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    Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU: A Systematic Review and Meta-analysis.

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    Author
    Tan, E; Song, J; Deane, AM; Plummer, MP
    Date
    2020-10-15
    Source Title
    Chest
    Publisher
    Elsevier BV
    University of Melbourne Author/s
    Deane, Adam
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Tan, E., Song, J., Deane, A. M. & Plummer, M. P. (2020). Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU: A Systematic Review and Meta-analysis.. Chest, https://doi.org/10.1016/j.chest.2020.10.014.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254470
    DOI
    10.1016/j.chest.2020.10.014
    Open Access URL
    https://europepmc.org/articles/PMC7557272?pdf=render
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557272
    Abstract
    BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented burden on the delivery of intensive care services worldwide. RESEARCH QUESTION: What is the global point estimate of deaths and risk factors for patients who are admitted to ICUs with severe COVID-19? STUDY DESIGN AND METHODS: In this systematic review and meta-analysis Medline, Embase, and the Cochrane library were searched up to August 1, 2020. Pooled prevalence of participant characteristics, clinical features, and outcome data was calculated with the use of random effects models. Subgroup analyses were based on geographic distribution, study type, quality assessment, sample size, end date, and patient disposition. Studies that reported in-hospital mortality rate of adult patients (age >18 years) with confirmed COVID-19 admitted to an ICU met study eligibility criteria. Critical evaluation was performed with the Newcastle Ottawa Scale for nonrandomized studies. RESULTS: Forty-five studies with 16,561 patients from 17 countries across four continents were included. Patients with COVID-19 who were admitted to ICUs had a mean age of 62.6 years (95% CI, 60.4-64.7). Common comorbidities included hypertension (49.5%; 95% CI, 44.9-54.0) and diabetes mellitus (26.6%; 95% CI, 22.7-30.8). More than three-quarters of cases experienced the development of ARDS (76.1%; 95% CI, 65.7-85.2). Invasive mechanical ventilation was required in 67.7% (95% CI, 59.1-75.7) of case, vasopressor support in 65.9% (95% CI, 52.4-78.4) of cases, renal replacement therapy in 16.9% (95% CI, 12.1-22.2) of cases, and extracorporeal membrane oxygenation in 6.4% (95% CI, 4.1-9.1) of cases. The duration of ICU and hospital admission was 10.8 days (95% CI, 9.3-18.4) and 19.1 days (95% CI, 16.3-21.9), respectively, with in-hospital mortality rate of 28.1% (95% CI, 23.4-33.0; I2 = 96%). No significant subgroup effect was observed. INTERPRETATION: Critically ill patients with COVID-19 who are admitted to the ICU require substantial organ support and prolonged ICU and hospital level care. The pooled estimate of global death from severe COVID-19 is <1 in 3.

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