OBJECTIVES: To pool evidence on the safety and efficacy of MSCs in treating COVID-19 by observing MSC-related adverse effects as well as evaluating its effects in reducing inflammatory response and improving pulmonary function.
DATA SOURCES AND METHODS: Following literature search across six databases and one trial register, full-text retrieval, and screening against eligibility criteria, only eight studies were included for data extraction. All eight studies evaluated the use of umbilical cord-derived mesenchymal stromal/stem cell (UC-MSC), infused intravenously. Of these eight studies, six studies were included in meta-analysis on the incidence of mortality, adverse events (AEs), and serious adverse events (SAEs), and the levels of C-reactive protein (CRP) and interleukin (IL)-6. Meta-analysis on pulmonary function was not performed due to insufficient data.
RESULTS: MSC-treated group showed significantly lower risk of mortality than the control group (p = 0.03). No statistical significance was observed on the incidence of AEs (p = 0.78) and SAEs (p = 0.44), and the levels of CRP (p = 0.06) and IL-6 (p = 0.09).
CONCLUSION: MSCs were safe for use, with lower risk of mortality and no association with AEs. Regarding efficacy, descriptive analysis showed indications of improvement on the inflammatory reaction, lung clearance, and oxygenation status despite the lack of statistical significance in meta-analysis of CRP and IL-6. Nevertheless, more studies are needed for affirmation.
REGISTRATION: This systematic review and meta-analysis was registered on the PROSPERO database (no. CRD42022307730).
PATIENTS AND METHODS: Participants were clients and caregivers of a speech-language clinic at a public university. Services were primarily provided by student clinicians, who were undergoing supervised clinical training. An online survey was distributed, which consisted of three sections: Background Information, Overall Satisfaction in SLT, and Satisfaction in SLTT. All participants completed the first two sections, while the third section was completed only by those who experienced SLTT or H-SLT.
RESULTS: Most of the respondents were caregivers (89.7%), female (79.4%), of Malay ethnicity (80.9%), have received tertiary education (77.9%), within the low-income category (66.2%), held a job (76.5%), and resided in central West Malaysia (83.8%). Many participants experienced C-SLT (51%), followed by H-SLT (34%), and SLTT (15%). There were no significant differences in the overall satisfaction of the participants across three modes of services delivery (F[2,67] = 0.02, p = 0.95), and in the satisfaction with teletherapy between the H-SLT and SLTT groups (t = 0.90, p = 0.38). Income was the only sociodemographic factor that was correlated with the satisfaction level in teletherapy (r = 0.37, p = 0.04).
PURPOSE: To develop and validate a risk assessment tool for the therapeutic outcomes of ASM therapy.
PATIENTS AND METHODS: A cross-sectional study was carried out in a hospital-based specialist clinic from September 2022 to August 2023. Data was analyzed from patients' medical records and face-to-face assessments. The seizure control domain was determined from the patients' medical records while seizure severity (SS) and adverse effects (AE) of ASM were assessed using the Seizure Severity Questionnaire and the Liverpool Adverse Event Profile respectively. The developed tool was devised from prediction models using logistic and linear regressions. Concurrent validity and interrater reliability methods were employed for validity assessments.
RESULTS: A total of 397 patients were included in the analysis. For seizure control, the identified predictors include ≥10 years' epilepsy duration (OR:1.87,95% CI:1.10-3.17), generalized onset (OR:7.42,95% CI:2.95-18.66), focal onset seizure (OR:8.24,95% CI:2.98-22.77), non-adherence (OR:3.55,95% CI:1.52-8.27) and having ≥3 ASM (OR:3.29,95% CI:1.32-8.24). Younger age at epilepsy onset (≤40) (OR:3.29,95% CI:1.32-8.24) and neurological deficit (OR:3.55,95% CI:1.52-8.27) were significant predictors for SS. For AE, the positive predictors were age >35 (OR:0.12,95% CI:0.03-0.20), <13 years epilepsy duration (OR:2.89,95% CI:0.50-5.29) and changes in ASM regimen (OR:2.93,95% CI: 0.24-5.62). The seizure control domain showed a good discriminatory ability with a c-index of 0.711. From the Bonferroni (ANOVA) analysis, only SS predicted scores generated a linear plot against the mean of the actual scores. The AE domain was omitted from the final tool because it did not meet the requirements for validity assessment.
CONCLUSION: This newly developed tool (RAS-TO) is a promising tool that could help healthcare providers in determining optimal treatment strategies for adults with epilepsy.