Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020

Ferguson, Jessica; Rosser, Joelle I.; Quintero, Orlando; Scott, Jake; Subramanian, Aruna; Gumma, Mohammad; Rogers, Angela J.; Kappagoda, Shanthi

doi:10.3201/eid2608.201776

Cited by 78 publications

(94 citation statements)

References 14 publications

(3 reference statements)

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“…One study reported both adult and paediatric populations: only data from adult patients were included in this analysis [11]. Two further articles were found by manual searching, resulting in 24 articles for analysis [11–34] (Table 1, Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies

2020

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Summary The emergence of coronavirus disease 2019 (COVID‐19) has led to high demand for intensive care services worldwide. However, the mortality of patients admitted to the intensive care unit (ICU) with COVID‐19 is unclear. Here, we perform a systematic review and meta‐analysis, in line with PRISMA guidelines, to assess the reported ICU mortality for patients with confirmed COVID‐19. We searched MEDLINE, EMBASE, PubMed and Cochrane databases up to 31 May 2020 for studies reporting ICU mortality for adult patients admitted with COVID‐19. The primary outcome measure was death in intensive care as a proportion of completed ICU admissions, either through discharge from the ICU or death. The definition thus did not include patients still alive on ICU. Twenty‐four observational studies including 10,150 patients were identified from centres across Asia, Europe and North America. In‐ICU mortality in reported studies ranged from 0 to 84.6%. Seven studies reported outcome data for all patients. In the remaining studies, the proportion of patients discharged from ICU at the point of reporting varied from 24.5 to 97.2%. In patients with completed ICU admissions with COVID‐19 infection, combined ICU mortality (95%CI) was 41.6% (34.0–49.7%), I2 = 93.2%). Sub‐group analysis by continent showed that mortality is broadly consistent across the globe. As the pandemic has progressed, the reported mortality rates have fallen from above 50% to close to 40%. The in‐ICU mortality from COVID‐19 is higher than usually seen in ICU admissions with other viral pneumonias. Importantly, the mortality from completed episodes of ICU differs considerably from the crude mortality rates in some early reports.

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Section: Resultsmentioning

confidence: 99%

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies

2020

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“…Those with chronic medical conditions are known to have longer symptom duration, higher rates of ICU admission, increased development of ARDS, and elevated risk of death (Bhatraju et al., 2020; Tian et al., 2020; To et al., 2020; Wang, Yang, Li, Wen, & Zhang, 2020). Specifically, those with hypertension, cardiovascular disease, cerebrovascular disease, diabetes, and malignancy are at particular risk for ICU admission and fatal outcomes with COVID‐19 (Chen, Yang, et al, 2020; Chen, Sang, et al, 2020; Chen, Yang, et al, 2020; Feng et al., 2020; Ferguson et al, 2020; He et al., 2020; Liu, Jin, et al, 2020; Shi, Zhang, et al, 2020; Stroppa et al., 2020; Wang, He, et al, 2020; Wang, Du, & Zhu, 2020; Zhang, Zhu, et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

Clinical presentation and outcomes of hospitalized adults with COVID‐19: A systematic review

Keller

Reangsing

Schneider

2020

Journal of Advanced Nursing

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Aims The aims of this review were to: (a) determine the clinical presentation; and (b) outcomes of adult hospitalized patients with COVID‐19 to provide practicing nurses with a cogent and concise clinical impression of COVID‐19 patients. Design We conducted a systematic review of early published, peer‐reviewed, original research where researchers presented data from adult hospitalized COVID‐19 patients regarding their presenting signs, symptoms, and definitive survival outcomes. Data Sources We searched the databases PubMed, CINAHL, and Scopus for relevant articles published between 1 January 2020 ‐18 May 2020. Review Methods We extracted data from each study and synthesized them across primary sources using a literature matrix table to provide a global impression of this rapidly growing body of literature. Results We retrieved 97 mainly descriptive observational studies. SARS‐CoV‐2 is efficiently transmitted between humans, particularly those in close contact. Symptomatic COVID‐19 patients can present with a broad array of nonspecific symptoms. Fever and cough are the most commonly reported symptoms; some patients have atypical presentations. In patients with respiratory decompensation, disease progression can be rapid. Some patients experience mild symptoms that are self‐limited; others experience organ failure and death. Risk factors for poor outcomes include older age, chronic medical conditions, male gender, obesity, and presenting with signs of declining respiratory status. Conclusion Nurses can mitigate the spread of SARS‐CoV‐2 and sequelae of COVID‐19 with prompt and capable responses. Impact This study addresses the problem of the continued spread of SARS‐CoV‐2 while little is known about this virus. This review provides nurses with a summary of the most current evidence regarding the signs, symptoms, and outcomes of adult hospitalized COVID‐19 patients that they might identify COVID‐19 patients rapidly on presentation to medical care and be attuned to indicators of patient decompensation.

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“…The incidence of AKI in ICU patients with the COVID-19 was particularly high range from 8%-62% 15,18,[23][24][25]28,29 . Critical ill patients hospitalized with COVID-19, requiring ventilator is more likely to develop AKI 4 .…”

Section: Discussionmentioning

confidence: 98%

“…Overall, COVID-19 patients were included in our meta-analysis. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 12.0% (95% CI: 9.0%-15.0%, Fig. 2), and a signi cant heterogeneity (I 2 = 98%, Chi-square = 0.19, P < 0.01) was observed ( Table 3).…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

Whether Remdesivir Increases the Risk of Acute Kidney Injury (AKI) in Patients with COVID-19: A Systematic Review and Meta-Analysis

Xu¹,

Tang²,

Huang³

et al. 2020

Preprint

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Background: Acute kidney injury (AKI) occurs among patients with COVID-19, it is also proved to be associated with in-hospital mortality. Remdesivir, an RNA polymerase inhibitor, has shown its antiviral activity in vitro and animal models. The adverse effect of Remdesivir especially AKI is the most common cause which lead to drug discontinuation. Whether Remdesivir increases the risk of AKI in patients with COVID-19 is not clear. We conducted a systematic review and meta-analysis to evaluate the incidence rate of AKI in hospitalized COVID-19 patients and whether Remdesivir increases the risk of AKI. Methods: A thorough search was carried out to find relevant studies in PubMed, medRxiv, and Web of Science from 1 Jan 2020 till 1 June 2020. 15135 COVID-19 patients and 981 COVID-19 patients using Remdesivir were included in our meta-analysis. Results: The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 12.0% (95% CI:9.0%-15.0%). According to our subgroup study, the incidence of AKI was associated with the age, disease severity and race of patients. The incidence of AKI in hospitalized COVID-19 patients using Remdesivir was 6% (95% CI: 3%-13%) with a total of 5 studies. Comparing with COVID-19 patients without Remdesivir treatment, Remdesivir treatment do not increase the risk of AKI in COVID-19 patients showing OR 0.80(95%CI: 0.44-1.46, P>0.05). Conclusions: We found out that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI was associated with age, disease severity and race. Remdesivir treatment did not increase the risk of AKI in hospitalized COVID-19 patients. Our meta-analysis may provide an evidence for future study that AKI is associated with the natural cause of COVID-19, not the adverse event after the usage of Remdesivir.

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Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020

Cited by 78 publications

References 14 publications

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies

Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies

Clinical presentation and outcomes of hospitalized adults with COVID‐19: A systematic review

Whether Remdesivir Increases the Risk of Acute Kidney Injury (AKI) in Patients with COVID-19: A Systematic Review and Meta-Analysis

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