A bibliometric analysis of polycystic ovary syndrome research in Southeast Asia: Insights and implications

Background and aimsThere has been an increased understanding in the pathophysiology and management of polycystic ovary syndrome (PCOS) in recent years. This study aimed to evaluate the trends and characteristics of PCOS publications in Southeast Asia (SEA) through a bibliometric analysis.MethodsSystematic review of literature on PCOS in SEA countries between 1975 and 2020 was performed using the Scopus database. All published studies on PCOS conducted in or published by authors from any of the countries in SEA were included in this analysis. Bibliographic information was obtained, and visualization of collaboration networks of countries and keywords was conducted using VOSviewer software.ResultsA total of 260 articles were included in this analysis. The number of PCOS publications in SEA continued to increase through the years. The country with the highest number of publications was Thailand while Singapore produced the most publications with the greatest impact. The focus of research in SEA was on PCOS prevalence, risk factors, infertility, and metabolic complications. A country's fertility rate, research and development expenditures (%GDP), number of researchers per million people, and international research collaborations significantly correlated with PCOS research impact in SEA.ConclusionThis is the first bibliometric analysis in PCOS research in SEA. Despite the continuing increase in PCOS publications in SEA, it still lags compared to other regions. Countries in SEA should consider policies and strategies directed at increasing research support and encouraging international collaborations for local researchers to produce more meaningful publications and augment PCOS knowledge in the region.     

Dyslipidemia research landscape and socioeconomic facilitators of scientific productivity in Southeast Asia

BackgroundThe growing prevalence of lipid disorder in Southeast Asia (SEA) resulted in an increase in clinical and epidemiological studies on dyslipidemia in the region. Thus, there is a need to summarize the existing evidence from the literature.AimsThis paper determined the research landscape of dyslipidemia in SEA. This study also identified the socioeconomic facilitators of scientific productivity in dyslipidemia research in SEA.MethodsA database search of dyslipidemia literature in SEA countries was performed using the Scopus database. Bibliographic information was obtained, and network visualization of collaboration among countries and keywords was created using VOSviewer software.ResultsThis bibliometric analysis showed a continuous increase in published articles in SEA, most of which were from universities and hospitals in Thailand, Singapore, Malaysia, and Indonesia. The usual topics of dyslipidemia research in SEA include epidemiology, pathophysiology, comorbidities and complications, and treatment options for dyslipidemia. Research & development expenditure (total citations: p = 0.037; h-index: p = 0.031) and researchers in R&D (total citations: p = 0.005; h-index: p = 0.017) were positively correlated with citations and h-index for dyslipidemia publications from SEA countries. Moreover, the number of research collaborations within SEA and worldwide was positively correlated with the total publications, citations, and h-index of SEA countries for their dyslipidemia research outputs.ConclusionIn summary, this bibliometrics study showed an increasing trend of dyslipidemia research in SEA countries. Policymakers and administrators should invest more in dyslipidemia studies to propose better strategies in curbing the prevalence of this condition in SEA.     

Indian Publications on SARS-CoV-2: A bibliometric study of WHO COVID-19 database

Background & aimsNowadays, the whole World is under threat of Coronavirus disease (COVID-19). The ongoing COVID-19 pandemic has resulted in many fatalities and forced scientific communities to foster their Research and Development (R&D) activities. As a result, there is an enormous growth of scholarly literature on the subject. We here in this study have assessed the Indian publications contributions on COVID-19.MethodsWHO is curating global scientific literature on coronavirus since it declared COVID-19 a global pandemic through Global Research Database on COVID-19. The present study analyzed Indian publications on SARS-CoV-2 as found in WHO COVID-19 database. The research data was restricted for the period of March 2, 2020 to May 12, 2020.ResultsThe study found that there is a considerable and constant growth of Indian publications on COVID-19 from mid-April. It is interesting to note that, the most prolific authors belong to either AIIMS or ICMR institutes. Delhi state contributed highest number of publications on COVID-19. The AIIMS, New Delhi was the most productive institution in terms of publications. The Indian Journal of Medical Research has emerged as the productive journal contributing highest number of the publications. In terms of research area, the majority of the publications were related to Epidemiology.ConclusionsThe highly cited publications were of evidenced based studies. It is observed that the studies pertaining to virology, diagnosis and treatment, clinical features etc. have received highest citations than general studies on epidemiology or pandemic.     

Bibliometric overview of Ramadan fasting studies during 2010–2021

Background and aimsTo quantify the bibliometric parameters of Ramadan fasting literature from 2010 to 2021.Materials and methodsScopus was searched for all articles related to Ramadan fasting or Islamic fasting from the beginning of 2010 to the end of 2021. Only original articles and reviews were included and their bibliometric and scientometric parameters were determined using Excel, Graph Pad Prism, VOSviewer, and Sci2 tool software.ResultsFinally 1276 articles, including 1109 original articles and 167 reviews, were included. These articles had 14263 citations and an H-index of 48. Based on the number of publications, top institute, top journal, top country, and top authors were University of Sfax (n = 48 articles), Diabetes Research and Clinical Practice (n = 69), the United States (n = 144), and Chtourou H & Hassanein M (n = 38), respectively. Also, Diabetes Research and Clinical Practice had a strong bibliographic coupling with other journals. The recent bursting words were adrenal insufficiency and COVID-19. The most co-occurred topics were the effect of Ramadan fasting on diabetic patients, pregnant women, and glycemic state and body composition of diabetic patients.ConclusionThis study provided a comprehensive bibliometric overview of Ramadan fasting literature from 2010 to 2021. The temporal change in the number of publications and other analyses on the literature of 2019, 2020 and 2021 showed that substantial increasing publications with new emerging subjects had become of interest to many researchers during the last three years.     

Seven decades of Ramadan intermittent fasting research: Bibliometrics analysis,global trends,and future directions

Background and aimsThere is a large body of research focused on various aspects related to Ramadan intermittent fasting (RIF) and human health and disease. This study aimed to quantify the bibliometric data of RIF medical research over the past seven decades and explore these variables qualitatively via text mining analysis.MethodsWe used the Scopus search engine to identify published articles related to RIF from inception to December 31, 2021. All types of research articles were included. Scientometric and bibliometric measures were determined using Excel, Biblioshiny, and VOSviewer. This study proposed a bibliometric and text mining method to qualitatively and quantitatively recognize the RIF research trend.ResultsThe Scopus search returned 1915 relevant articles. Most citations pertained to publications from the last two decades, and most publications were original research articles. These publications had received around 27,000 citations, and the 20 most prolific publishing journals had an average h-index of 112.25. More than one-third of all medical publications were in open-access journals. There was a 13-fold increase in medical research on RIF over the past few decades. We identified the 10 most prolific publishing countries, institutes, journals, and authors. We also identified five scientific hotspots of RIF scientific literature, which were: diabetes, metabolic health, public health, physiology, and maternity.ConclusionThis is the first comprehensive bibliometric analysis of medical research related to RIF. The research gaps identified will shape future research directions and foster collaborative research activities toward enhanced medical nutrition research revolving around RIF.     

Global analysis of the COVID-19 research landscape and scientific impact

ObjectivesTo consider a 1-year time window of the coronavirus disease 2019 (COVID-19) crisis to integrate qualitative and quantitative data and provide an in-depth analysis of all COVID-19 publications from geographical, epidemiological and chronological perspectives.MethodsPublications on COVID-19 from December 1, 2019, to December 31, 2020 without document type limitations were extracted from the Web of Science database. Microsoft Excel 2016, GraphPad Prism 9, VOSviewer 1.6.15 and IBM SPSS 21.0 were used to analyze the global epidemiological publication landscape and its correlations, research hotspots around the world and the top 5 countries in terms of publications.ResultsA total of 51,317 documents were analyzed in the present study. The publication trend could be divided into an increasing output stage and an explosive output stage. There were positive correlations between monthly publications, confirmed cases and deaths. Research hotspots from the whole year, from individual quarters, and from the top 5 countries with the most publications were further identified.ConclusionsThe correlation analysis of publications indicated that confirmed cases and deaths were forces driving the scientific output, reflecting the growing trend to some extent. Moreover, the hotspot analysis provided valuable information for scientists, funders, policy and decision-makers to determine what areas should be their focus when faced with public health emergencies in the future.     

COVID-19 and ethnicity: A novel pathophysiological role for inflammation

IntroductionThere have been recent mounting concerns regarding multiple reports stating a significantly elevated relative-risk of COVID-19 mortality amongst the Black and Minority Ethnic (BAME) population. An urgent national enquiry investigating the possible reasons for this phenomenon has been issued in the UK. Inflammation is at the forefront of COVID-19 research as disease severity appears to correlate with pro-inflammatory cytokine dysregulation. This narrative review aims to shed light on the novel, pathophysiological role of inflammation in contributing towards the increased COVID-19 mortality risk amongst the BAME population.MethodsSearches in PubMed, Medline, Scopus, medRxiv and Google Scholar were performed to identify articles published in English from inception to 18^th June 2020. These databases were searched using keywords including: ‘COVID-19’ or ‘Black and Minority Ethnic’ or ‘Inflammation’. A narrative review was synthesized using these included articles.ResultsWe suggest a novel pathophysiological mechanism by which acute inflammation from COVID-19 may augment existing chronic inflammation, in order to potentiate a ‘cytokine storm’ and thus the more severe disease phenotype observed in the BAME population. Obesity, insulin resistance, cardiovascular disease, psychological stress, chronic infections and genetic predispositions are all relevant factors which may be contributing to elevated chronic systemic inflammation amongst the BAME population.ConclusionOverall, this review provides early insights and directions for ongoing research regarding the pathophysiological mechanisms that may explain the severe COVID-19 disease phenotype observed amongst the BAME population. We suggest ‘personalization’ of chronic disease management, which can be used with other interventions, in order to tackle this.     

Clinical considerations in patients with diabetes during times of COVID19: An update on lifestyle factors and antihyperglycemic drugs with focus on India

BackgroundDiabetes is recognized as an important comorbidity in patients with COVID-19 and a large amount of literature has become available regarding this. The aim of this article is to review the literature regarding various aspects of association between diabetes and COVID-19 and to highlight clinically relevant points with focus on India.MethodsWe searched Pubmed and Google Scholar databases for articles regarding diabetes and COVID-19 published between March 19, 2020 and August 30, 2020.ResultsDiabetes and poor glycemic control are associated with increased severity and mortality in patients with COVID-19. Several clinical scenarios about hyperglycemia and COVID-19 are identified and each of these needs specific management strategies.ConclusionIt is prudent to maintain good glycemic control in patients with diabetes in order to minimize the complications of COVID-19. There is a need for well conducted studies to asses the role of individual antihyperglycemic therapies in COVID-19 and also the behavior of new onset diabetes diagnosed either after COVID-19 infection or during this time.     

Impact of COVID-19 and comorbidities on health and economics: Focus on developing countries and India

Background and aimsPresence of comorbidities in patients with Coronavirus disease 2019 (COVID-19) have often been associated with increased in-hospital complications and mortality. Intriguingly, several developed countries with a higher quality of life have relatively higher mortality with COVID-19, compared to the middle- or low-income countries. Moreover, certain ethnic groups have shown a higher predilection to contract COVID-19, with heightened mortality. We sought to review the available literature with regards to impact of COVID-19 and comorbidities on the health and economics, especially in context to the developing countries including India.MethodsA Boolean search was carried out in PubMed, MedRxiv and Google Scholar databases up till August 23, 2020 using the specific keywords, to find the prevalence of comorbidities and its outcome in patients with COVID-19.ResultsAll available evidence consistently suggests that presence of comorbidities is associated with a poor outcome in patients with COVID-19. Diabetes prevalence is highest in Indian COVID-19 patients, compared to other countries. Majority of the patients with COVID-19 are asymptomatic ranging from 26 to 76%.ConclusionsUniversal masking is the need of hour during unlock period. Low-income countries such as India, Brazil and Africa with less resources and an average socio-economic background, must adopt a strict policy for an affordable testing programs to trace, test, identify and home quarantine of asymptomatic cases. Despite the huge number of COVID-19 patients, India still has low volume research at the moment.     

Effects of COVID-19 in South African health system and society: An explanatory study

Background and aimsThe underestimation of the severity of COVID-19 by the South African government resulted in delayed action against the pandemic. Ever since WHO declared COVID-19 a pandemic preventive action was comprehensively upgraded worldwide. This prompted South African authorities to implement physical distancing, self-isolation, closure of non-essential services, schools, travelling restrictions and recursive national lockdowns to mitigate the impact of COVID-19. This explanatory study sought to review the effects of COVID-19 in the South African health system and society.MethodsThe study applied literature research of COVID-19 reports, policies from the National Department of Health, WHO, Africa CDC, and articles from Google Scholar, Science Direct, Web of Science, Scopus and PubMed.ResultsThe South African health system is affected by the lack of PPEs, increased mortality rates, mental health problems, substance abuse, resurgent of NCDs. The closure of international borders, global demand meltdown, supply disruptions, dramatic scaling down of human and industrial activities during lockdown cause socio-economic problems. The prolonged effects of lockdown on psychosocial support services resulted in the outbursts of uncertainties, acute panic, fear, depression, obsessive behaviours, social unrests, stigmatization, anxiety, increased gender-based violence cases and discrimination in the distribution of relief food aid.ConclusionTo slow down the spread of COVID-19, massive testing must be adopted, contact tracing, isolation, and home quarantine guidelines for asymptomatic cases which promote behavioural change and reviewing of policy on food relief.     

Perfil bibliométrico y redes de colaboración en investigación científica sobre lupus eritematoso sistémico en Latinoamérica, 1982-2018

ObjectiveTo analyse the scientific production and collaboration networks on publications in systemic lupus erythematosus in Latin America.Materials and methodsBibliometric study between 1982 and 2018 of journals indexed in Scopus. Data were analysed by annual production and a co-occurrence analysis of the collaboration between countries with VOSviewer was plotted.Results3,843 related documents on systemic lupus erythematosus were recorded between 1982 and 2018 in Scopus. An increasing trend was observed, with a significant increase in the last 20 years, the original articles being the highest percentage (75.4%). Eleven Latin American countries were identified in collaboration with 29 extra-regional countries, with Brazil, Mexico and Argentina having the highest production and scientific collaboration, mainly with the United States and Spain.ConclusionIn Latin America, there is a sustained increase in research on systemic lupus erythematosus. Brazil and Mexico generated more than half the publications and are the main collaboration network together with Argentina.     

COVID-19 and diabetes: Analysis of the scientific production indexed in Scopus

Background and aimCOVID-19 has affected the world population, with a higher impact among at-risk groups, such as diabetic patients. This has led to an exponential increase in the number of studies related to the subject, although their bibliometric characteristics are unknown. This article aims to characterize the world scientific production on COVID-19 and diabetes indexed in Scopus.MethodsArticles on the subject were retrieved using a search strategy and bibliometric indicators of production, visibility, collaboration and impact were studied.ResultsThe total scientific production was 1956 documents, which have 35086 citations and an h-index of 67. Articles published in Diabetes and Metabolic Syndrome: Clinical Research and Reviews (n = 127), as well as those by researchers from the United States (n = 498) predominated. Articles by Chinese authors (n = 314) had the highest impact according to the received citations (n = 21757). India, China and Spain are leading countries in terms of the research in which they participate. There is extensive international scientific collaboration led by China, the United States and Italy.ConclusionThe volume of publications on COVID-19 and diabetes and their scientific impact show the incentive that the study of these diseases represents for the scientific community worldwide.     

Top 50 cited articles on Covid-19 after the first year of the pandemic: A bibliometric analysis

Background & aimsIt has been just over a year since the Covid-19 pandemic started. The top 50 cited articles on this subject would help identify trends and focus on the research efforts.MethodsWe utilised e-utilities in PubMed to find publications on Covid-19 until the date of search on 7/2/21. The iCite website was used to find the top 50 citations of the output from the search strategy. We looked into their full text for the editorial dates, type of study, level of evidence, focus of the article and country of origin. We also counted the errata and comments on each of them.ResultsThe total number of citations of all 50 articles was 123,960, the highest being 10, 754 for a single article. Huang C was the most cited first author. They were published from week 4–17, with February being the month with most citations. Lancet was the most cited journal, having published 9 of the 50 articles. Majority belonged to level 3 of the evidence ladder and were retrospective studies. Thirty percent of them had an errata published and an average of 7 comments per article.ConclusionThe top 50 most cited articles identify the most impactful studies on Covid-19, providing a resource to educators while identifying trends to guide research and publishing efforts. There has been an explosion of publications and an unprecedented rate and number of citations within the first year for any single condition in the literature.     

Application of Artificial intelligence in COVID-19-related geriatric care: A scoping review

BackgroundOlder adults have been disproportionately affected by the COVID-19 pandemic. This scoping review aimed to summarize the current evidence of artificial intelligence (AI) use in the screening/monitoring, diagnosis, and/or treatment of COVID-19 among older adults.MethodThe review followed the Joanna Briggs Institute and Arksey and O'Malley frameworks. An information specialist performed a comprehensive search from the date of inception until May 2021, in six bibliographic databases. The selected studies considered all populations, and all AI interventions that had been used in COVID-19-related geriatric care. We focused on patient, healthcare provider, and healthcare system-related outcomes. The studies were restricted to peer-reviewed English publications. Two authors independently screened the titles and abstracts of the identified records, read the selected full texts, and extracted data from the included studies using a validated data extraction form. Disagreements were resolved by consensus, and if this was not possible, the opinion of a third reviewer was sought.ResultsSix databases were searched , yielding 3,228 articles, of which 10 were included. The majority of articles used a single AI model to assess the association between patients' comorbidities and COVID-19 outcomes. Articles were mainly conducted in high-income countries, with limited representation of females in study participants, and insufficient reporting of participants' race and ethnicity.DiscussionThis review highlighted how the COVID-19 pandemic has accelerated the application of AI to protect older populations, with most interventions in the pilot testing stage. Further work is required to measure effectiveness of these technologies in a larger scale, use more representative datasets for training of AI models, and expand AI applications to low-income countries.     

Twenty-year span of global acute pancreatitis trends: A bibliometric analysis

ObjectiveThis study aims to investigate the global research routine and trends of acute pancreatitis over the last twenty years based on the production, hotspots, and frontiers of published articles as well as to provide the global health system with a bibliometric reference.MethodsThe Web of Science core collection database was retrieved for acute pancreatitis original articles and review articles published from January 1, 1999 to May 17, 2020. Duplicates and discrete papers were excluded. Articles were evaluated for several characteristics including number of citations, publication time, country of origin, institution, journal and authorship.ResultsA total of 7001 articles originated from 94 countries and were published in 1263 journals. The China contributed most articles (1752) followed by USA (1214). The research was major published in specialized journals including the Pancreas (511) and pancreatology (351). Universities were the main institutions of science progress. High-impact articles focused on the fields of clinical medicine. A steady growth was observed in the last 20 years from 1999 to 2020.ConclusionThis comprehensive bibliometric study indicates that severe acute pancreatitis and necrotizing pancreatitis are significant topic in the acute pancreatitis research. The structured information may be helpful in understanding research trends, and locating research hot spots and gaps in this domain.     

Diabetes management and specific considerations for patients with diabetes during coronavirus diseases pandemic: A scoping review

Background and aimsThe global pandemic of coronavirus (COVID-19) affects almost all countries in the world, which potentially alter diabetes management. Many diabetes patients are experiencing barrier of care due to the policy related to COVID-19. This article aims to review the current evidence on diabetes management and specific considerations during the COVID-19 pandemic for people living with diabetes.MethodsWe conducted a scoping review in PubMed, Science Direct, DOAJ and Microsoft Academics databases from January 1 to April 17, 2020. Searching terms included “COVID-19”, “severe acute respiratory syndrome coronavirus 2”, and “Diabetes Mellitus” were used. Only scientific articles discussing diabetes management and specific considerations were selected and extracted.ResultsA total of 7 articles was selected in the analysis. Most were published in diabetes journals (85.71%). All articles (100%) discussed diabetes management and 71.43% of them provided diabetes care in specific considerations. We discussed issue of diabetes management in glycemic control and monitoring, dietary intake, physical activity, medication, education and prevention of COVID-19 infection that applicable for diabetes patients. In addition, specific considerations explored caring for diabetes in children and adolescents, pregnancy, elderly, emergency or critical care, to offer certain concern for raising the awareness.ConclusionsThis review specifies a summary of diabetes management as well as the particular considerations to care people living with diabetes during COVID-19 pandemic. Patients, health care providers, and policy makers could take advantage of the review to assist diabetic people passing through COVID-19 pandemic session with optimum glycemic outcome.     

COVID-19 mortality,excess mortality,deaths per million and infection fatality ratio,Belgium, 9 March 2020 to 28 June 2020

BackgroundCOVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.AimWe examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.MethodsThe relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.ResultsIn the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.DiscussionDuring the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.     

Incidence of acute pulmonary embolism in COVID-19 patients: Systematic review and meta-analysis.

BackgroundAcute pulmonary embolism (PE) has been described as a frequent and prognostically relevant complication of COVID-19 infection.AimWe performed a systematic review and meta-analysis of the in-hospital incidence of acute PE among COVID-19 patients based on studies published within four months of COVID-19 outbreak.Material and MethodsSystematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in abstracting data and assessing validity. We searched Medline, Scopus and Web of Science to locate all articles published up to August 1, 2020 reporting the incidence of acute PE (or lung thrombosis) in COVID-19 patients. The pooled in-hospital incidence of acute PE among COVID-19 patients was calculated using a random effects model and presenting the related 95% confidence interval (CI). Statistical heterogeneity was measured using the Higgins I² statistic.ResultsWe analysed data from 7178 COVID-19 patients [mean age 60.4 years] included in twenty-three studies. Among patients hospitalized in general wards and intensive care unit (ICU), the pooled in-hospital incidence of PE (or lung thrombosis) was 14.7% of cases (95% CI: 9.9–21.3%, I²=95.0%, p<0.0001) and 23.4% (95% CI:16.7–31.8%, I2=88.7%, p<0.0001), respectively. Segmental/sub-segmental pulmonary arteries were more frequently involved compared to main/lobar arteries (6.8% vs18.8%, p<0.001). Computer tomography pulmonary angiogram (CTPA) was used only in 35.3% of patients with COVID-19 infection across six studies.ConclusionsThe in-hospital incidence of acute PE among COVID-19 patients is higher in ICU patients compared to those hospitalized in general wards. CTPA was rarely used suggesting a potential underestimation of PE cases.     

Nutritional determinants and COVID-19 outcomes of older patients with COVID-19: A systematic review

BackgroundMalnutrition among older people is one of the serious public health problem worldwide. Nutritional status and levels of nutrients of older patients with COVID-19 effect on COVID-19 outcomes. The purpose of this systematic review was to identify the prevalence of malnutrition and levels of nutrients associated with outcomes of the older patients with COVID-19.Materials and MethodsA literature search was performed using PubMed, Science direct and Google scholar database using specific keywords related to the aims. All related articles published on COVID-19 during 2020 were retrieved. PRISMA Statement was followed. The quality of the study was assessed using the quality assessment tools of the National Heart, Lung, and Blood Institute of the National Institutes of Health.ResultsOf the 2979 studies found, a total of eight studies were included in this review. Of these studies, three provided data on nutritional status and outcomes of COVID-19 among older patients with COVID-19. The prevalence of malnutrition among older patients with COVID-19 was high and it was associated with negative outcomes including hospital deaths and transfer to intensive care units. Five studies provided data on nutrients and outcomes of COVID-19. Low albumin, vitamin D, magnesium ,vitamin B12, Se status were associated with malnutrition, oxygen therapy and/or intensive care support of the patients, survival of COVID -19.ConclusionsExtra care should be provided to older patients with COVID-19 to minimize the prevalence of malnutrition and negative outcomes of COVID-19.     

Assessment of basic reproductive number for COVID-19 at global level: A meta-analysis

Background:There are large knowledge gaps regarding how transmission of 2019 novel coronavirus disease (COVID-19) occurred in different settings across the world. This study aims to summarize basic reproduction number (R₀) data and provide clues for designing prevention and control measures.Methods:Several databases and preprint platforms were retrieved for literature reporting R₀ values of COVID-19. The analysis was stratified by the prespecified modeling method to make the R₀ values comparable, and by country/region to explore whether R₀ estimates differed across the world. The average R₀ values were pooled using a random-effects model.Results:We identified 185 unique articles, yielding 43 articles for analysis. The selected studies covered 5 countries from Asia, 5 countries from Europe, 12 countries from Africa, and 1 from North America, South America, and Australia each. Exponential growth rate model was most favored by researchers. The pooled global R₀ was 4.08 (95% CI, 3.09–5.39). The R₀ estimates for new and shifting epicenters were comparable or even higher than that for the original epicenter Wuhan, China.Conclusions:The high R₀ values suggest that an extraordinary combination of control measures is needed for halting COVID-19.