ABSTRACT
BACKGROUND: The coronavirus disease 2019 has quickly spread worldwide since it first appeared in Wuhan, China, in late 2019. The most affected country in Africa was South Africa. This study aimed to identify the risk factors for death in hospitalized COVID-19 patients in Africa. METHODS: We conducted a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We searched articles from the following database: PubMed, Embase, Cochrane Library, Medline, and COVID-19 Research Database. We used Google Scholar for gray literature. The language used in this article was English. The last search was conducted on January 15, 2023. Pooled HRs, or ORs, and 95% confidence intervals, were calculated separately to identify the risk factors for death in hospitalized COVID-19 patients. Heterogeneity was assessed by Cochran's Q statistic and the I2 test. The Egger test was used to assess publication bias. Subgroup analysis was performed to determine the source of heterogeneity. Data analysis was performed using Stata version 17. A P valueâ <â .05 was considered significant. RESULTS: A total of 16,600 articles were obtained from the database search; finally, 16 articles met the inclusion criteria and were eligible for data extraction. The analysis revealed that the pooled prevalence of mortality in hospitalized COVID-19 patients was 13.9%. Advanced age was a significant risk factor for death in hospitalized COVID-19 patients, with the pooled coronavirus mortality HR and OR being 3.73 (95% CI: 2.27-5.19) and 1.04 (95% CI: 1.02-1.06), respectively. In addition, male gender (pOR 1.23; 95% CI: 1.07-1.40), patients with diabetes mellitus (DM) (pOR 1.26; 95% CI: 1.01-1.51), hypertension (HTN) (pOR 1.56; 95% CI: 1.27-1.85), chronic kidney disease (CKD) (pHR 5.43; 95% CI: 0.18-10.67), severe or critical conditions (pOR 9.04; 95% CI: 3.14-14.94) had a significantly increased risk of coronavirus-related mortality. The main limitations of the present study stem from the predominant use of published studies, which could introduce publication bias. CONCLUSION: According to this study, advanced age, male gender, hypertension, diabetes mellitus, chronic kidney disease, and severe or critical condition were clinical risk factors associated with death outcomes in hospitalized COVID-19 patients in Africa.
Subject(s)
COVID-19 , Hypertension , Humans , Male , Risk Factors , South Africa , ChinaABSTRACT
BACKGROUND: One of the most challenging health problems is liver disease, which can be caused by medications, toxic substances, and excessive consumption of alcohol. Liver problems can be also caused by infections, autoimmune disorders, and food. This study aims to establish evidence of the use of Moringa oleifera in sub-Saharan African countries to manage liver damage conditions in animals. METHODS: In vivo studies will include those in which the activity of the serum levels of hepatic enzymes alanine transaminase (ALT) or serum glutamate-pyruvate transaminase (SGPT), aspartate transaminase (AST) or serum glutamic oxaloacetic transaminase (SGOT), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), and malondialdehyde (MDA) were measured after administering substances that induced liver injury as a primary outcome. The secondary outcome will include studies that measure the serum levels of hepatic enzymes (ALT, AST, GGT and ALP, SOD, CAT, and GR), free radical formation represented by MDA after administering the sub-Saharan Moringa oleifera, and decreases in their levels indicating the improvement of their activity. Search engines will include MEDLINE, CINAHL, PubMed, Google Scholar, SABINET, EBSCO, and WHO/African Index Medicus. The screened results will be grouped according to any noteworthy grouping variable, such as study characteristics. Data will be analyzed using Stata statistical software (Stata Corp V.14, TX, USA). Study data will be quantitatively synthesized by first assessing heterogeneity to examine whether the estimates from included studies could be pooled. Heterogeneity will be assessed by the chi-squared test on Cochran's Q statistic, which will be quantified by I 2 values. DISCUSSION: Results from this protocol will give new insights into the Moringa oleifera plant for developing effective hepatoprotective drugs against liver damage. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018084698 .