Rate of Intensive Care Unit admission and outcomes among patients with coronavirus: A systematic review and Meta-analysis

Semagn Mekonnen Abate, Siraj Ahmed Ali, Bahiru Mantfardo, Bivash Basu, Semagn Mekonnen Abate, Siraj Ahmed Ali, Bahiru Mantfardo, Bivash Basu

Abstract

Background: The rate of ICU admission among patients with coronavirus varied from 3% to 100% and the mortality was as high as 86% of admitted patients. The objective of the systematic review was to investigate the rate of ICU admission, mortality, morbidity, and complications among patients with coronavirus.

Methods: A comprehensive strategy was conducted in PubMed/Medline; Science direct and LILACS from December 2002 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting rate of ICU admission, the prevalence of mortality and its determinants among ICU admitted patients with coronavirus were included and the rest were excluded.

Result: A total of 646 articles were identified from different databases and 50 articles were selected for evaluation. Thirty-seven Articles with 24983 participants were included. The rate of ICU admission was 32% (95% CI: 26 to 38, 37 studies and 32, 741 participants). The Meta-Analysis revealed that the pooled prevalence of mortality in patients with coronavirus disease in ICU was 39% (95% CI: 34 to 43, 37 studies and 24, 983 participants).

Conclusion: The Meta-Analysis revealed that approximately one-third of patients admitted to ICU with severe Coronavirus disease and more than thirty percent of patients admitted to ICU with a severe form of COVID-19 for better care died which warns the health care stakeholders to give attention to intensive care patients.

Registration: This Systematic review and Meta-Analysis was registered in Prospero international prospective register of systemic reviews (CRD42020177095) on April 9/2020.

Conflict of interest statement

The authors declare that there are no competing interests.

Figures

Fig 1. Prisma flow chart.
Fig 1. Prisma flow chart.
Fig 2. Forest plot for the prevalence…
Fig 2. Forest plot for the prevalence of ICU admission patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 3. Forest plot for subgroup analysis…
Fig 3. Forest plot for subgroup analysis prevalence of ICU admission patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 4. Forest plot for the prevalence…
Fig 4. Forest plot for the prevalence of ICU mortality among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 5. Forest plot for subgroup analysis…
Fig 5. Forest plot for subgroup analysis of the prevalence of ICU mortality among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 6. Forest plot for the prevalence…
Fig 6. Forest plot for the prevalence of ICU Comorbidity among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 7. Forest plot for subgroup analysis…
Fig 7. Forest plot for subgroup analysis of the prevalence of ICU Comorbidity among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 8. Forest plot for of prevalence…
Fig 8. Forest plot for of prevalence of ICU Complication among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
ICU: Intensive Care Unit.
Fig 9. Funnel plot to assess publication…
Fig 9. Funnel plot to assess publication bias.
The vertical line indicates the effect size whereas the diagonal line indicates the precision of individual studies with a 95% confidence interval.

References

    1. Kanwar A, Selvaraju S, Esper F. Human coronavirus-HKU1 infection among adults in Cleveland, Ohio Open forum infectious diseases: Oxford University Press, 2017.
    1. Lau SK, Chan JF. Coronaviruses: emerging and re-emerging pathogens in humans and animals. BioMed Central, 2015.
    1. Wang L-F, Shi Z, Zhang S, et al. Review of bats and SARS. Emerging infectious diseases. 2006; 12: 1834 10.3201/eid1212.060401
    1. Weiss SR, Navas-Martin S. Coronavirus pathogenesis, and the emerging pathogen severe acute respiratory syndrome coronavirus. Microbiol Mol Biol Rev. 2005; 69: 635–64. 10.1128/MMBR.69.4.635-664.2005
    1. Wu D, Wu T, Liu Q, et al. The SARS-CoV-2 outbreak: what we know. International Journal of Infectious Diseases. 2020.
    1. Young BE, Ong SWX, Kalimuddin S, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. Jama. 2020; 323: 1488–94.
    1. Adhikari SP, Meng S, Wu Y-J, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious diseases of poverty. 2020; 9: 1–12.
    1. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. The Lancet. 2020.
    1. Jain V, Yuan J-M. Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection. medRxiv. 2020.
    1. Novel CPERE. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. 2020; 41: 145.
    1. World Health Organization: Coronavirus disease 2019 (COVID-19) Situation Report –72.
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395: 507–13.
    1. Chan J, Ng C, Chan Y, et al. Short term outcome and risk factors for adverse clinical outcomes in adults with the severe acute respiratory syndrome (SARS). Thorax. 2003; 58: 686–89. 10.1136/thorax.58.8.686
    1. Chen C-Y, Lee C-H, Liu C-Y, et al. Clinical features and outcomes of the severe acute respiratory syndrome and predictive factors for acute respiratory distress syndrome. Journal of the Chinese Medical Association. 2005; 68: 4–10. 10.1016/S1726-4901(09)70124-8
    1. Choi KW, Chau TN, Tsang O, et al. Outcomes and prognostic factors in 267 patients with the severe acute respiratory syndrome in Hong Kong. Annals of internal medicine. 2003; 139: 715–23. 10.7326/0003-4819-139-9-200311040-00005
    1. Joynt GM, Yap H. SARS in the intensive care unit. Current infectious disease reports. 2004; 6: 228 10.1007/s11908-004-0013-6
    1. Al-Dorzi HM, Aldawood AS, Khan R, et al. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study. Annals of intensive care. 2016; 6: 101 10.1186/s13613-016-0203-z
    1. Al-Hameed F, Wahla AS, Siddiqui S, et al. Characteristics and outcomes of Middle East respiratory syndrome coronavirus patients admitted to an intensive care unit in Jeddah, Saudi Arabia. Journal of intensive care medicine. 2016; 31: 344–48. 10.1177/0885066615579858
    1. Arabi YM, Arifi AA, Balkhy HH, et al. Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Annals of internal medicine. 2014; 160: 389–97. 10.7326/M13-2486
    1. Assiri A, McGeer A, Perl TM, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. New England Journal of Medicine. 2013; 369: 407–16. 10.1056/NEJMoa1306742
    1. World Health Organization: Coronavirus disease 2019 (COVID-19) Situation Report –52.
    1. World Health Organization: Coronavirus disease 2019 (COVID-19) Situation Report –141.
    1. Al-Dorzi HM, Aldawood AS, Khan R, et al. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study. Ann Intensive Care. 2016; 6: 101 10.1186/s13613-016-0203-z
    1. Al-Dorzi HM, Alsolamy S, Arabi YM. Critically ill patients with Middle East respiratory syndrome coronavirus infection. Critical Care. 2016; 20: 65 10.1186/s13054-016-1234-4
    1. Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. Jama. 2020.
    1. Halim AA, Alsayed B, Embarak S, et al. Clinical characteristics and outcome of ICU admitted MERS corona, virus-infected patients. Egyptian Journal of Chest Diseases and Tuberculosis. 2016; 65: 81–87. 10.1016/j.ejcdt.2015.11.011
    1. Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020; 55: 105924.
    1. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020.
    1. Assiri A, McGeer A, Perl TM, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med. 2013; 369: 407–16. 10.1056/NEJMoa1306742
    1. Liu R, Ming X, Zhu H, et al. Association of Cardiovascular Manifestations with In-hospital Outcomes in Patients with COVID-19: A Hospital Staff Data. medRxiv. 2020.
    1. Liu W, Tao Z-W, Lei W, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chinese medical journal. 2020.
    1. Rasmussen SA, Smulian JC, Lednicky JA, et al. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American journal of obstetrics and gynecology. 2020.
    1. Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. International Journal of Infectious Diseases. 2014; 29: 301–06. 10.1016/j.ijid.2014.09.003
    1. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020.
    1. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. International Journal of Infectious Diseases. 2020.
    1. Arabi YM, Murthy S, Webb S. COVID-19: a novel coronavirus and a novel challenge for critical care. Intensive care medicine. 2020: 1–4.
    1. Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. Jama. 2020; 323: 1612–14.
    1. Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: a retrospective study. BMJ. 2020; 368.
    1. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al. Clinical, laboratory, and imaging features of COVID-19: A systematic review and meta-analysis. Travel medicine and infectious disease. 2020: 101623.
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS med. 2009; 6: e1000097 10.1371/journal.pmed.1000097
    1. Liu W, Tao Z-W, Wang L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chinese medical journal. 2020.
    1. Xu X-W, Wu X-X, Jiang X-G, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020; 368.
    1. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in critically ill patients in the Seattle region—case series. New England Journal of Medicine. 2020; 382: 2012–22. 10.1056/NEJMoa2004500
    1. COVID C, Team R. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69: 343–46. 10.15585/mmwr.mm6912e2
    1. Cao J, Hu X, Cheng W, et al. Clinical features and short-term outcomes of 18 patients with coronavirus disease 2019 in the intensive care unit. Intensive care medicine. 2020: 1–3.
    1. Chen J, Qi T, Liu L, et al. Clinical progression of patients with COVID-19 in Shanghai, China. Journal of Infection. 2020.
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020; 395: 497–506.
    1. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. MedRxiv. 2020.
    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. Jama. 2020.
    1. Simonnet A, Chetboun M, Poissy J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation. Obesity. 2020.
    1. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020; 323: 1061–69.
    1. Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA internal medicine. 2020.
    1. Guan W-j, Liang W-h, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. European Respiratory Journal. 2020; 55.
    1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020.
    1. Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis research. 2020.
    1. Klok FA, Kruip M, Van Der Meer N, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thrombosis Research. 2020.
    1. Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. clinical medicine. 2020: 100331.
    1. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: a prospective observational cohort study. BMJ. 2020; 369.
    1. Du R-H, Liu L-M, Yin W, et al. Hospitalization and critical care of 109 decedents with COVID-19 pneumonia in Wuhan, China. Annals of the American Thoracic Society. 2020.
    1. Ling L, So C, Shum HP, et al. Critically ill patients with COVID-19 in Hong Kong: a multicentre retrospective observational cohort study. Crit Care Resusc. 2020; 6.
    1. Zangrillo A, Beretta L, Scandroglio AM, et al. Characteristics, treatment, outcomes, and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy. Crit Care Resusc. 2020.
    1. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. Jama. 2020; 323: 1574–81.
    1. Lew TW, Kwek T-K, Tai D, et al. Acute respiratory distress syndrome in critically ill patients with the severe acute respiratory syndrome. Jama. 2003; 290: 374–80. 10.1001/jama.290.3.374
    1. Almekhlafi GA, Albarrak MM, Mandurah Y, et al. Presentation and outcome of the Middle East respiratory syndrome in Saudi intensive care unit patients. Critical Care. 2016; 20: 123 10.1186/s13054-016-1303-8
    1. Garbati MA, Fagbo SF, Fang VJ, et al. A comparative study of clinical presentation and risk factors for adverse outcomes in patients hospitalized with acute respiratory disease due to MERS coronavirus or other causes. PloS one. 2016; 11.
    1. Al Ghamdi M, Alghamdi KM, Ghandoora Y, et al. Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC infectious diseases. 2016; 16: 174 10.1186/s12879-016-1492-4
    1. Aleanizy FS, Mohmed N, Alqahtani FY, et al. Outbreak of Middle East respiratory syndrome coronavirus in Saudi Arabia: a retrospective study. BMC infectious diseases. 2017; 17: 23 10.1186/s12879-016-2137-3
    1. Aya AG, Vialles N, Tanoubi I, et al. Spinal anesthesia-induced hypotension: a risk comparison between patients with severe preeclampsia and healthy women undergoing preterm cesarean delivery. Anesthesia & Analgesia. 2005; 101: 869–75.

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