Characteristics and Outcomes of COVID-19 Patients Admitted to Intensive Care Units in a Large Health System in Western Pennsylvania

Nasrullah, Adeel; Jayakrishnan, Thejus; Wedgeworth, Patrick; Mosley, Melissa; Vashistha, Kirtivardhan; Haag, Aaron; Bakalov, Veli; Chaturvedi, Abhishek; Manzi, Susan; Kapetanos, Anastasios

doi:10.7759/cureus.16552

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…All the 33 included studies were observational in their design [20–52]. The studies originated from multiple countries [20,21,23,32–35,38,42,43,45,48,51]. Nineteen studies included only patients admitted to the ICU [20,22,24,25,27,30-32,35–39,43–47,52], five studies included patients admitted to a COVID-19-dedicated HDU [28,29,33,34,42], eight studies included patients who were admitted to both HDU and ICU [21,23,26,40,41,48,49,51], and one study included Emergency Department patients who were later admitted either to the HDU of ICU [50].…”

Section: Resultsmentioning

confidence: 99%

“…The studies originated from multiple countries, with 13 of coming from institutions located in the USA [20,21,23,[32][33][34][35]38,42,43,45,48,51]. Nineteen studies included only patients admitted in the ICU [20,22,24,25,27,[30][31][32][35][36][37][38][39][43][44][45][46][47]52], five studies included patients admitted in a COVID-19-dedicated HDU [28,29,33,34,42], eight studies included patients who were admitted in both HDU and ICU [21,23,26,40,41,48,49,51], and one study included Emergency Department patients who were later admitted either in the HDU of ICU [50]. Thirty studies included data about patients who received vs. patients who did not receive vasopressors…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Twenty-one out of the 33 included studies provided data on hospital mortality in patients who received vs. patients who did not receive vasopressors, resulting in a total population of 7900 individuals [25,27,[31][32][33][34][35][36][37][39][40][41][42][43][44][45][46][47][48]50,52]. Due to high heterogeneity (I 2 : 94%, PQ<0.001), the random-effects model was implemented.…”

Section: Primary Outcomementioning

confidence: 99%

“…All the 33 included studies were observational in their design . The studies originated from multiple countries [20,21,23,[32][33][34][35]38,42,43,45,48,51].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Mermiri

Mavrovounis

Laou

et al. 2022

Preprint

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Purpose: The effect of vasopressors on mortality of critically ill patients with COVID-19 has not been studied extensively. Methods: A systematic search of PubMed, Scopus, and clinicaltrials.gov was conducted for relevant articles until January 2022. Eligibility criteria were randomized controlled and non-randomized trials. The primary outcome was all-cause mortality at 28 days or 30 days. The quality of studies was assessed using the MINORS tool. Paired meta-analysis was used to estimate the pooled risk ratios along with their 95% Confidence Interval. Results: In total, 33 studies were included. Twenty-one studies with a total population of 7900 individuals provided data on mortality. Patients who received vasopressors were statistically significantly more likely to die compared to those who did not receive vasopressor therapy [RR (95%CI): 4.26 (3.15, 5.76); p<0.001]. This result remained statistically significant regardless of the in-hospital setting. In-hospital and 30-day mortality were statistically significantly higher in patients who received vasopressors [RR (95%CI): 4.60 (2.47, 8.55); p<0.001 and RR (95%CI): 2.97 (1.72, 5.14); p<0.001, respectively]. Four studies provided data on specific vasopressors; the highest mortality rate was observed in patients treated with vasopressin or epinephrine, while patients receiving angiotensin-II as a sole or second-line vasopressor agent had the lowest mortality rate. Also, analysis of 10 studies with a total population of 3519 individuals revealed that patients who received vasopressors were statistically significantly more likely to experience acute kidney injury [RR (95%CI): 3.17 (2.21, 4.54); p<0.001]. Conclusion: Vasopressors have detrimental effect on survival of critically ill patients with COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Primary Outcomementioning

confidence: 99%

“…All the 33 included studies were observational in their design . The studies originated from multiple countries [20,21,23,[32][33][34][35]38,42,43,45,48,51].…”

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Mermiri

Mavrovounis

Laou

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“… 15 Several studies examined the factors associated with ICU admission and poor outcomes among patients hospitalized with COVID-19 overall the world. 19 , 20 Ahlstrom and colleagues 21 showed that various comorbid conditions such as hypertension, DM, CKD, asthma, and obesity were associated with ICU admission in a case-control study conducted in Sweden. Another nationwide retrospective study of 116 539 patients with COVID-19 in Poland found that age > 60 years, male sex, and the presence of at least 1 endocrine, cardiovascular, nutritional, or metabolic disorders were independent determinants of ICU admission.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Direct Medical Expenditures Associated With Intensive Care Unit Admission for Inpatients With COVID-19 in Jordan: A Retrospective Cohort Study

Altawalbeh¹,

Alshogran²,

Al‐Sawalha³

et al. 2023

Value in Health Regional Issues

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Association of vasopressors with mortality in critically ill patients with COVID-19: a systematic review and meta-analysis

Mermiri

Mavrovounis

Laou

et al. 2023

APS

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Exogenous catecholamines may have pronounced side effects and affect physiological cascades. The aim of this study was to investigate the effect of vasopressors on mortality of critically ill patients with coronavirus disease 2019 (COVID-19). A systematic search of PubMed, Scopus, and ClinicalTrials.gov was conducted for relevant articles until December 2022. Eligibility criteria were randomized controlled and non-randomized trials. The primary outcome was in-hospital and 30-day mortality. The quality of studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool, while paired meta-analysis was used to estimate the pooled risk ratios (RR) along with their 95% Confidence Interval (95% CI). Analyses of 22 studies (n = 8034) revealed that vasopressor use is associated with mortality compared to no vasopressor therapy [RR (95%CI): 4.30 (3.21, 5.75); p < 0.001]. In-hospital and 30-day mortality are significantly higher in patients who receive vasopressors [RR (95%CI): 4.60 (2.47, 8.55); p < 0.001 and RR (95%CI): 2.97 (1.72, 5.14); p < 0.001, respectively]. Also, analyses of data from 10 studies (n = 3519) revealed that vasopressor use is associated with acute kidney injury [RR (95%CI): 3.17 (2.21, 4.54); p < 0.001]. In conclusion, current use of vasopressors in critically ill patients with COVID-19 may be associated with higher in-hospital mortality, 30-day mortality, and incidence rate of acute kidney injury. Further research is required to estimate the correlation of specific vasopressor characteristics (type, timing, dose, combination) with adverse effects and mortality in this population. Graphical Abstract

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Characteristics and Outcomes of COVID-19 Patients Admitted to Intensive Care Units in a Large Health System in Western Pennsylvania

Cited by 4 publications

References 15 publications

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Clinical Outcomes and Direct Medical Expenditures Associated With Intensive Care Unit Admission for Inpatients With COVID-19 in Jordan: A Retrospective Cohort Study

Association of vasopressors with mortality in critically ill patients with COVID-19: a systematic review and meta-analysis

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