Critical care survival rates in COVID-19 patients improved as the first wave of the pandemic developed

Bateson, Meghan; McPeake, Joanne

doi:10.1136/ebnurs-2020-103370

Cited by 8 publications

(9 citation statements)

References 4 publications

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“…The overall COVID-19 mortality in Jakarta, Indonesia, was 12%, lower than other reports involving a large cohort in high-income countries [28]. The ICU mortality rate of critically ill patients was 67% in the US and 42% in the UK study [33,34]. Meanwhile, in China, it was more than 49% [35].…”

Section: Discussionmentioning

confidence: 90%

Bronchoscopy Findings of Severe and Critical COVID-19 Patients Treated in ICU: A Year of Experience in a Developing Country

Pratomo¹,

Priyonugroho²,

Baskoro³

et al. 2022

TORMJ

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Background: Bronchoscopy procedure in patients with COVID-19 poses significant challenges, especially in a developing country with limited resources. Objectives: We aim to describe the clinical characteristics of severe and critical COVID-19 patients treated in an intensive care unit (ICU) and their bronchoscopy findings. Methods: We performed a retrospective analysis of clinical data of ICU patients with COVID-19 treated and received bronchoscopy procedures. This study retrospectively obtained all consecutive patients who underwent bronchoscopy at a teaching hospital in Depok, Indonesia, from May 2020 until May 2021. Results: A total of 57 bronchoscopy procedures in 54 patients was performed in this study. Primary procedure indications were retained mucus (68.4%) and ventilatory support weaning failure (15.8%). Bronchoscopic findings were mostly hyperaemic mucosa (95.00%) and purulent secretion (50.90%). Microbiological findings from bronchoalveolar samples were Acinetobacter baumanii, Klebsiella pneumoniae, and Candida albicans (33.3%, 26.6%, and 10.5%, respectively). The most common fungal isolated were Candida albicans (28%), followed by Candida tropicalis (16%), and Aspergillus sp (8%). The overall length of hospital stay was 24 days, and the in-ICU stay was 22.06 ± 10.99 days. The patients’ survival of 28-days postprocedural outcome was 25.9% (14 subjects). Follow-up found that 20.4% of patients survived after sixty days of hospitalization. Conclusions: Diagnostic and therapeutic bronchoscopy in ICU patients with COVID-19 was safe and feasible to perform in developing countries with limited resources. It could help bronchial mucous clearance and confirm microbiological infection. The procedures should be strictly performed for patients with indications and comply with safety standards.

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Section: Discussionmentioning

confidence: 90%

Bronchoscopy Findings of Severe and Critical COVID-19 Patients Treated in ICU: A Year of Experience in a Developing Country

Pratomo¹,

Priyonugroho²,

Baskoro³

et al. 2022

TORMJ

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“…Potential differences in the treatment of COVID-19 might be attributed to the evolving understanding of the condition and the identification of effective therapeutic options 77. As the pandemic progressed, individuals affected later on received more informed care, especially regarding treating individuals with comorbidities 78–80. Another explanation could be the notion of a‘quality penalty’ imposed by overburdened healthcare services occurred early in the pandemic, where the benefits of treatment at high-quality facilities are diminished when the system is overwhelmed 81.…”

Section: Discussionmentioning

confidence: 99%

Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis

Li,

Islam,

Gutierrez

et al. 2023

BMJ Glob Health

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IntroductionDespite a growing body of scholarly research on the risks of severe COVID-19 associated with diabetes, hypertension and obesity, there is a need for estimating pooled risk estimates with adjustment for confounding effects. We conducted a systematic review and meta-analysis to estimate the pooled adjusted risk ratios of diabetes, hypertension and obesity on COVID-19 mortality.MethodsWe searched 16 literature databases for original studies published between 1 December 2019 and 31 December 2020. We used the adapted Newcastle-Ottawa Scale to assess the risk of bias. Pooled risk ratios were estimated based on the adjusted effect sizes. We applied random-effects meta-analysis to account for the uncertainty in residual heterogeneity. We used contour-funnel plots and Egger’s test to assess possible publication bias.ResultsWe reviewed 34 830 records identified in literature search, of which 145 original studies were included in the meta-analysis. Pooled adjusted risk ratios were 1.43 (95% CI 1.32 to 1.54), 1.19 (95% CI 1.09 to 1.30) and 1.39 (95% CI 1.27 to 1.52) for diabetes, hypertension and obesity (body mass index ≥30 kg/m2) on COVID-19 mortality, respectively. The pooled adjusted risk ratios appeared to be stronger in studies conducted before April 2020, Western Pacific Region, low- and middle-income countries, and countries with low Global Health Security Index scores, when compared with their counterparts.ConclusionsDiabetes, hypertension and obesity were associated with an increased risk of COVID-19 mortality independent of other known risk factors, particularly in low-resource settings. Addressing these chronic diseases could be important for global pandemic preparedness and mortality prevention.PROSPERO registration numberCRD42021204371.

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“…Tracking the evolution of patient outcomes can help improve hospital services, supply chain management, human resources planning, and prioritize future research 51 . In addition, the average length of ICU stay is a critical metric required to project census ICU bed, which has been a limiting factors of healthcare systems in several settings 52 .…”

Section: Discussionmentioning

confidence: 99%

Mortality trends and lengths of stay among hospitalized COVID-19 patients in Ontario and Québec (Canada): a population-based cohort study of the first three epidemic waves

Xia

Mishra

et al. 2021

Preprint

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Background: Epidemic waves of COVID-19 strained hospital resources. We describe temporal trends in mortality risk and length of stay in intensive cares units (ICUs) among COVID-19 patients hospitalized through the first three epidemic waves in Canada. Methods: We used population-based provincial hospitalization data from Ontario and Qu&eacutebec to examine mortality risk and lengths of ICU stay. For each province, adjusted estimates were obtained using marginal standardization of logistic regression models, adjusting for patient-level characteristics and hospital-level determinants. Results: Using all hospitalizations from Ontario (N=26,541) and Qu&eacutebec (N=23,857), we found that unadjusted in-hospital mortality risks peaked at 31% in the first wave and was lowest at the end of the third wave at 6-7%. This general trend remained after controlling for confounders. The odds of in-hospital mortality in the highest hospital occupancy quintile was 1.2 (95%CI: 1.0-1.4; Ontario) and 1.6 (95%CI: 1.3-1.9; Qu&eacutebec) times that of the lowest quintile. Variants of concerns were associated with an increased in-hospital mortality. Length of ICU stay decreased over time from a mean of 16 days (SD=18) to 15 days (SD=15) in the third wave but were consistently higher in Ontario than Qu&eacutebec by 3-6 days. Conclusion: In-hospital mortality risks and lengths of ICU stay declined over time in both provinces, despite changing patient demographics, suggesting that new therapeutics and treatment, as well as improved clinical protocols, could have contributed to this reduction. Continuous population-based monitoring of patient outcomes in an evolving epidemic is necessary for health system preparedness and response.

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Critical care survival rates in COVID-19 patients improved as the first wave of the pandemic developed

Cited by 8 publications

References 4 publications

Bronchoscopy Findings of Severe and Critical COVID-19 Patients Treated in ICU: A Year of Experience in a Developing Country

Bronchoscopy Findings of Severe and Critical COVID-19 Patients Treated in ICU: A Year of Experience in a Developing Country

Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis

Mortality trends and lengths of stay among hospitalized COVID-19 patients in Ontario and Québec (Canada): a population-based cohort study of the first three epidemic waves

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