Mortality and morbidity in critically ill COVID-19 patients: A systematic review and meta-analysis

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-08-29 DOI:10.1016/j.jiph.2024.102533

Gebreamlak Gebremedhn Gebremeskel , Degena Bahrey Tadesse , Teklehaimanot Gereziher Haile

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Abstract

Background

The COVID-19 pandemic has caused 14.83 million deaths globally. This systematic review and meta-analysis aimed to provide a pooled estimate of the overall mortality and morbidity of critically ill COVID-19 patients.

Method

Four electronic databases, Medline/PubMed, the Cochrane Library, the WHO COVID-19 database, and the Web of Science, were used to identify relevant studies. Two authors independently screened the studies, evaluated the eligibility criteria and resolved discrepancies through discussion with the third author. The pooled effect size was computed using STATA software version 14. The Cochran Q test and I² test were utilized to assess heterogeneity across the studies. Additionally, subgroup analysis, sensitivity analysis, and publication bias were evaluated. It is registered in Prospero with Prospero ID CRD42020212146.

Results

A total of 1003 published articles were screened from various databases, and 24 studies involving a total of 142,291 critically ill COVID-19 participants were selected for inclusion in the review. Among the participants, 67 % were male, and the mean age was 63.43 + SD3.33 years. The mortality rate reported in the individual studies ranged from 4.5 % to 69.5 %. The findings from the analysis revealed that the overall pooled mortality rate was 34 % (95 % confidence interval: 31 %−37 %). Additionally, the findings showed that 62 % of critically ill COVID-19 patients required mechanical ventilation, while 68.7 % of these patients had chronic disease comorbidities.

Conclusion

Critically ill COVID-19 patients face a high-risk risk of death, with an estimate of about one in three patients dying from the virus. Notably, a substantial portion of critically ill COVID-19 patients (62 %) require mechanical ventilation; surprisingly, more than two-thirds of patients with COVID-19 have chronic disease comorbidities, highlighting the importance of managing comorbidities in this population.

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COVID-19 重症患者的死亡率和发病率：系统回顾和荟萃分析。

背景：COVID-19大流行已造成全球1 483万人死亡。本系统综述和荟萃分析旨在对 COVID-19 重症患者的总体死亡率和发病率进行综合估计：方法：使用 Medline/PubMed、Cochrane 图书馆、WHO COVID-19 数据库和 Web of Science 四个电子数据库来确定相关研究。两位作者独立筛选研究，评估资格标准，并通过与第三位作者讨论解决差异。汇总效应大小使用 STATA 软件 14 版计算。Cochran Q 检验和 I2 检验用于评估各研究之间的异质性。此外，还对亚组分析、敏感性分析和发表偏倚进行了评估。该研究已在 Prospero 注册，Prospero ID 为 CRD42020212146：从各种数据库中共筛选出 1003 篇已发表的文章，其中有 24 项研究被纳入综述，共涉及 142291 名 COVID-19 重症患者。其中男性占 67%，平均年龄为 63.43 + SD3.33 岁。各项研究报告的死亡率从 4.5% 到 69.5% 不等。分析结果显示，总死亡率为 34%（95% 置信区间：31%-37%）。此外，研究结果显示，COVID-19 重症患者中有 62% 需要机械通气，其中 68.7% 有慢性疾病合并症：结论：COVID-19 重症患者面临着很高的死亡风险，估计每三名患者中就有一人死于该病毒。值得注意的是，相当一部分 COVID-19 重症患者（62%）需要进行机械通气；令人惊讶的是，超过三分之二的 COVID-19 患者患有慢性疾病合并症，这凸显了控制这类人群合并症的重要性。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.