The Effectiveness of Face Masks in Preventing COVID-19 Transmission: A Systematic Review.

INTRODUCTION: Since the beginning of the COVID-19 pandemic, face masks have been among the cornerstones of COVID-19 prevention. Therefore, evaluating their preventive effects against COVID-19 is crucial. This review aimed to systematically search for the systematic review articles that explored the role of various types of face masks in preventing COVID-19. METHODS: We browsed the keywords of this study in the online databases of Scopus, Web of Science, PubMed, and Cochrane on 10th January 2023 and retrieved all the relevant systematic review articles. The records were downloaded into an Endnote file, and the duplicates were removed. A two-step screening process consisting of title/abstract and full-text screenings was conducted to select the most relevant articles. To ensure the validity and reliability of the results, this study adhered to the PRISMA protocol. RESULTS: A total of 28 systematic reviews were included in this review. Most studies found that face masks are beneficial against viral respiratory infections, such as COVID-19. Different types of masks were evaluated in included studies. It appeared that mask efficacy depends on the material, layers, fitting on the face and user compliance. N 95 respirator had maximum efficacy, especially when used continuously. CONCLUSION: Face masks have a beneficial effect against COVID-19. Home masks are less protective than surgical masks or N95 personal breathing masks. Besides, the use of masks may elicit a false sense of security in people, which may lead to poor hand hygiene and violation of social distancing. Therefore, the necessary training should be provided to the public to increase awareness and encourage the right practice of using the mask, emphasizing the preventive effects of washing hands, social distancing, and using a face mask against COVID-19.

SARS-CoV-2 Infection and Severity in Patients with Hematologic Malignancies: A Systematic Review.

INTRODUCTION: Earlier reports described the possibility of higher SARS-CoV-2 infection and severity in patients with hematological malignancies. Given the importance and incidence of these malignancies, we aimed to systematically review SARS-CoV-2 infection and severity in patients with hematologic cancers. METHODS: We retrieved the relevant records by searching the keywords in online databases of PubMed, Web of Science, Cochrane, and Scopus on December 31st , 2021. A two-step screening; title/abstract and full-text screening, was employed to select the eligible studies. These eligible studies entered the final qualitative analysis. The study is adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of the results. RESULTS: Forty studies concerning different hematologic malignancies and the effect of COVID-19 infection on them were included in the final analysis. The findings showed that in general, the prevalence of SARS-CoV-2 infection and the severity of the disease are often higher in hematologic malignancies and the patients could experience higher morbidity and mortality compared to general populations. CONCLUSION: It appeared that individuals with hematologic malignancies are more vulnerable to COVID-19 infection and they experience more severe disease with higher mortality rates. The presence of other comorbidities could also deteriorate this situation. Further Investigation is recommended to evaluate the outcome of COVID-19 infection in different subtypes of hematologic malignancies.

Late Complications of COVID-19; An Umbrella Review on Current Systematic Reviews.

Introduction: Several clinical manifestations have been discovered for COVID-19 since the emergence of SARS-CoV-2, which can be classified into early, medium, and long-term complications. However, late complications can be present after recovery from acute COVID-19 illness. The present study aims to comprehensively review the available evidence of late complications related to COVID-19. Method: A search was conducted, using keywords, through electronic databases, which included Scopus, Web of Science, PubMed, and Embase up to August 29, 2022. Study selection was performed according to a strict inclusion and exclusion criteria. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was followed, and studies were appraised using the National Institute of Health (NIH) quality assessment and risk of bias tool. Results: In total, 50 studies were included, and nine distinct COVID-19 late complication categories were identified. A review of these studies revealed that neurologic and psychiatric (n=41), respiratory (n=27), musculoskeletal and rheumatologic (n=22), cardiovascular (n=9), and hepatic and gastrointestinal (n=6) complications were the most prevalent complications of long COVID-19. Conclusion: Almost all human body systems are affected by late complications of COVID-19 with different severity and prevalence. Fatigue and some other neuropsychiatric symptoms are the most common late complications among long COVID-19 patients. Respiratory symptoms including dyspnea (during exercise), cough, and chest tightness were the next most prevalent long-term complications of COVID-19. Since these complications are persistent and late, being aware of the signs and symptoms is essential for the healthcare providers and patients.

Telemedicine technologies and applications in the era of COVID-19 pandemic: A systematic review.

INTRODUCTION: Telemedicine services saw substantial surges in their use during the COVID-19 pandemic due to the lockdowns and characteristics of the pandemic. Therefore, the authors aimed to systematically review the telemedicine services provided during the COVID-19 pandemic and their potential applications. METHODS: The authors searched PubMed, Scopus, and Cochrane databases on September 14, 2021. Then, the retrieved records underwent two-step title/abstract and full-text screening processes, and the eligible articles were included for qualitative synthesis. RESULTS: The review of studies demonstrated that the telephone is listed 38 times, making it the most common technology used in telemedicine. Video conferencing is also mentioned in 29 articles, as well as other technologies: Mobile-health (n = 15), Virtual reality (n = 7). According to the findings of the present study, Tele-follow-up (n = 24), Tele-consulting (n = 20), Virtual visits (20), and Tele-monitoring (n = 18) were the most widely used telemedicine applications. CONCLUSION: Telemedicine has been an effective approach to COVID-19 management. Telemedicine technology is going to play a key role in the future of health medicine, patient consultation, and many other extended applications of health care in remote rural locations.

Minimum infective dose of severe acute respiratory syndrome coronavirus 2 based on the current evidence: A systematic review.

Objective: Understanding the minimum infective dose is significant for risk assessment in the performance of suitable infection control strategies in healthcare centers. However, the literature lacks strong evidence regarding this value for severe acute respiratory syndrome coronavirus 2. Therefore, the aim of this study was to investigate the minimum infectious dose of coronavirus disease 2019. Methods: We searched the databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved all the relevant literature by 25 July 2021. The records were downloaded into the EndNote software and underwent title/abstract and full-text screenings. A summary of included studies was organized into tables for further analysis, interpretation, and drafting of the results. Results: Nineteen studies including the laboratory data on human and animal hosts were selected based on the eligibility criteria. All the literature reported on the infective dose, particularly in humans. The main methods for measurement of infection were through tissue culture infectious dose (TCID50) and counting plaque-forming units. The range of minimum infective was 1.26-7 × 106.25 PFU. Conclusion: In this study, we have presented a range of minimum infective doses in humans and various animal species. Such numbers can possibly vary between the individuals based on numerous demographic, immunologic, or other factors.

The Impact of COVID-19 Pandemic on the Levels of Physical Activity: A Systematic Review.

INTRODUCTION: Earlier studies demonstrated a decreased level of physical activity (PA) during the COVID-19 pandemic. Therefore, we aimed to systematically review the relevant studies among various age groups and explore the impact on physical and mental health. METHODS: We searched and retrieved all relevant articles using the keywords on the online databases of PubMed, Scopus, and Cochrane from the start of the pandemic until May 3rd, 2021. A two-phase screening process of identified records was carried out to shortlist the most relevant studies. First, the studies were evaluated based on their title/abstract, and then the full-text of included studies was thoroughly read. The eligible studies based on the eligibility criteria were included in this review. RESULTS: A total of 57 studies were included based on the eligibility criteria. Lockdowns and infection with SARS-CoV-2 have led to a decreased level of PA in the general population compared to the prepandemic era. Men had significantly less PA compared to women in some studies, probably due to higher pre-pandemic PA. The level of PA among those with chronic diseases also significantly diminished, putting them at a higher risk of cardiovascular incidents. Sedentary lifestyles have dominated people's life, including adolescents and university students. The increased levels of mental health issues, such as depression, anxiety, and occupational stress, have been suggested to contribute to the decreased PA. On the other hand, the decreased PA appeared to lead to more mental health issues. Fortunately, the decreasing trend of PA seemed to taper towards the end of the quarantines. CONCLUSION: Overall, the COVID-19 pandemic and subsequent quarantines reduced PA among all age groups and both sexes and had detrimental effects on people's physical and mental health. We suggest countries implement strategies to alleviate restrictions and encourage people to exercise in safe environments and prepare healthy routines for themselves.

The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review.

INTRODUCTION: The COVID-19 epidemic and various control and mitigation measures to combat the widespread outbreak of the disease may affect other parts of health care systems. There is a concern that the COVID-19 pandemic could disrupt HIV services. Therefore, this study aimed to systematically evaluate the effect of the COVID-19 pandemic on service delivery and treatment outcomes in people with HIV. METHODS: In this study, a systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, and Cochrane databases. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. RESULT: We selected 16 studies out of 529 retrieved records that met the inclusion criteria for this review. Study populations of the selected studies were either HIV-positive patients or HIV clinics and healthcare providers. Most studies were focused on adhering to and obtaining medication and attending clinical appointments and their decrement during the pandemic. Other aspects of HIV care (alternative healthcare settings, viral suppression, psychological care, etc.) were discussed to a lesser extent by the included studies. CONCLUSION: Interruption in in-person visits and medical follow-up services, loss of adherence to treatment, and subsequent increase in mortality due to the COVID-19 pandemic complications in PLHIV have led to growing concerns. Other challenges were psychological disorders such as anxiety and depression, an increase in substance abuse, and a rise in experienced stigma and discrimination. However, the use of telemedicine in some countries helps to alleviate the situation to some extent and is recommended in similar settings in the future.

The relationship between C-reactive protein and levels of various cytokines in patients with COVID-19: A systematic review and correlation analysis.

Introduction: C-reactive protein (CRP) and cytokines levels could alter in patients with coronavirus disease (COVID-19) due to the inflammatory response caused by the virus. This analysis aimed to assess the relationship between the CRP levels and the levels of various cytokines in COVID-19 patients. Materials and Methods: We searched the databases of PubMed, Cochrane, and Web of Science for relevant articles on May 29th, 2021. Applying the inclusion/exclusion criteria, the retrieved records underwent two-phase screenings; first, a title/abstract screening process, and then, a full-text screening to find the eligible studies. Data for study variables were extracted, including the CRP levels and the levels of all reported cytokines. A strong and significant relationship between Interleukins and CRP was defined as: p ≤ 0.05, 0.7 ≤ r ≤ 1. Results: In this study, 103 studies were included for systematic review and correlation analysis. The aggregate mean and SD of study variables were calculated and reported. The correlation between Interleukins and CRP was measured using correlation coefficient (r). It appeared that interleukin (IL)-10 has a moderate and significant relationship with CRP (p ≤ 0.05, r = 0.472). IL-10 predicted almost 10% of CRP changes. Conclusion: This correlation analysis suggests IL-10 is moderately correlated with CRP levels in patients with COVID-19 infection. A better understanding of the pro-inflammatory markers could contribute to the implementation of therapeutic and preventive approaches. More prospective studies are suggested to explore the relationship between CRP and cytokines as potential markers for the early identification of COVID-19 progression and severity.

COVID-19 mortality in patients with immunodeficiency and its predictors: a systematic review.

INTRODUCTION: Patients with immunodeficiency are usually more prone to worse outcomes of infectious diseases. However, there are some disagreements in the context of COVID-19, for example, in patients with human immunodeficiency virus (HIV). Herein, we aimed to systematically review the risk and predictors of COVID-19 mortality in people with primary or secondary immunodeficiency. METHODS: PubMed, Scopus, Web of Science, and Science Direct were searched. We followed a two-step screening process to identify eligible results. We first reviewed the title and abstract of the records and the unqualified studies were removed. Then, their full texts were evaluated based on their coherence with the purpose and inclusion/exclusion criteria, and those eligible for qualitative synthesis were included. RESULTS: Twenty-two articles were included, which investigated a total of 109,326 with primary or secondary immunodeficiencies. Three studies investigated the pediatric and infant population, while other studies were conducted on the adult population. Overall, studies on both primary and secondary immunodeficiency conflicted as some reported higher and some mentioned lower mortality rates in patients with immunodeficiency. CONCLUSIONS: Overall, there were two points of view in both types of immunodeficiencies. The first is the classical viewpoint that all immunodeficient patients are at a higher risk of infection leading to a higher mortality rate. The second types of studies found that immunodeficiency might play a less important or even an inverse role in mortality rates by lowering the severity of the inflammatory response. However, it is important to take note to comorbidities, such as DM, HTN, CAD, ESRD, history of lower respiratory infection, etc., and demographic factors, such as obesity and age > 70 years, as they appear to influence the mortality rate, especially in patients with secondary immunodeficiency.

Minimum infective dose of severe acute respiratory syndrome coronavirus 2 based on the current evidence: A systematic review

Objective: Understanding the minimum infective dose is significant for risk assessment in the performance of suitable infection control strategies in healthcare centers. However, the literature lacks strong evidence regarding this value for severe acute respiratory syndrome coronavirus 2. Therefore, the aim of this study was to investigate the minimum infectious dose of coronavirus disease 2019. Methods: We searched the databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved all the relevant literature by 25 July 2021. The records were downloaded into the EndNote software and underwent title/ and full-text screenings. A summary of included studies was organized into tables for further analysis, interpretation, and drafting of the results. Results: Nineteen studies including the laboratory data on human and animal hosts were selected based on the eligibility criteria. All the literature reported on the infective dose, particularly in humans. The main methods for measurement of infection were through tissue culture infectious dose (TCID50) and counting plaque-forming units. The range of minimum infective was 1.26–7 × 106.25 PFU. Conclusion: In this study, we have presented a range of minimum infective doses in humans and various animal species. Such numbers can possibly vary between the individuals based on numerous demographic, immunologic, or other factors.

Safety and Adverse Events Related to Inactivated COVID-19 Vaccines and Novavax;a Systematic Review.

Introduction: Knowledge of the safety of vaccines is crucial, both to prevent and cure them and to decrease the public hesitation in receiving vaccines. Therefore, this study aimed to systematically review the adverse events reported for inactivated vaccines and Novavax. Methods: In this systematic review, the databases of PubMed, Scopus, Cochrane, and Web of Science were searched on September 15, 2021. Then we identified the eligible studies using a two-step title/abstract and full-text screening process. Data on the subjects, studies, and types of adverse events were extracted and entered in a word table, including serious, mild, local, and systemic adverse events as well as the timing of side effects' appearance. Results: Adverse effects of inactivated coronavirus vaccines side effects were reported from phases 1, 2, and 3 of the vaccine trials. The most common local side effects included injection site pain and swelling, redness, and pruritus. Meanwhile, fatigue, headache, muscle pain, fever, and gastrointestinal symptoms including abdominal pain and diarrhea were among the most common systemic adverse effects. Conclusion: This systematic review indicates that inactivated COVID-19 vaccines, including Sinovac, Sinopharm, and Bharat Biotech, as well as the protein subunit vaccines (Novavax) can be considered as safe choices due to having milder side effects and fewer severe life-threatening adverse events.

COVID-19 in Pediatrics: A Systematic Review of Current Knowledge and Practice.

INTRODUCTION: SARS-CoV-2 is the novel coronavirus that causes severe acute respiratory syndrome and could afflict individuals from all walks of life. Children are usually asymptomatic or represent non-specific mild to moderate symptoms; therefore, they often remain undiagnosed and could be potential reservoirs and silent carriers of the virus. Despite the global attention to COVID-19 and its importance in public health, some clinical and paraclinical aspects of this disease in children are still unclear. Thus, we conducted a comprehensive systematic review of available literature to reflect on the current knowledge and practice of the disease among children. METHODS: This study was a systematic review of current evidence conducted in October 2020. We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of extracted literature and results. RESULTS: We selected and reviewed 23 most related studies out of 1744 identified papers in an initial online search based on the inclusion and exclusion criteria of the present review; of whom 13 were original research studies, and 10 were letters to the editors, commentaries, viewpoints, consensus statements, and perspectives. Although due to the origin of the current pandemic, China was the country with the most publications (12 articles), data from several countries have been included in this review. CONCLUSION: COVID-19 can also affect children and cause systemic disease with several internal organ involvements. However, the prevalence, severity, and diversity of the symptoms in children are less than in adults. Cough and fever appear to be some of the most common symptoms, followed by other symptoms such as gastrointestinal manifestations. Comorbidities increase the risk of severe COVID-19 in children, and those without underlying conditions are very unlikely to suffer from severe disease. Mental health issues such as anxiety and depression due to the isolated situation caused by pandemics are common findings in children of early ages and should be seriously considered in current practice.

Safety and Adverse Events Related to COVID-19 mRNA Vaccines; a Systematic Review.

Introduction: Knowledge of vaccine-related adverse events is crucial as they are among the most important factors that cause hesitation in receiving vaccines. Therefore, we aimed to systematically review the adverse events related to the mRNA vaccines reported in the literature. . Method: A systematic literature search was carried out in the databases of Scopus, PubMed, Cochrane, and Web of Science. We selected original studies that explored the side effects of mRNA COVID-19 vaccines using a two-phase (title/abstract and full-text) screening process. . Results: Cardiac complications were the most commonly reported severe adverse events. It appeared that systemic adverse reactions are more common after the second dose of vaccines. The number of adverse effects reported after the Pfizer vaccine was higher than other vaccines, mostly due to its earlier approval and more widespread use throughout the world. Cardiac adverse events had a higher prevalence but no significant association has been found between COVID-19 mRNA vaccines and cardiac adverse events except for myopericarditis. . Conclusion: Vaccines play a crucial role in controlling the COVID-19 pandemic and decreasing mortalities and the results of the present review acknowledge the fact that the benefits outweigh the adverse events of these vaccines. .

Vaccines for COVID-19: A Systematic Review of Feasibility and Effectiveness.

INTRODUCTION: Many potential vaccines for COVID-19 are being studied and developed. Several studies have reported on the safety and efficacy of these vaccines. This systematic review aimed to report on the current evidence concerning the feasibility and effectiveness of vaccines for COVID-19. METHODS: A systematic search was carried out utilizing the keywords in the online databases, including Scopus, Web of Science, PubMed, Embase, and Cochrane. We included both human and non-human studies because of the vaccine novelty, limiting our ability to include sufficient human studies. RESULTS: This review showed several SARS-CoV-2 vaccines to be currently under development using different platforms, including eight vaccines that are adenovirus-based vectors, six vaccines that are RNA-based formulations, one vaccine being DNA-based formulation, and other vaccines using other platforms, including lipid nanoparticles. Although the safety and efficacy profiles of these vaccines are still under debate, some countries have allowed for emergency use of some vaccines in at-risk populations, such as healthcare workers and the elderly. CONCLUSION: It is crucial to gather as much clinically relevant evidence as possible regarding the immunogenicity, efficacy, and safety profiles of available vaccines and adhere wisely to CDC protocols and guidelines for vaccine production.

Public acceptability of COVID-19 vaccines and its predictors in Middle Eastern/North African (MENA) countries: a systematic review .

INTRODUCTION: COVID-19 vaccines emerged as a worldwide hope to contain the pandemic. However, many people are still hesitant to receive these vaccines. We aimed to systematically review the public knowledge, perception, and acceptability of COVID-19 vaccines in the Middle East and North Africa (MENA) countries and the predictors of vaccine acceptability in this region. METHODS: We systematically searched databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved all relevant studies by 5 August 2021. RESULTS: There was a considerable variation in the COVID-19 vaccine acceptance rates, from 12% in a study from Israel to 83.3% in Kuwait, although two other studies from Israel mentioned 75% and 82.2% acceptability rates. Concerns about the side effects and safety of the vaccine were the main reasons for the lack of acceptability of taking the vaccine, which was reported in 19 studies. . CONCLUSION: Several factors, such as age, gender, education level, and comorbidities, are worthy of attention as they could expand vaccine coverage in the target population. .

Internet of things in the management of chronic diseases during the COVID-19 pandemic: A systematic review.

Introduction: The use of new technologies such as the Internet of Things (IoT) in the management of chronic diseases, especially in the COVID pandemics, could be a life-saving appliance for public health practice. The purpose of the current study is to identify the applications and capability of IoT and digital health in the management of the COVID-19 pandemic. Methods: This systematic review was conducted by searching the online databases of PubMed, Scopus, and Web of Science using selected keywords to retrieve the relevant literature published until December 25th, 2021. The most relevant original English studies were included after initial screening based on the inclusion criteria. Results: Overall, 18 studies were included. Most of the studies reported benefits and positive responses in the form of patients' and healthcare providers' satisfaction and trust in the online systems. Many services were provided to the patients, including but not limited to training the patients on their conditions; monitoring vital signs and required actions when vital signs were altered; ensuring treatment adherence; monitoring and consulting the patients regarding diet, physical activity, and lifestyle. Conclusion: IoT is a new technology, which can help us improve health care services during the COVID-19 pandemic. It has a network of various sensors, obtaining data from patients. We have found several applications for this technology. Future studies can be conducted for the capability of other technologies in the management of chronic diseases.

Prenatal and neonatal complications of COVID-19: A systematic review.

BACKGROUND AND AIMS: The outbreak of coronavirus disease 2019 (COVID-19) over the past year has affected public health worldwide. During pregnancy, the maternal immune system and inflammatory responses are widely suppressed. Pregnancy-related immune system suppression could make the mother vulnerable to infectious diseases like SARS-COV-2. However, current data suggest little to no possibility of COVID-19 transmission in pregnant women to the fetus during pregnancy or childbirth. This systematic review focused on the possible complications of COVID-19 infection in the fetus and newborn babies including the possibility and evidence of vertical transmission by reviewing articles published during the first year of the COVID-19 pandemic. METHODS: We conducted a systematic search using keywords on PubMed, Embase, and Scopus databases. The studies followed a title/abstract and a full-text screening process, and the eligible articles were included in the study. RESULTS: In total, 238 published papers were identified using a systematic search strategy (44 articles met the inclusion criteria and were included in the final review). In all studies, a total of 2375 women with signs and symptoms of COVID-19, who were in the second and third trimester of pregnancy, were assessed mild to moderate pneumonia was one of the most common symptoms. Seventy-three percent of the women did not present any comorbidity, 19% had a fever, 17% had to cough as the most frequent clinical signs and symptoms, 7.5% had pulmonary changes with chest scans, 8% had increased C reactive protein, and 9.4% had decreased lymphocytes (lymphocytopenia). A total of 2716 newborns and fetal were assessed; the delivery method of 1725 of them was reported, 913 (53%) through C-section delivery, and 812 through normal vaginal delivery (47%). Of total newborns, 13 died (five died along with the mother), and 1965 were tested for SARS-CoV-2:118 tested positive. In a study, vertical transmission in seven cases was reported in total of 145 cases assessed. CONCLUSION: It appeared that most pregnant COVID patients were mildly ill, and there is currently no convincing evidence to support the vertical transmission of COVID-19 disease. Therefore, neonates do not represent any additional risk for adverse outcomes neither during the prenatal period nor after birth.

The relationship between COVID-19 viral load and disease severity: A systematic review.

INTRODUCTION: Patients with COVID-19 may present different viral loads levels. However, the relationship between viral load and disease severity in COVID-19 is still unknown. Therefore, this study aimed to systematically review the association between SARS-CoV-2 viral load and COVID-19 severity. METHODS: The relevant studies using the keywords of "COVID-19" and "viral load" were searched in the databases of PubMed, Scopus, Google Scholar, and Web of Science. A two-step title/abstract screening process was carried out and the eligible studies were included in the study. RESULTS: Thirty-four studies were included from the initial 1015 records. The vast majority of studies have utilized real-time reverse transcription-polymerase chain reaction of the nasopharyngeal/respiratory swabs to report viral load. Viral loads were commonly reported either as cycle threshold (Ct ) or log10 RNA copies/ml. CONCLUSION: The results were inconclusive about the relationship between COVID-19 severity and viral load, as a similar number of studies either approved or opposed this hypothesis. However, the studies denote the direct relationship between older age and higher SARS-CoV-2 viral load, which is a known risk factor for COVID-19 mortality. The higher viral load in older patients may serve as a mechanism for any possible relationships between COVID-19 viral load and disease severity. There was a positive correlation between SARS-CoV-2 viral load and its transmissibility. Nonetheless, further studies are recommended to precisely characterize this matter.

The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review.

BACKGROUND: Oxygenation serves as a cornerstone in the treatment of COVID-19, and several methods have been extensively studied so far. Herein, we aimed to systematically review the studies discussing hyperbaric oxygen therapy (HBOT) to examine its reported efficacy and adverse events in patients with COVID-19. METHODS: We systematically searched and retrieved the relevant articles using keywords on the online databases, including PubMed, Scopus, Embase, Web of Science, and Cochrane databases up to April 11th, 2021. The retrieved records underwent a two-step title/abstract and full-text screening process, and the eligible papers were identified. National Institutes of health (NIH) quality assessment tool was used for this study. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021269821. RESULTS: Eight articles from three countries were included. All the included studies had good and fair quality scores, with no poor studies included in this systematic review (Good: n = 5, Fair: n = 3). Studies were divided into clinical trials and case reports/series. Most of the studies used HBOT less than 1.5-2 absolute atmospheres (ATA) for 90 min sessions and thereafter sessions were decreased to 60 min. Trials demonstrated most of the patients recovered after receiving HBOT, and blood oxygen saturation increased after several sessions of HBOT. CONCLUSION: Overall, HBOT seems to be a safe and effective oxygenation method in patients with COVID-19. However, there is limited knowledge and evidence regarding the effects and mechanism of HBOT in COVID-19 treatment, and further evaluations require extensive well-designed studies.