Mortality of intubated patients with COVID-19 during first and subsequent waves: a meta-analysis involving 363,660 patients from 43 countries.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2022-10-01 Epub Date: 2022-11-17 DOI:10.1080/17476348.2022.2145950

Eleni Xourgia, Dimitrios E Katsaros, Nikoleta A Xixi, Vasiliki Tsolaki, Christina Routsi, Spyros G Zakynthinos, Anastasia Kotanidou, Ilias I Siempos

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引用次数: 2

Abstract

Background: We attempted to investigate the change in mortality of intubated patients with coronavirus disease (COVID-19) from first to subsequent waves across several countries.

Methods: We pre-registered our meta-analysis with PROSPERO [Anonymized]. We searched PubMed, Scopus, and gray literature for observational studies reporting data on all-cause mortality of intubated patients with COVID-19 recruited both during first and subsequent waves of the pandemic. We considered studies published after 31 August 2020 up to 12 July 2021. The primary outcome of the meta-analysis was all-cause mortality. We used a random effects model to calculate pooled risk ratio (RR) and 95% confidence intervals (CI).

Results: By incorporating data of 363,660 patients from 43 countries included in 28 studies, we found that all-cause mortality of intubated patients with COVID-19 increased from first to subsequent waves (from 62.2% to 72.6%; RR 0.90, 95% CI 0.85-0.94, p < 0.00001). This finding was independent of the geo-economic variation of the included studies and persisted in several pre-specified subgroup and sensitivity analyses.

Conclusions: The robust finding of this meta-analysis suggests that mortality of intubated patients with COVID-19 did not improve over time. Future research should target this group of patients to further optimize their management.

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第一波和随后的COVID-19插管患者死亡率:一项涉及43个国家363,660名患者的荟萃分析。

背景:我们试图调查几个国家的冠状病毒病(COVID-19)插管患者从第一波到随后的死亡率变化。方法:我们在PROSPERO[匿名]预先注册了meta分析。我们检索了PubMed、Scopus和灰色文献，寻找报告在大流行的第一波和随后的浪潮中招募的COVID-19插管患者全因死亡率数据的观察性研究。我们考虑了2020年8月31日至2021年7月12日期间发表的研究。荟萃分析的主要结果是全因死亡率。我们使用随机效应模型计算合并风险比(RR)和95%置信区间(CI)。结果:通过纳入28项研究中来自43个国家的363,660例患者的数据，我们发现COVID-19插管患者的全因死亡率从第一波增加到随后的波(从62.2%增加到72.6%;RR 0.90, 95% CI 0.85-0.94, p < 0.00001)。这一发现独立于纳入研究的地理经济差异，并在几个预先指定的亚组和敏感性分析中持续存在。结论:这项荟萃分析的有力发现表明，COVID-19插管患者的死亡率并没有随着时间的推移而改善。未来的研究应针对这组患者进一步优化其管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity