Neonatal outcome among pregnant women with COVID-19: a systematic review and meta-analysis.

BACKGROUND: COVID-19 has raised many concerns about the possible side effects of pregnancy. There is currently no conclusive evidence of the vertical transmission of COVID-19. Accordingly, this paper is a Systematic Review and Meta-Analysis investigated neonatal outcomes among pregnant women with COVID-19. METHODS: PubMed, Web of Science (WoS), EMBASE, ProQuest, Scopus, and Google Scholar were searched up to November 2020. The Cochran's Q-test and I2 statistic were applied to assess heterogeneity, a random-effects model was used to estimate the pooled estimate of the mean, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. RESULTS: Of 1132 studies, 23 were included in the analysis (sample size: 749 for neonates and 820 for mothers). Most of these studies (n = 13) were conducted in China. The pooled estimate for the mean of birth weight, APGAR score in min 1 and 5 was 3084.97 g (95% CI: 2993.66-3176.29), 8.76 (95% CI: 8.27-9.25), and 9.44 (95% CI: 9.18-9.70), respectively. Also, the pooled prevalence of premature birth, shortness of breath, and neonatal death was 17.80% (95% CI: 12.47-23.13), 8.43% (95% CI: 4.50-12.37), and 7.73% (95% CI: 2.00-13.47), respectively. The meta-regression results indicated that the mother's age, disease duration, and sample size had no significant effect on heterogeneity between studies (p-value all of them was >.05). Finally, 15 studies (65.22%) reported that vertical transmission did not occur. CONCLUSION: The COVID-19 infection can have adverse outcomes for the newborn. Despite the positive test of neonates, the vertical transmission of COVID-19 from the infected mother to the fetus has not yet been conclusively proven; thus, further research is needed.

Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis.

Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I2 statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO2/FIO2 Ratio in before-after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo2 (Sao2) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco2 (PMD: - 8.69; 95% CI - 14.69 to - 2.69 mmHg) but significantly increase the PaO2 (PMD: 37.74; 95% CI 7.16-68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo2 (Sao2) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19-32.61) and 30.68 (21.39-40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.