Critical Care for Severe COVID-19: A Population-Based Study from a Province with Low Case-Fatality Rate in China

Liao, Xuelian; Chen, Hong; Wang, Bo; Jiang, Xiaodong; Li, Zhen; Zhang, Zhongwei; Li, Weimin; Tang, Jin; Wang, Jian; Shi, Rui; Zhen, Xiangfan; Wang, Maojuan; Xin, Lei; Gong, Yu; Lv, Sheng; Jia, Chao; Chen, Li; Shang, Juan; Yang, Min; Wei, Hailong; Zhang, Yuanjun; Xiong, Yong; Shen, Hua; Xiao, Xilong; Yang, Jie; Liu, Chang; Wu, Qin; Wen, Wang; Jin, Yang; Yin, Wei Hsian; Xie, Xiaoqi; Tian, Yongming; Liu, Huan; Shuai, Bingxing; Zhang, Wei; Song, Xiangrong; Kang, Yanming

doi:10.2139/ssrn.3566160

Cited by 8 publications

(15 citation statements)

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“…Among patients with symptoms, those with severe or critical conditions had much higher BMIs and individuals with obesity prevalence than the normal population or patients who were COVID‐19 negative 32,61–70 . Two studies showed that the odds of having COVID‐19 increased by 30% (OR = 1.30; 95% CI, 1.09–1.54; p = 0.0030) 61 and by 38% (OR = 1.38; p < 0.0001), 32 respectively, among the individuals with obesity (Table 1).…”

Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

“…A few studies showed that individuals with obesity may decrease in‐hospital mortality 31,75,87,89 . Some studies showed that obesity may insignificantly decrease 41,47,81,90 or increase 55,67,68,84,91–96 the odds of death among individuals with obesity. The majority of studies showed that obesity significantly increased the odds of death among COVID‐19 patients with obesity.…”

Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

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Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

et al. 2020

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Summary The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

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Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

et al. 2020

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“…After evaluating 62 full-text articles for eligibility, 53 full-text articles were further excluded. Finally, 9 studies from different provinces/cities [6,[18][19][20][21][22][23][24][25] were included in the meta-analysis (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China: A meta-analysis

Guo

Shi

Zhang

et al. 2020

Diabetes Research and Clinical Practice

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Diabetes mellitus has been reported to be one of the most prevalent comorbidity in patients with Coronavirus Disease 2019 (COVID-19). We aimed to assess the association of comorbid diabetes with COVID-19 severity or mortality in China. Methods: We performed a systematic literature search from six electronic databases on diabetes and COVID-19. The outcome of interest was disease severity or mortality. Heterogeneity among the studies was assessed by the Cochran Q test and the I 2 statistic. A random effects model was applied to calculate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: Nine studies from different provinces/cities were identified according to the predefined inclusion and exclusion criteria. There were a total of 1070 patients with diabetes, out of the 8807 COVID-19 cases. The majority of the cases were derived from Hubei Province. A low degree of heterogeneity in the risk estimates was observed in the included studies. Meta-analysis showed that there was a significant association of preexisting diabetes with disease severity or death. The pooled RR was 2.96 (95% CI: 2.31-3.79; p < 0.001). Sensitivity analysis demonstrated no significant changes in the pooled estimates. Conclusions: Comorbid diabetes was associated with an increased risk of disease severity or death in Chinese COVID-19 patients.

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“…In the only study from Italy, Duca and associates (25) reported a higher death rate in patients receiving helmet CPAP or other NIV compared with IMV. For the 3 studies from China, Liao and coworkers (28) reported rates of recovery greater than 40% after 28 days of follow-up in patients who received NIV, HFNC, and conventional oxygen therapy. Wang and colleagues (29) found low rates of the need for IMV in patients receiving NIV or HFNC.…”

Section: Stream 1: Systematic Review Of Ventilation Strategies In Patmentioning

confidence: 99%

Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19

Schünemann

Khabsa

Solo

et al. 2020

Annals of Internal Medicine

116

108

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Background: Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19). Purpose: To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19. Data Sources: 21 standard, World Health Organization-specific and COVID-19-specific databases, without language restrictions, until 1 May 2020. Study Selection: Studies of any design and language comparing different oxygenation approaches in patients with coronavirus infections, including severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS), or with hypoxemic respiratory failure. Animal, mechanistic, laboratory, and preclinical evidence was gathered regarding aerosol dispersion of coronavirus. Studies evaluating risk for virus transmission to health care workers from aerosol-generating procedures (AGPs) were included. Data Extraction: Independent and duplicate screening, data abstraction, and risk-of-bias assessment (GRADE for certainty of evidence and AMSTAR 2 for included systematic reviews). Data Synthesis: 123 studies were eligible (45 on COVID-19, 70 on SARS, 8 on MERS), but only 5 studies (1 on COVID-19, 3 on SARS, 1 on MERS) adjusted for important confounders. A study in hospitalized patients with COVID-19 reported slightly higher mortality with noninvasive ventilation (NIV) than with invasive mechanical ventilation (IMV), but 2 opposing studies, 1 in patients with MERS and 1 in patients with SARS, suggest a reduction in mortality with NIV (very-low-certainty evidence). Two studies in patients with SARS report a reduction in mortality with NIV compared with no mechanical ventilation (low-certainty evidence). Two systematic reviews suggest a large reduction in mortality with NIV compared with conventional oxygen therapy. Other included studies suggest increased odds of transmission from AGPs. Limitation: Direct studies in COVID-19 are limited and poorly reported. Conclusion: Indirect and low-certainty evidence suggests that use of NIV, similar to IMV, probably reduces mortality but may increase the risk for transmission of COVID-19 to health care workers.

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Critical Care for Severe COVID-19: A Population-Based Study from a Province with Low Case-Fatality Rate in China

Cited by 8 publications

References 0 publications

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China: A meta-analysis

Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19

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