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J Rehabil Med Long-term Clinical Outcomes in Survivors of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome Coronavirus Outbreaks After Hospitalisation or ICU Admission: A Systematic Review and Meta-Analysis

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  • J Rehabil Med Long-term Clinical Outcomes in Survivors of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome Coronavirus Outbreaks After Hospitalisation or ICU Admission: A Systematic Review and Meta-Analysis


    J Rehabil Med


    . 2020 May 25.
    doi: 10.2340/16501977-2694. Online ahead of print.
    Long-term Clinical Outcomes in Survivors of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome Coronavirus Outbreaks After Hospitalisation or ICU Admission: A Systematic Review and Meta-Analysis


    Hassaan Ahmed 1 , Kajal Patel, Darren C Greenwood, Stephen Halpin, Penny Lewthwaite, Abayomi Salawu, Lorna Eyre, Andrew Breen, Rory J O'Connor, Anthony Jones, Manoj Sivan



    AffiliationsFree article

    Abstract

    Objective: To determine long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections after hospitalization or intensive care unit admission.
    Data sources: Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO were searched.
    Study selection: Original studies reporting clinical outcomes of adult SARS and MERS survivors 3 months after admission or 2 months after discharge were included.
    Data extraction: Studies were graded using the Oxford Centre for Evidence-Based Medicine 2009 Level of Evidence Tool. Meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to 6 months, and beyond.
    Data synthesis: Of 1,169 identified studies, 28 were included in the analysis. Pooled analysis revealed that common complications up to 6 months were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15-45%); and reduced exercise capacity ((mean 6-min walking distance 461 m, CI 450-473 m). The prevalences of post-traumatic stress disorder (39%, 95% CI 31-47%), depression (33%, 95% CI 20-50%) and anxiety (30%, 95% CI 10-61) beyond 6 months were considerable. Low scores on Short-Form 36 were identified at 6 months and beyond.
    Conclusion: Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Clinicians should anticipate and investigate similar long-term outcomes in COVID-19 survivors.

    Keywords: COVID-19; MERS, ARDS; SARS; anxiety; depression; exercise tolerance; fatigue; follow-up; follow-up studies; lung function; post-traumatic stress disorder; prevalence; quality of life; coronavirus infection.

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