Mortality of critical care interventions in the COVID-19:A systematic review

• 作者: Joshua Davis Rebecca Leff Anuj Patel Sriram Venkatesan
• 来源期刊: 世界荟萃分析杂志
• 学科: 医学
• 关键词: CORONAVIRUS SARS-CoV-2 COVID-19 MORTALITY Systematic review Critical care
• 年，卷（期）: 2021,（1）
• 页码范围: 64-73
• 页数: 10页
• 分类号: R57

摘要

BACKGROUND The novel coronavirus severe acute respiratory syndrome coronavirus 2 is associated with a severe disease known as coronavirus disease 2019(COVID-19).A small percentage of patients with COVID-19 will require intensive care and possibly mechanical ventilation.The mortality of intensive care interventions in patients with COVID-19 remains unclear.AIM To identify mortality rate of COVID-19 patients receiving different interventions in the critical care unit.METHODS We searched OVID Medline,SCOPUS,MedRxIv,preprints.org,and Centers for Disease Control databases from November 2019 to April 10,2020 for articles on COVID-19.Teams of 2 independent reviewers reviewed titles and abstract for studies that reported mortality of human adults with COVID-19 and exposure to a critical care intervention[Intensive care admission,mechanical ventilation,acute hemodialysis,extracorporeal membrane oxygenation,or cardiopulmonary resuscitation(CPR)].We used a descriptive analysis and unweighted averages of mortality across studies.RESULTS Our search identified 6973 articles and 20 met inclusion:17 for intensive care,13 for mechanical ventilation,5 for hemodialysis,2 for extracorporeal membrane oxygenation,and 1 for CPR.Mortality associated with intensive care admission ranged from 9%-83%,with overall mortality 32.5%(95%CI:32.4%-32.6%).Mortality associated with intubation from 16.7%-100%with overall mortality 64.0%(95%CI:62.4%-65.5%).In patients requiring hemodialysis,mortality ranged from 0%-100%,with average mortality 75.3%(95%CI:72.6%-77.4%).CONCLUSION Patients with COVID-19 requiring intensive care have high mortality rates.Authorities can use this data to establish pharmacoeconomic studies to make decisions about allocation of scarce resources if necessary.