efficacy. Modification of CVD and cardiometabolic risk became the cornerstone for sustainable control of pandemic.

Coronavirus disease-19 and headache; impact on pre-existing and characteristics of de novo: a cross-sectional study

“…COVID-19 is a systemic inflammation affecting all age groups, with high mortality rate and severe adverse outcomes. It involves nervous system, blood vessels, lung, heart, liver, gastrointestinal system, kidney, eyes, and other organs [ 14 ].…”

“…A total of 62.5% of patients (30/32) had daily constant and poorly responsive to headache treatment. The recent study by Magdy et al [ 14 ] has found that most of the patients had headache onset during COVID-19 (57%) with diffuse headache (52.9%), pressing character (40.7%) with a median intensity of 7, a median duration of 6 h, and median frequency of 7 days/week [ 19 ]. In another study by Caronna et al, of 130 patients, 74.6% (97/130) had headache with COVID-19 infection [ 25 ].…”

Possible mechanisms of cholesterol elevation aggravating COVID-19

“…Increased cholesterol levels are associated with high CVD risk in both old 6 and young 7 adults, and a confirmed diagnosis of CVD is a prognostic factor for both mortality and severity in COVID‑19 8 . Therefore, elevated cholesterol may indirectly aggravate the infection severity in COVID-19, and possibly even mortality, by causing cardiovascular disease.…”

Is there a role for immune-enhancing therapies for acutely ill patients with coronavirus disease 2019?

“…Another paradigm of the disease soon emerged: a concomitant immunodeficiency involving among other a (profound) decreased lymphocyte count and an impaired type-I interferon response [ 2 , 3 ]. Lymphopenia occurs in up to 68--80% of patients [ 3 , 4 ], is correlated to severity [ 4 ], and involves all subsets including CD4+ and CD8+ cytotoxic T cells, natural killer (NK) cells, memory and regulatory T cells along with B cells [ 3 , 5 ]. Furthermore, blood mononuclear cells obtained from COVID-19 patients produce lower levels of cytokines upon stimulation than those from septic or nonseptic critically ill patients [ 5 ], consistent with a marked impairment of immune effector cell function.…”