Assessment of COVID-19-related meta-analysis reporting quality.

BACKGROUND: Meta-analysis of high-quality primary articles represents the top-quality evidence in medical literature. In this project, our aim was to assess the number and quality of COVID-related meta-analysis published since the beginning of the COVID-19 pandemic. METHODS: The search included the period from January 1, 2020, when the beginning of primary articles on COVID-19, till October 31, 2020. We screened a total of 793 studies. We excluded non-meta-analytic non-COVID-19-related studies. We obtained different characteristics, and we determined the quality of reporting using the AMSTAR tool, an 11-items tool that assesses the content validity and methodological quality of systematic reviews and meta-analysis. RESULTS: A total of 538 studies were included in our assessment. The first meta-analysis included was published in March, while the last one was on the 31st of October. Upon comparing the mean AMSTAR score for meta-analysis published during each month, we found a significant difference (p < 0.001, F = 4.139), where the mean score almost steadily increased since March. CONCLUSION: The urge to publish during the COVID-19 period or any other surge in publishing should not be at the expense of quality.

Effect of Hydrocortisone on Intradialytic Hypotension: A Preliminary Investigational Study.

INTRODUCTION: Approximately 15 to 33% of all dialysis treatments are complicated by intradialytic hypotension (IDH). In this study, we tested the hypothesis that the intravenous administration of hydrocortisone prior to HD treatment could prevent IDH or at least decrease the drop in the blood pressure resulting from IDH. METHODS: This study was approved by our local ethics committee/IRB (2017/87) and by the Jordan Food and Drug Administration (7/clinical/18). Additionally, it is registered on ClinicalTrials.gov (NCT03465007). In this preliminary investigational study, we screened all chronic hemodialysis patients at our clinic who were 18 years of age or older (n = 82) for IDH. There were 14 patients included in the interventional part of this study; patients were given IV hydrocortisone for 3 consecutive HD sessions, followed or preceded by 3 intervention-free sessions where they were given 5 ml of saline as a placebo. RESULTS: The initial total sample size was 82 patients. The frequency of IDH at our clinic was 24.4%. Fourteen out of the 20 patients who were diagnosed with IDH agreed to enroll in the interventional part of our study. The mean age of the patients in the interventional part of our study was 53.5 years (±10.3). These patients included 5 (35.7%) men and 9 (64.3%) women. Upon comparing the number of hypotensive attacks with and without the hydrocortisone administration, we found a significant difference (p = 0.003) between the hydrocortisone and placebo treatments in which 12 (85.7%) patients had fewer IDH episodes with the hydrocortisone treatment than with placebo. CONCLUSION: This preliminary investigational study found that the administration of a stress dose of hydrocortisone prior to hemodialysis could be an effective measure for preventing or minimizing the risk of IDH episodes. Additional prospective studies on this subject are needed. Ruling out adrenal insufficiency in patients diagnosed with IDH is also crucial.