Type 2 diabetes associated with areca nut usage: A systematic review and meta-analysis.

AIMS/HYPOTHESIS: This study aimed to evaluate the potential association between chewing areca nuts and the occurrence of type 2 diabetes and to investigate whether chewing status (current chewers or ex-chewers) affects this association. METHODS: We searched The Cochrane Library, PubMed, and EMBASE databases for relevant studies up to May 21, 2023, using predefined inclusion and exclusion criteria. Three population-based studies conducted in Taiwan were included in the systematic review and meta-analysis. RESULTS: When combined current or ex-chewers were more likely to develop diabetes (Odds Ratio [OR] = 1.45; 95% confidence interval [CI]: 1.30-1.62) compared to the never chewers. Ex-chewers had a higher risk of diabetes (OR: 1.53, 95% CI: 1.45-1.62) compared to never chewers. However, there was no evidence that current chewers were associated with a higher risk of diabetes compared to never chewers. Male current and ex-chewers were associated with higher risk of diabetes compared with never chewers (OR: 1.55, 95% CI: 1.49-1.61). For females there was insufficient evidence. CONCLUSIONS/INTERPRETATION: Existing evidence suggests a link between chewing areca nuts and the development of type 2 diabetes. Therefore, areca chewers should monitor diabetes-related biomarkers.

The association between internet use and the choice of medical institution among Chinese older adults.

BACKGROUND: As older people have complex medical needs and still encounter challenges in accessing online health information, the relationship between Internet use and the choice of medical institution made by them is unclear, and we aimed to examine this relationship. METHODS: Data from the newly released 2020 China Family Panel Survey database were used. Furthermore, we used descriptive statistics to analyze the background characteristics of the sample and a logistic regression model to estimate the impact of Internet use on the choice of medical institution made by older adults. We conducted a stratified analysis to explore the influence of different characteristics on the relationship between Internet use and the choice of medical institution. RESULTS: Totally 4,948 older adults were included. Multivariate logistic regression showed that, compared to non-Internet users, Internet users were less likely to choose community health service centers over general hospitals (P < 0.001, OR = 0.667, 95CI%: 0.558-0.797). The subgroup analyses found that Internet use only had an impact on the choice of medical institution in older adults aged 65-69 years, those with partners, those with primary or secondary education, those residing in urban areas, those without medical insurance, those with a self-rated health status as average or healthy, those with unchanged or better health trend, and those without chronic disease. The effect of Internet use on the choice of medical institution did not differ by sex, satisfaction, or trust in doctors. CONCLUSION: Internet use may significantly affect older adults' tendency to choose general hospitals to meet their daily medical needs. The subgroup analyses indicated that different characteristics of older people affected this association.

Prevalence of skin diseases among elderly prisoners in Taiwan: an examination of skin health in prison.

BACKGROUND: Although prisoner health is a topic of significant importance, it has received limited attention in epidemiological studies, likely due to challenges in obtaining data. Therefore, this study aimed to investigate the prevalence of skin diseases among elderly prisoners in Taiwan. METHODS: We examined the presence of skin diseases in 2215 elderly prisoners based on the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). Additionally, the most common types of skin diseases among elderly prisoners in Taiwan were identified. RESULTS: The prevalence of skin diseases among prisoners was estimated to be 55.03%. Elderly men prisoners exhibited a higher prevalence of skin diseases than the women prisoners. The most common skin diseases observed were as follows: contact dermatitis and other forms of eczema; pruritus and related conditions; cellulitis and abscesses; and urticaria. CONCLUSION: Skin diseases were identified in more than half of the elderly prisoners. The overall quality of life of elderly prisoners can be improved by addressing their skin health, which would contribute to the fulfilment of their basic human rights. CLINICAL TRIALS NUMBER: NA.

Prevalence of eye and adnexal disorders among elderly inmates in Taiwan prisons.

BACKGROUND: Prisoner health is a topic of significant importance; however, it has received limited attention in epidemiological studies, likely because of challenges in obtaining relevant data. Specifically, research on ocular disorders among elderly prisoners is lacking. Thus, the aim of this study was to evaluate the prevalence of disorders of the eye and adnexa among elderly prisoners in Taiwan. METHODS: We investigated the presence of eye and adnexal disorders in elderly prisoners in Taiwan using data from the Taiwan National Health Insurance Research Database. The ocular disorders were identified using the appropriate disease codes in the International Classification of Diseases, 9th revision Clinical Modification (codes 360-379). In addition, the most common types of eye and adnexal disorders among the prisoners were identified. RESULTS: A total of 2215 elderly prisoners (age ≥ 65 years; 2073 men and 142 women) were examined. The prevalence of eye and adnexal disorders among the prisoners was 18.87%. The elderly female prisoners exhibited a higher prevalence of eye and adnexal disorders than the elderly male prisoners. The most common disorders were disorders of the conjunctiva, cataract, and disorders of the lacrimal system. CONCLUSIONS: A considerable proportion of elderly prisoners have disorders of the eye and adnexa. The overall quality of life of elderly prisoners can be improved by addressing their visual health, which contributes to the fulfillment of their basic human rights.

Identification of key potential risk areas and key potential failure modes in hemodialysis rooms by the FMEA method following routine prevention and control of the COVID-19 pandemic.

Hemodialysis is an important part of nosocomial infection prevention and control (IPC). This study aimed to identify the key potential risk areas and failure modes in hemodialysis rooms in hospitals and put forward a series of improvement measures to prevent and control the spread of the coronavirus disease 2019 (COVID-19). Hemodialysis patients are highly susceptible to COVID-19 and usually have a high incidence of severe illness and mortality after infection with COVID-19. Therefore, IPC in hemodialysis patients is of crucial strategic significance. Based on 30 domain experts' interviews and careful analysis of prevention and control documents, we constructed a comprehensive failure system for a model that identifies the potential risks for nosocomial COVID-19 infection in the hemodialysis room. Subsequently, a thorough risk assessment of the potential failure factors identified in our model was conducted. The failure key factors corresponding to the human element in medical waste (garbage) disposal (C2) are verified to be the highest risk factors. They are as follows: The cleaning staff did not dispose of different types of medical waste (garbage) (C21), did not wear masks according to the regulations (C22), and lacked knowledge and norms of nosocomial IPC (C23). This study provides valuable insights for hospital decision-makers on the potential failure factors related to COVID-19 infections in hemodialysis rooms. By working with hospital infection specialists, the suggested improvement measures can help reduce the risk of virus exposure among hospital medical staff, patients, and cleaning staff.

Analysis of sterilizer allocation and related factors in dental health-care settings in Yunnan Province, China: a cross-sectional study.

OBJECTIVE: To investigate the status and related factors of sterilizers in dental health-care settings in Yunnan Province, with the aim of providing a theoretical basis for the health administrative department to formulate regional quality control programs and systems, proposing reasonable suggestions for optimizing the allocation of sterilizer resources in Yunnan's dental health-care settings, thereby improving resource utilization efficiency. METHODS: This cross-sectional survey was conducted in 2600 dental health-care settings in Yunnan Province in March 2020. Uni-variable linear regression, multi-variable linear regression, curve fitting and threshold effect analysis were used to understand the relationship between dental units and sterilizers. RESULTS: A total of 2600 dental health-care settings were included. The disinfection and sterilization work were mainly completed by the dental department in 1510(58.1%) institutions. 44(1.7%) institutions were not allocated sterilization equipment, and 1632 (62.8%) had only one sterilizer. The median allocation of sterilizers was 1.0. Uni-variable linear regression showed significant differences in covariates such as dental unit, dental handpiece, disinfection equipment, dentist, and dental assistant, which were more sensitive (p < 0.001) and statistically significant. The adjusted model was more stable in the multi-variable linear regression, and the differences in covariates between different settings were statistically significant. Curve fitting revealed an S-shaped curvilinear relationship between the number of dental units and sterilizers in oral healthcare settings. CONCLUSION: The disinfection and sterilization work was mainly completed by the dental department in dental health-care settings in Yunnan Province. Sterilizer allocation increases with the number of dental units, but some institutions have insufficient allocation of sterilizer and manpower resources, resulting in certain risks of infection control. Thus, it is necessary to strengthen supervision, inspection and regional quality control work in infection control of dentistry.

The association between abusive behaviour and physician-patient relations: a systematic review.

OBJECTIVE: This systematic review aims to explore the association between abusive behaviour and physician-patient relations in healthcare settings. STUDY DESIGN: Systematic review. METHODS: We searched for related studies on databases such as PubMed, Embase, and the Cochrane library, without restrictions on language, from inception until July 15, 2022. The risk of bias and the methodological quality was evaluated using the Newcastle-Ottawa Scale and Risk of Bias in Non-randomised Studies of Interventions tool. RESULTS: Ten studies were included in this systematic review, the participants of which were physicians and patients. The research from all the studies highlighted the detrimental effects of abusive behaviour on the relationship between physicians and patients, regardless of who the abusers were. CONCLUSIONS: Abusive behaviour in a clinical setting has a negative influence on the physician-patient relationship, whoever the perpetrator might be. The research sheds light on the importance of teaching communication skills to physicians and training them to manage conflicts and aggressive behaviours in healthcare settings.

Using hybrid consistent fuzzy preference relations-importance-performance analysis model to improve shared decision-making quality based on orthopaedic nurses' perceptions.

PURPOSE: To understand key factors for shared decision-making (SDM) and the quality improvement of nursing decisions in the orthopaedic clinical environment. METHOD: This study applied the consistent consistent fuzzy preference relations (CFPRs) and importance-performance analysis (IPA) methods to explore the attribute weights and SDM performance, respectively. The dataset was collected from 16 orthopaedic clinical nurses' experiences in a third-grade and first-level general hospital in Taizhou, China. This study was performed according to the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines. RESULTS: The results showed that "I made clear to my patient or patient's family that a nursing care decision needs to be made", "I explained the advantages and disadvantages of the nursing care options to my patient or patient's family" and "I told my patient or patient's family that there are different nursing care options for caring his/her medical condition" were key factors for affecting SDM. The statistical significance confidence and difference error of weight results were 98.321% and 1.679%, respectively. In addition, "I asked my patient or patient's family which nursing care option he/she prefers" was the key factor for improving orthopaedic clinical nursing in the case hospital. CONCLUSION: The hybrid CFPRs-IPA model can help hospital managers effectively understand the key factors of SDM quality and improve the orthopaedic clinical nursing performance from nurses' perspectives. RELEVANCE TO CLINICAL PRACTICE: A quantitative decision-making model can help nurses understand the key factors affecting the quality of SDM in nursing decision-making and promote nursing decision-making and patient-centred nursing service quality. A series of corresponding SDM training courses (i.e. concepts, knowledge and skills) can be provided for hospital and nursing department managers to maximise the potentially available resources. PATIENT OR PUBLIC CONTRIBUTION: The clinical care process should be committed to involving patients in their care decisions and also provide an opportunity for patients to gain a comprehensive understanding of the care decision-making process in order to inform future patient contributions to care decisions.

Association of acute kidney injury with frailty in elderly population: a systematic review and meta-analysis.

Aim: The objective of this study was to assess whether an elderly patient's frailty was associated with acute kidney injury (AKI) and to examine whether severe frailty group had an increased risk of AKI than mild-moderate group.Methods: We searched The Cochrane Library, PubMed, and EMBASE for relevant studies without language limitations before 1 March 2019 with a priori defined inclusion and exclusion criteria. Five population-based cohort studies were included for systematic review and meta-analysis.Results: Compared with the control group, the frailty group is significantly associated AKI (Odds Ratio = 2.05; 95% CI: 1.23-3.43). The moderate-severe frailty group has an increased risk of AKI than mild frailty group (Hazard Ratio = 2.87; 95% CI: 1.60-5.17.Conclusion: In conclusion, the available best evidence support an association between frailty and AKI among elder patients, thus relevant interventions should be taken among elderly under potential risk of AKI.

Utilization of Emergency and Hospitalization Care after Coronary Artery Bypass Surgery for Patients with Ischemic Heart Disease.

This retrospective follow-up study explored the status of patients with myocardial infarction with regard to the likelihood of being readmitted to the hospital within 30 days after undergoing coronary artery bypass surgery (CABG) and their survival status within one year of the procedure.The rate of readmission within 30 days was 10.7% (167/1,575), primarily due to surgical wound infection (11.3% of readmission cases), ischemic heart disease (10.3%), and heart failure (8.7%). The readmission group consisted mainly of older males with a high comorbidity index. No significant differences existed between the two groups with regard to case distribution, hospital level, tenure of physicians, or teaching status of the hospitals. Most subsequent emergency department visits one month after surgery involved older male patients with a high comorbidity index. Compared to patients in the non-emergency group, those in the emergency group had longer hospital stays but lower mortality rates. Males constituted a higher proportion of survivors at one year post CABG, with age and comorbidity index being the primary variables affecting the risk of death.The National Health Insurance may adopt the policy of increasing payments for medical institutions that avoid readmission within 30 days post CABG in order to encourage better patient care and avoid the costs associated with readmission.

Application of failure mode and effect analysis in ICU admission of potentially COVID-19 infected patients.

BACKGROUND: To analyze the admission and treatment process of potentially COVID-19-infected patients in the intensive care unit under normalization, prevention, and control of the pandemic. METHODS: A multidisciplinary team was assembled to develop a flowchart of potentially COVID-19-infected patients admitted to the intensive care unit and identify potential failure steps and modes throughout the process using the failure mode and effect analysis method. Through risk priority number (RPN) analysis of each failure mode, those with the highest impact on nosocomial infection were identified, and the priority of implementation was determined. Related corrective measures have been developed to continuously improve clinical practice and management. RESULTS: Eighty potential failure modes were identified, and 8 potential failure modes were identified with RPNs greater than 100. These high RPNs of the failure modes were associated with careless inquiries of epidemiological histories by nurses, inadequate implementation of management standards by nursing assistants, and exposure of attending physicians to potentially risky environments. Finally, 18 general corrective measures are proposed. CONCLUSIONS: Application of the failure mode and effect analysis method for quality improvement is a powerful tool for predicting potential failures in the process and can suggest corrective measures that could help avoid nosocomial infection during a pandemic.

Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study.

Objective: Diabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. Methods: By retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. Results: After adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277-1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. Conclusions: There is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.

Increased Long-Term Risk of Dementia in Patients With Carbon Monoxide Poisoning: A Systematic Review and Meta-Analysis of Cohort Studies.

OBJECTIVE: To assess whether carbon monoxide (CO) poisoning increases the incidence of dementia. METHODS: We searched the Cochrane Library, PubMed, and EMBASE from inception to 14 August 2022. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Only cohort study with an enough follow-up period was included for systematic reviews and meta-analysis. RESULTS: Thirty-three full texts were initially searched, but only three studies met our inclusion criteria, and they were comprised of 134,563 participants who were initially free of dementia. The follow-up period ranged from 9 to 12 years. We found that CO poisoning increased the risk of dementia incidence (adjusted hazard ratio 2.61, 95% confidence interval 1.56 to 4.36, p=0.0003). Subgroup analysis showed that the increased dementia risk was significant in males but not in females, and the highest risk was in young age group, followed by in middle age group, but not in the old one. CONCLUSION: Overall the evidence from prospective cohort studies supported a link between CO exposure and an increased dementia risk, although all the included studies were limited to Taiwanese population.

Association between COVID-19 and sexual health: an umbrella review.

PURPOSE: We conducted this umbrella review to review the current evidence on the relationship between COVID-19 and sexual health in both men and women. METHODS: We conducted searches in Pubmed, Embase, and the Cochrane dataset for meta-analyses that met our pre-set inclusion criteria. We included studies with detailed information investigating the link between COVID-19 and sexual health in men/women. We did not limit the language. RESULTS: The results of the included studies frequently relied on the Female Sexual Function Index to assess sexual health in women. For men, the International Index of Male Function and hospital diagnoses were commonly used to assess sexual health. Currently, there is conflicting evidence regarding the impact of COVID-19 on sexual health. However, since most studies were observational in nature, additional study designs are necessary to draw definitive conclusions across different contexts. CONCLUSION: Our findings highlight the importance of sexual health among COVID-19 patients and people affected due to COVID-19. Further critical studies should investigate the mechanism underlying the association between COVID-19 and sexual health.

Effectiveness and Safety of COVID-19 Vaccinations: An Umbrella Meta-Analysis.

Objectives: This umbrella meta-analysis aims to provide comprehensive and synthesized evidence regarding the effectiveness and safety of COVID-19 vaccinations based on current studies. Methods: Studies from the Cochrane Library, PubMed, and EMBASE, published before 10 December 2021, were included in the analysis. The pooled results of effectiveness and safety were estimated and shown in forest plots. Results: We included nineteen studies (fifteen studies regarding safety and nine regarding effectiveness) in the analysis. The mRNA vaccines, adenovirus vector vaccines, subunit vaccines, and inactivated vaccines were found to be effective; however, mRNA vaccines, adenovirus vector vaccines and subunit vaccines were associated with local adverse events and systemic events when compared with inactivated vaccines. Conclusion: Our study suggested that till date, COVID-19 vaccination is still a preferred pharmaceutical way to control the widespread pandemic. However, all reported adverse events should be revisited to provide further evidence for mass vaccinations.

Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis.

PURPOSE: Exercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and exercise capacity in patients with HF. METHODS: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was performed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis. RESULTS: Baduanjin exercise showed a favourable improvement of the overall QOL (mean difference = -8.25; 95% confidence interval: -13.62 to -2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% confidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients' physical (mean difference = -2.83; 95% confidence interval: -3.76, -1.90; P < 0.00001), emotional (mean difference = -2.52; 95% confidence interval: -3.67 to -1.37; P < 0.0001), and general QOL (mean difference = -2.61; 95% confidence interval: -5.17 to -0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes. CONCLUSIONS: Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.

A population-based study on the association between acute renal failure (ARF) and the duration of polypharmacy.

BACKGROUND: Because of the rapid growth in elderly population, polypharmacy has become a serious public health issue worldwide. Although acute renal failure (ARF) is one negative consequence of polypharmacy, the association between the duration of polypharmacy and ARF remains unclear. We therefore assessed this association using a population-based database. METHODS: Data were collected from the Taiwan National Health Insurance Research Database (NHIRD) from 2003 through 2006. The case group included patients hospitalized for ARF during 2006, but not admitted due to trauma, surgery, burn trauma, car accident, transplantation, or infectious diseases; the control group included patients hospitalized without ARF. The cumulative number of days of polypharmacy (defined as more than 5 prescriptions per day) for 1 year prior to admission was determined, with patients further subdivided into 4 categories: less than 30 days, 31-90 days, 91-180 days, and over 181 days. The dependent variable was ARF, and the control variables were age, gender, comorbidities in patients hospitalized for ARF, stay in ICUs during ARF hospitalization and site of operation for prior admissions within one month of ARF hospitalization. RESULTS: Of 20,790 patients who were admitted to hospitals for ARF in 2006, 12,314 (59.23 %) were male and more than 60 % were older than 65 years. Of patients with and without ARF, 16.14 % and 10.61 %, respectively, received polypharmacy for 91-180 days and 50.22 % and 24.12 %, respectively, for over 181 days. A statistical model indicated that, relative to patients who received polypharmacy for less than 30 days, those who received polypharmacy for 31-90, 91-180 and over 181 days had odds ratios of developing ARF of 1.33 (p<0.001), 1.65 (p<0.001) and 1.74 (p<0.001), respectively. CONCLUSIONS: We observed statistically significant associations between the duration of polypharmacy and the occurrence of ARF.

Belimumab combined with standard therapy does not increase adverse effects compared with a control treatment: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: The increasing administration of belimumab has demonstrated its biological benefits. Prior meta-analyses have examined the overall adverse events (AEs) associated with belimumab, but such knowledge needs to be updated with a high volume of new trials. However, little is known about the occurrence of AEs associated with different underlying diseases. This study aimed to address the safety of the intravenous (IV) administration of belimumab combined with standard of care (SoC) therapy in Systemic lupus erythematosus (SLE) patients. METHODS: We used PubMed, Embase, and the Cochrane Library to systematically search for randomised controlled trials (RCTs) reporting AEs and specific AEs in SLE patients receiving belimumab and SoC therapy before 30 November 2021. We extracted the data of the eligible studies and calculated pooled risk ratios (RRs) and their 95% confidence intervals (CIs) in SLE patients receiving belimumab and SoC therapy and experiencing various AEs. The main outcomes were as follows: (1) any AEs, any serious AEs (SAEs), and any severe AEs; (2) serious organ specific adverse events; (3) adverse events of special interest (AESIs). RESULTS: Of the 1,621 studies identified, nine RCTs involving 7,974 patients were eligible for the meta-analysis. There were no significant differences between the experimental and control groups in terms of the incident of AEs: AEs (RR = 0.99, 95% CI: 0.97-1.02, P = 0.68), SAEs (RR = 0.91, 95% CI: 0.81-1.02, P = 0.09), and severe AEs (RR = 0.92, 95% CI: 0.75-1.14, P = 0.46). The pooled data also showed that there was no significant correlation between five types of SAEs grouped by organ class and the IV belimumab (10 mg/kg) intervention, except for 'infections and infestations' (RR = 0.82, 95% CI: 0.70-0.97, P = 0.02) and 'musculoskeletal and connective tissue disorders' (RR = 0.46, 95% CI: 0.32-0.67, P < 0.0001). In addition, we found no significant association between AESIs and the IV administration of belimumab (10 mg/kg) (all malignancies: RR = 1.53, 95% CI: 0.69-3.36, P = 0.3; all post-infusion systemic reactions: RR = 1.05, 95% CI: 0.85-1.30, P = 0.63; depression: RR = 1.42, 95% CI: 0.92-2.20, P = 0.11; serious depression: RR = 2.60, 95% CI: 0.85-7.93, P = 0.09; suicide or self-injury: RR = 0.97, 95% CI: 0.48-1.96, P = 0.92; serious suicide or self-injury: RR = 1.26, 95% CI: 0.59-2.70, P = 0.56). CONCLUSIONS: According to the results of the meta-analysis, SLE patients did not have significantly increased risk of experiencing any type of AEs when receiving SoC therapy. Special caution should be exercised during close follow-ups and individual clinical management before drug prescription.

Comparison of the Characteristics, Management, and Outcomes of STEMI Patients Presenting With vs. Those of Patients Presenting Without COVID-19 Infection: A Systematic Review and Meta-Analysis.

Objectives: This study aimed to investigate the differences in the characteristics, management, and clinical outcomes of patients with and that of those without coronavirus disease 2019 (COVID-19) infection who had ST-segment elevation myocardial infarction (STEMI). Methods: Databases including Web of Science, PubMed, Cochrane Library, and Embase were searched up to July 2021. Observational studies that reported on the characteristics, management, or clinical outcomes and those published as full-text articles were included. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of all included studies. Results: A total of 27,742 patients from 13 studies were included in this meta-analysis. Significant delay in symptom onset to first medical contact (SO-to-FMC) time (mean difference = 23.42 min; 95% CI: 5.85-40.99 min; p = 0.009) and door-to-balloon (D2B) time (mean difference = 12.27 min; 95% CI: 5.77-18.78 min; p = 0.0002) was observed in COVID-19 patients. Compared to COVID-19 negative patients, those who are positive patients had significantly higher levels of C-reactive protein, D-dimer, and thrombus grade (p < 0.05) and showed more frequent use of thrombus aspiration and glycoprotein IIbIIIa (Gp2b3a) inhibitor (p < 0.05). COVID-19 positive patients also had higher rates of in-hospital mortality (OR = 5.98, 95% CI: 4.78-7.48, p < 0.0001), cardiogenic shock (OR = 2.75, 95% CI: 2.02-3.76, p < 0.0001), and stent thrombosis (OR = 5.65, 95% CI: 2.41-13.23, p < 0.0001). They were also more likely to be admitted to the intensive care unit (ICU) (OR = 4.26, 95% CI: 2.51-7.22, p < 0.0001) and had a longer length of stay (mean difference = 4.63 days; 95% CI: 2.56-6.69 days; p < 0.0001). Conclusions: This study revealed that COVID-19 infection had an impact on the time of initial medical intervention for patients with STEMI after symptom onset and showed that COVID-19 patients with STEMI were more likely to have thrombosis and had poorer outcomes.