COVID-19 ICU and Mechanical Ventilation Patient Characteristics and Outcomes - A Systematic Review and Meta-analysis

Chang, Raymond; Elhusseiny, Khaled Mossad; Yeh, Yu-Chang; Sun, Wei‐Zen

doi:10.21203/rs.3.rs-66766/v1

Cited by 34 publications

(51 citation statements)

References 56 publications

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“…A meta-analysis study compiling data from several countries showed broad variability in ICU admission, IMV requirement and IMV mortality rates [31]. Brazilian COVID-19 patients ICU admission rate (39.37%) was similar a USA patients (35%).…”

Section: Discussionmentioning

confidence: 94%

On the Analysis of Mortality Risk Factors for Hospitalized COVID-19 Patients: a Data-driven Study Using the Major Brazilian Database

Souza

Hojo-Souza

Batista

et al. 2020

Preprint

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Background: Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand. Methods: This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe, 2020) regarding notified cases of hospitalized COVID-19 patients during the period from February 26 to August 10, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed. Results: The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the mortality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Heart disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with heart disease (65.7%) and diabetes (53.55%) and with a high mortality rate of around 50% was observed. The ICU admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities. Conclusion: Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.

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Section: Discussionmentioning

confidence: 94%

On the Analysis of Mortality Risk Factors for Hospitalized COVID-19 Patients: a Data-driven Study Using the Major Brazilian Database

Souza

Hojo-Souza

Batista

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…A meta-analysis study compiling data from several countries showed broad variability in ICU admission, IMV requirement and IMV lethality rates [ 34 ]. Brazilian COVID-19 patients ICU admission rate (39.37%) was similar to USA patients (35%).…”

Section: Discussionmentioning

confidence: 99%

On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database

et al. 2021

View full text Add to dashboard Cite

Background Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand. Methods This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe) regarding notified cases of hospitalized COVID-19 patients during the period from February 26th to August 10th, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed. Results The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the lethality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Cardiac disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with cardiac disease (65.7%) and diabetes (53.55%) and with a high lethality rate of around 50% was observed. The intensive care unit (ICU) admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities. Conclusion Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.

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“…The need for IMV varied widely, from 29.1% to 89.9%, among patients admitted to the ICU with COVID-AHRF. IMV is invariably associated with high mortality ranging from 16% to 78% ( 2 , 4 , 31 , 36 , 37 ). Very few studies have assessed the impact on the mortality of the mode of respiratory support in severe forms of COVID-19 pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Association Between Early Invasive Mechanical Ventilation and Day-60 Mortality in Acute Hypoxemic Respiratory Failure Related to Coronavirus Disease-2019 Pneumonia

Dupuis

Bouadma

Montmollin

et al. 2021

Critical Care Explorations

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Objectives: About 5% of patients with coronavirus disease-2019 are admitted to the ICU for acute hypoxemic respiratory failure. Opinions differ on whether invasive mechanical ventilation should be used as first-line therapy over noninvasive oxygen support. The aim of the study was to assess the effect of early invasive mechanical ventilation in coronavirus disease-2019 with acute hypoxemic respiratory failure on day-60 mortality. Design: Multicenter prospective French observational study. Setting: Eleven ICUs of the French OutcomeRea network. Patients: Coronavirus disease-2019 patients with acute hypoxemic respiratory failure (Pao 2/Fio 2 ≤ 300 mm Hg), without shock or neurologic failure on ICU admission, and not referred from another ICU or intermediate care unit were included. Intervention: We compared day-60 mortality in patients who were on invasive mechanical ventilation within the first 2 calendar days of the ICU stay (early invasive mechanical ventilation group) and those who were not (nonearly invasive mechanical ventilation group). We used a Cox proportional-hazard model weighted by inverse probability of early invasive mechanical ventilation to determine the risk of death at day 60. Measurement and Main Results: The 245 patients included had a median (interquartile range) age of 61 years (52–69 yr), a Simplified Acute Physiology Score II score of 34 mm Hg (26–44 mm Hg), and a Pao 2/Fio 2 of 121 mm Hg (90–174 mm Hg). The rates of ICU-acquired pneumonia, bacteremia, and the ICU length of stay were significantly higher in the early (n = 117 [48%]) than in the nonearly invasive mechanical ventilation group (n = 128 [52%]), p < 0.01. Day-60 mortality was 42.7% and 21.9% in the early and nonearly invasive mechanical ventilation groups, respectively. The weighted model showed that early invasive mechanical ventilation increased the risk for day-60 mortality (weighted hazard ratio =1.74; 95% CI, 1.07–2.83, p=0.03). Conclusions: In ICU patients admitted with coronavirus disease-2019-induced acute hypoxemic respiratory failure, early invasive mechanical ventilation was associated with an increased risk of day-60 mortality. This result needs to be confirmed.

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COVID-19 ICU and Mechanical Ventilation Patient Characteristics and Outcomes - A Systematic Review and Meta-analysis

Cited by 34 publications

References 56 publications

On the Analysis of Mortality Risk Factors for Hospitalized COVID-19 Patients: a Data-driven Study Using the Major Brazilian Database

On the Analysis of Mortality Risk Factors for Hospitalized COVID-19 Patients: a Data-driven Study Using the Major Brazilian Database

On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database

Association Between Early Invasive Mechanical Ventilation and Day-60 Mortality in Acute Hypoxemic Respiratory Failure Related to Coronavirus Disease-2019 Pneumonia

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