Mortality in mechanically ventilated patients with COVID-19: a systematic review

Vafea, Maria Tsikala; Zhang, Raina; Kalligeros, Markos; Mylona, Evangelia K.; Shehadeh, Fadi

doi:10.1080/17434440.2021.1915764

Cited by 10 publications

(4 citation statements)

References 127 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mortality was observed to be higher in mechanically ventilated COVID-19 patients than in non-COVID-19 patients (75.80% versus 52.64%). A comparable result was observed in another study, with mechanically ventilated COVID-19 patients dying at a rate of 97% [ 42 ]. This could be attributed to the acute respiratory distress syndrome and sepsis caused by COVID-19 infection [ 43 , 44 ].…”

Section: Discussionsupporting

confidence: 87%

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Ayenew,

Gedfew,

Fetene

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background In the intensive care unit (ICU), mechanical ventilation (MV) is a typical way of respiratory support. The severity of the illness raises the likelihood of death in patients who require MV. Several studies have been done in Ethiopia; however, the mortality rate differs among them. The objective of this systematic review and meta-analysis is to provide a pooled prevalence of mortality and associated factors among ICU-admitted patients receiving MV in Ethiopian hospitals. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria to conduct a comprehensive systematic review and meta-analysis in this study. We searched PubMed/Medline, SCOPUS, Embase, Hinari, and Web of Science and found 22 articles that met our inclusion criteria. We used a random-effects model. To identify heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger’s regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses. Results In this systematic review and meta-analysis, the pooled prevalence of mortality among 7507 ICU-admitted patients from 22 articles, who received MV was estimated to be 54.74% [95% CI = 47.93, 61.55]. In the subgroup analysis by region, the Southern Nations, Nationalities, and Peoples (SNNP) subgroup (64.28%, 95% CI = 51.19, 77.37) had the highest prevalence. Patients with COVID-19 have the highest mortality rate (75.80%, 95% CI = 51.10, 100.00). Sepsis (OR = 6.85, 95%CI = 3.24, 14.46), Glasgow Coma Scale (GCS) score<8 (OR = 6.58, 95%CI = 1.96, 22.11), admission with medical cases (OR = 4.12, 95%CI = 2.00, 8.48), Multi Organ Dysfunction Syndrome (MODS) (OR = 2.70, 95%CI = 4.11, 12.62), and vasopressor treatment (OR = 19.06, 95%CI = 9.34, 38.88) were all statistically associated with mortality. Conclusion Our review found that the pooled prevalence of mortality among mechanically ventilated ICU-admitted patients in Ethiopia was considerably high compared to similar studies in the United States (US), China, and other countries. Sepsis, GCS<8, medical cases, MODS, and use of vasopressors were statistically associated with mortality. Clinicians should exercise caution while mechanically ventilating ICU-admitted patients with these factors. However, it should be noted that the exact cause and effect relationship could not be established with this meta-analysis, as the available evidence is not sufficient. Thus, more studies using prospective methods will be required.

show abstract

Section: Discussionsupporting

confidence: 87%

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Ayenew,

Gedfew,

Fetene

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Initiation of IMV is one of the most important ICU mortality risk in our study with mortality of 83.8% for mechanically ventilated patients, multivariate OR of survival of 11.80 (7.40-19.21, p<0.001) and HR of 0.12 (0.04-0.39, p<0.001) for patients that weren't mechanically ventilated compared to those who were. These numbers are among the higher ones reported 30 , 31 , 32 , 33 when general numbers are analyzed, but it must be stated that patients included in this study are among the oldest ones reported so far 12 , 23 , 26 , 27 , 28 , 34 , 35 , 36 . When patients were divided into age sub-groups, mortality rates for ventilated patients per age sub-group (53.3% under 45 years of age, 70.5% 45-65 years of age, 87.6%, 65 to 75 years of age, 90.4% over 75 years of age) are in general agreement with data reported from other studies.…”

Section: Discussionmentioning

confidence: 66%

Clinical and laboratory predictors at ICU admission affecting course of illness and mortality rates in a tertiary COVID-19 center

et al. 2022

View full text Add to dashboard Cite

Background: Survival rates of critically ill COVID-19 patients are affected by various clinical features and laboratory parameters at ICU admission. Some of these predictors are universal but others may be population specific.Objective: To determine utility of baseline clinical and laboratory parameters in a multivariate regression model to predict outcomes in critically ill COVID-19 patients in a tertiary hospital in Croatia. Methods: 692 critically ill COVID-19 patients treated during a 10-month period were included in this retrospective observational trial to assess the risk factors determining mortality rates. Various anthropometric features, comorbidities, laboratory parameters, clinical features and therapeutic interventions were included in the analysis. ICU mortality rates and length of ICU stay were primary endpoints analyzed in this study. Results: After multivariate adjustment, only the SOFA score, PaO 2 /FiO 2 and history of arterial hypertension had an effect on ICU mortality, as well as the need to initiate invasive mechanical ventilation. Increase in PaO 2 /FiO 2 over the first 7 days was present in survivors, while reverse applied to SOFA. Length of ICU stay was 9 (4À14) days. Factors affecting survival times were admission from wards, congestive heart failure, invasive mechanical ventilation, bacterial superinfections, age > 75 years, SOFA score, and serum ferritin, CRP and IL-6 values at ICU admission. Conclusion: Elevated inflammatory biomarkers and SOFA score at ICU admission were detected as significant predictors of ICU mortality in this cohort, while initiation of invasive mechanical ventilation is the most relevant interventional mortality risk factor in critically ill COVID-19 patients.

show abstract

“…[25,26] Other reported predictors of mortality are the need for IMV, days on mechanical ventilation, and hospital LOS. [27,28] Multiple studies have shown that mortality in ARDS patients is approximately 40%. [29][30][31][32] Similarly, in our study, older age, shock, the need for IMV, AKI, the need for hemodialysis, and COPD as a comorbid condition predicted mortality.…”

Section: Discussionmentioning

confidence: 99%

Comparison of patients admitted to an inner-city intensive care unit across 3 COVID-19 waves

Venkatram¹,

Dileep²,

Fortuzi

et al. 2023

Medicine

View full text Add to dashboard Cite

To expand our limited knowledge of COVID-19-related outcomes in patients admitted to inner-city intensive care unit (ICU across multiple infection waves. This retrospective study compared patients admitted to the ICU in Bronx, NY, during 3 COVID-19 waves (March 2020 to February 2022). Outcomes included in hospital mortality, length of stay (LOS), use of mechanical ventilation, and discharge disposition. The study included 716 patients (343, 276, and 97 in the first, second, and third COVID-19 waves, respectively). The number of days on mechanical ventilation and LOS were lower in the first wave. Of the 345 discharged patients, 37% went home directly, whereas 11% were discharged to a skill nursing facility. More patients went home during the second and third waves. Mortality decreased from the first to the third waves (57%–37%; P < .001). Predictors of mortality included age, male gender, COPD, shock, acute kidney injury (AKI), dialysis requirement, and mechanical ventilation. The decreased mortality and better discharge disposition of these inner-city patients during the second and third waves is encouraging, as this population historically had a high COVID-19-related mortality risk.

show abstract

Mortality in mechanically ventilated patients with COVID-19: a systematic review

Cited by 10 publications

References 127 publications

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Clinical and laboratory predictors at ICU admission affecting course of illness and mortality rates in a tertiary COVID-19 center

Comparison of patients admitted to an inner-city intensive care unit across 3 COVID-19 waves

Contact Info

Product

Resources

About