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Prevalence and clinical outcomes of pleural effusion in COVID-19 patients: A systematic review and meta-analysis.

ABSTRACT: Observational studies indicate that pleural effusion has an association with risk and the clinical prognosis of COVID-19 disease; however, the available literature on this area is inconsistent. The objective of this systematic review and meta-analysis is to evaluate the correlation between COVID-19 disease and pleural effusion. A rigorous literature search was conducted using multiple databases. All eligible observational studies were included from around the globe. The pooled prevalence and associated 95% confidence interval (CI) were calculated using the random effect model. Mantel-Haenszel odds ratios were produced to report overall effect size using random effect models for severity and mortality outcomes. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to appraise publication bias. Data from 23 studies including 6234 COVID-19 patients was obtained. The overall prevalence of pleural effusion in COVID-19 patients was 9.55% (95% CI, I² = 92%). Our findings also indicated that the presence of pleural effusions associated with increased risk of severity of disease(OR = 5.08, 95% CI 3.14-8.22, I² = 77.4%) and mortality due to illness(OR = 4.53, 95% CI 2.16-9.49, I² = 66%) compared with patients without pleural effusion. Sensitivity analyses illustrated a similar effect size while decreasing the heterogeneity. No significant publication bias was evident in the meta-analysis. The presence of pleural effusion can assist as a prognostic factor to evaluate the risk of worse outcomes in COVID-19 patients hence, it is recommended that hospitalized COVID-19 patients with pleural effusion should be managed on an early basis.

SUBMITTER: Rathore SS

PROVIDER: S-EPMC8662249 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionThe novel coronavirus pandemic is an ongoing challenge faced by the public and health care systems around the globe. Majority of information and evidence gathered so far regarding COVID-19 has been derived from data and studies in adult populations. Crucial information regarding the characterization, clinical symptomatology, sequelae, and overall outcomes in the pediatric population is lacking. As such, we aimed to conduct a comprehensive meta-analysis and systematic review to collect and analyze current evidence about COVID-19 in the pediatric population.MethodA systematic search and review of scientific literatures was conducted following the PRISMA guidelines using PubMed, Embase, Scopus, Medline, and Google Scholar databases. All relevant studies until June 16, 2020 were included. Studies were reviewed for methodological quality, and random-effects model was used to conduct the primary meta-analysis. I2 value and Egger's test was used to estimate heterogeneity and publication bias respectively.ResultsWe reviewed 20 eligible studies that included 1810 pediatric patient population (<21 yo) with PCR tested COVID-19 positivity. In pooled data, majority (25 % [CI 18-32], I2 59 %) of overall COVID-19 positive patients fell in the 6-10 yr age group. 13 % ([CI 11-14], I2 78 %) of the patients were asymptomatic, with headache (67 % [CI 60-74], I2 46 %), fever (55 % [CI 52-58], I2 61 %), and cough (45 % [CI 42-49], I2 79 %) accounting for the most prevalent physical signs seen in symptomatic patients. Leukopenia (12 % [CI 9-15], I250 %) and lymphopenia (15 % [CI 13-19], I2 85 %) was common. Elevated Ferritin (26 % [CI 16-40], I2 73 %), Procal (25 % [CI 21-29 %], I2 83 %), and CRP (19 % [CI 16-22 %], I2 74 %) were other laboratory abnormalities commonly observed. Common radiological features were ground-glass opacities (36 % [CI 32-39 %], I2 92 %), normal finding (33 % [CI 30-36 %], I2 81 %), and consolidation. 29 % ([CI 26-33], I2 85 %) of the patient cases was non-severe, whereas only 5 % ([CI 1-8], I2 87 %) was severe. Mortality was observed in 0.3 % ([CI 0.1-0.4], I2 0%) of the overall cases.ConclusionCOVID-19 is prevalent across all pediatric age-groups and presents with varying degree of symptomology. However, children have a milder course of the disease with extremely favorable prognosis. Laboratory and radiological features are inconsistent and require further investigations. Additional studies are needed on this topic to corroborate findings and establish evidence-based and consistent characterization of COVID-19 in the pediatric population.

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Prevalence and clinical outcomes of pleural effusion in COVID-19 patients: A systematic review and meta-analysis.

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