TY - JOUR
T1 - Intensive Care and Organ Support Related Mortality in Patients with COVID-19
T2 - A Systematic Review and Meta-Analysis
AU - Chandel, Abhimanyu
AU - Leazer, Sahar
AU - Alcover, Karl C.
AU - Farley, Josiah
AU - Berk, Joshua
AU - Jayne, Christopher
AU - McNutt, Ryan
AU - Olsen, Meredith
AU - Allard, Rhonda
AU - Yang, Jiahong
AU - Johnson, Caitlyn
AU - Tripathi, Ananya
AU - Rechtin, Maria
AU - Leon, Mathew
AU - Williams, Mathias
AU - Sheth, Phorum
AU - Messer, Kyle
AU - Chung, Kevin K.
AU - Collen, Jacob
N1 - Publisher Copyright:
© 2023. Critical Care Explorations. All rights reserved.
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
PY - 2023/3/3
Y1 - 2023/3/3
N2 - UNLABELLED: To perform a systematic review and meta-analysis to generate estimates of mortality in patients with COVID-19 that required hospitalization, ICU admission, and organ support.DATA SOURCES: A systematic search of PubMed, Embase, and the Cochrane databases was conducted up to December 31, 2021.STUDY SELECTION: Previously peer-reviewed observational studies that reported ICU, mechanical ventilation (MV), renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO)-related mortality among greater than or equal to 100 individual patients.DATA EXTRACTION: Random-effects meta-analysis was used to generate pooled estimates of case fatality rates (CFRs) for in-hospital, ICU, MV, RRT, and ECMO-related mortality. ICU-related mortality was additionally analyzed by the study country of origin. Sensitivity analyses of CFR were assessed based on completeness of follow-up data, by year, and when only studies judged to be of high quality were included.DATA SYNTHESIS: One hundred fifty-seven studies evaluating 948,309 patients were included. The CFR for in-hospital mortality, ICU mortality, MV, RRT, and ECMO were 25.9% (95% CI: 24.0-27.8%), 37.3% (95% CI: 34.6-40.1%), 51.6% (95% CI: 46.1-57.0%), 66.1% (95% CI: 59.7-72.2%), and 58.0% (95% CI: 46.9-68.9%), respectively. MV (52.7%, 95% CI: 47.5-58.0% vs 31.3%, 95% CI: 16.1-48.9%;
p = 0.023) and RRT-related mortality (66.7%, 95% CI: 60.1-73.0% vs 50.3%, 95% CI: 42.4-58.2%;
p = 0.003) decreased from 2020 to 2021.
CONCLUSIONS: We present updated estimates of CFR for patients hospitalized and requiring intensive care for the management of COVID-19. Although mortality remain high and varies considerably worldwide, we found the CFR in patients supported with MV significantly improved since 2020.
AB - UNLABELLED: To perform a systematic review and meta-analysis to generate estimates of mortality in patients with COVID-19 that required hospitalization, ICU admission, and organ support.DATA SOURCES: A systematic search of PubMed, Embase, and the Cochrane databases was conducted up to December 31, 2021.STUDY SELECTION: Previously peer-reviewed observational studies that reported ICU, mechanical ventilation (MV), renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO)-related mortality among greater than or equal to 100 individual patients.DATA EXTRACTION: Random-effects meta-analysis was used to generate pooled estimates of case fatality rates (CFRs) for in-hospital, ICU, MV, RRT, and ECMO-related mortality. ICU-related mortality was additionally analyzed by the study country of origin. Sensitivity analyses of CFR were assessed based on completeness of follow-up data, by year, and when only studies judged to be of high quality were included.DATA SYNTHESIS: One hundred fifty-seven studies evaluating 948,309 patients were included. The CFR for in-hospital mortality, ICU mortality, MV, RRT, and ECMO were 25.9% (95% CI: 24.0-27.8%), 37.3% (95% CI: 34.6-40.1%), 51.6% (95% CI: 46.1-57.0%), 66.1% (95% CI: 59.7-72.2%), and 58.0% (95% CI: 46.9-68.9%), respectively. MV (52.7%, 95% CI: 47.5-58.0% vs 31.3%, 95% CI: 16.1-48.9%;
p = 0.023) and RRT-related mortality (66.7%, 95% CI: 60.1-73.0% vs 50.3%, 95% CI: 42.4-58.2%;
p = 0.003) decreased from 2020 to 2021.
CONCLUSIONS: We present updated estimates of CFR for patients hospitalized and requiring intensive care for the management of COVID-19. Although mortality remain high and varies considerably worldwide, we found the CFR in patients supported with MV significantly improved since 2020.
KW - COVID-19
KW - mechanical ventilation
KW - pneumonia
KW - respiratory distress syndrome
KW - respiratory insufficiency
KW - viral
UR - https://www.scopus.com/pages/publications/85149501613
U2 - 10.1097/CCE.0000000000000876
DO - 10.1097/CCE.0000000000000876
M3 - Article
C2 - 36890875
AN - SCOPUS:85149501613
SN - 2639-8028
VL - 5
SP - E0876
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 3
ER -