Association of Pregnancy With Coronavirus Cytokine Storm: Systematic Review and Meta-analysis

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1. Version published to 10.2196/31579

   Oct 4, 2022
2. 

   ScreenIT

   Jul 1, 2021

   SciScore for 10.1101/2021.06.11.21258747: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Ethics

   not detected.

   Sex as a biological variable

   ,” OR “severe”. 2.2. Inclusion and Exclusion Criteria: Inclusion criteria were as follows: (i) studies that examined COVID-19 women within reproductive age and diagnosed COVID-19 according to WHO criteria; (ii) observational, cross-sectional, prospective, or retrospective studies; (iii) studies that compared pregnant women versus non-pregnant women with severe COVID-19 characterized by cytokine storm; (iv) studies evaluating the clinical prognosis in pregnancy and the immunological profile at any gestation stage and looking at the pro-inflammatory response, covid-19 disease and the hallmark outcome, the severe cytokine storm Exclusion criteria were …

   SciScore for 10.1101/2021.06.11.21258747: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Ethics	not detected.
   Sex as a biological variable	,” OR “severe”. 2.2. Inclusion and Exclusion Criteria: Inclusion criteria were as follows: (i) studies that examined COVID-19 women within reproductive age and diagnosed COVID-19 according to WHO criteria; (ii) observational, cross-sectional, prospective, or retrospective studies; (iii) studies that compared pregnant women versus non-pregnant women with severe COVID-19 characterized by cytokine storm; (iv) studies evaluating the clinical prognosis in pregnancy and the immunological profile at any gestation stage and looking at the pro-inflammatory response, covid-19 disease and the hallmark outcome, the severe cytokine storm Exclusion criteria were as follows: (i) unrelated, duplicated, and contain information answering our research question, (ii) non-English-language studies, (iii) case reports/series, (iv) reviews, (v) editorial letters, (vi) studies lacking a full-text (unavailable or not yet published), (vii) studies without a DOI, and (viii) studies with small sample sizes (<50 patients) because of low statistical power. 2.3. Data Extraction: Extraction of both adjusted and non-adjusted data was be performed to give the most allowed confounding factor which would be used in the analysis by pooling them later.
   Randomization	not detected.
   Blinding	not detected.
   Power Analysis	,” OR “severe”. 2.2. Inclusion and Exclusion Criteria: Inclusion criteria were as follows: (i) studies that examined COVID-19 women within reproductive age and diagnosed COVID-19 according to WHO criteria; (ii) observational, cross-sectional, prospective, or retrospective studies; (iii) studies that compared pregnant women versus non-pregnant women with severe COVID-19 characterized by cytokine storm; (iv) studies evaluating the clinical prognosis in pregnancy and the immunological profile at any gestation stage and looking at the pro-inflammatory response, covid-19 disease and the hallmark outcome, the severe cytokine storm Exclusion criteria were as follows: (i) unrelated, duplicated, and contain information answering our research question, (ii) non-English-language studies, (iii) case reports/series, (iv) reviews, (v) editorial letters, (vi) studies lacking a full-text (unavailable or not yet published), (vii) studies without a DOI, and (viii) studies with small sample sizes (<50 patients) because of low statistical power. 2.3. Data Extraction: Extraction of both adjusted and non-adjusted data was be performed to give the most allowed confounding factor which would be used in the analysis by pooling them later.

   Table 2: Resources

   Software and Algorithms
   Sentences	Resources
   Study Search Strategy: We searched by a simple search in Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify observational studies suitable for inclusion here with search terms; severe Covid-19 and pregnancy and moving on to other keywords, that is; pregnancy, severe cytokine storm, covid-19 (corona-virus, all in English for the period beginning from March 2020 to March 2021.	Google Scholar suggested: (Google Scholar, RRID:SCR_008878) PubMed suggested: (PubMed, RRID:SCR_004846) Embase suggested: (EMBASE, RRID:SCR_001650)
   Statistical Analyses: RevMan 5.4.1	RevMan suggested: (RevMan, RRID:SCR_003581)
   Heterogeneity was evaluated with Cochran’s Q and the Higgins test.	Cochran’s suggested: None
   Publication bias was evaluated using the Cochrane Risk of Bias tool.	Cochrane Risk of Bias suggested: None

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   Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

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   Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

   Given these limitations, caution should be exercised while interpreting the current findings for more valid clinical practice. Future studies may respond to these issues by defining disease severity more clearly and by obtaining more detailed information on the associated inflammatory cytokines defining the COVID-19 cytokine storm. Factors responsible for recurrent pregnancy loss are multiple and altered cytokine profile results in loss of pregnancy especially in the early stages of gestation. Similarly, exposure to high maternal pro-inflammatory cytokine concentrations in early pregnancy might play a part in several futuristic adverse effects on either the woman or the infant outcomes. With future studies, there is a need of the hour that women expecting a pregnancy must be screened to assess the cytokine profile even before conception to avoid loss of pregnancy and to improve the health and social well-being of the females as this may be aggravated in COVID-19 severity. Finally, the interactions between the inherent inflammatory cytokines and cytokine storm due to COVID 19 should also be examined and clarified. In addition, clinicians can pay more attention to the history of pregnancy-related altered immune responses of COVID-19 patients, and more further research may aim to determine mechanisms that drive or decrease this risk of the severity by a ‘within’ the pregnant population study approach.

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   Results from TrialIdentifier: No clinical trial numbers were referenced.

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   Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

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   Results from JetFighter: We did not find any issues relating to colormaps.

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   Results from rtransparent:

   • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
   • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
   • No protocol registration statement was detected.

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   Results from scite Reference Check: We found no unreliable references.

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3. 

   Version published to 10.1101/2021.06.11.21258747v1 on medRxiv

   Jun 18, 2021