Expert Rev Respir Med . Mortality of intubated patients with COVID-19 during first and subsequent waves: a meta-analysis involving 363660 patients from 43 countries

[tetano]

Expert Rev Respir Med


. 2022 Nov 10.
doi: 10.1080/17476348.2022.2145950. Online ahead of print.
Mortality of intubated patients with COVID-19 during first and subsequent waves: a meta-analysis involving 363660 patients from 43 countries


Eleni Xourgia ¹ , Dimitrios E Katsaros ¹ , Nikoleta A Xixi ¹ , Vasiliki Tsolaki ² , Christina Routsi ¹ , Spyros G Zakynthinos ¹ , Anastasia Kotanidou ¹ , Ilias I Siempos ^{1 3}



Affiliations

• PMID: 36355043
• DOI: 10.1080/17476348.2022.2145950

Abstract

Background: We attempted to investigate the change in mortality of intubated patients with coronavirus disease (COVID-19) from first to subsequent waves across several countries.
Methods: We pre-registered our meta-analysis with PROSPERO [Anonymized]. We searched PubMed, Scopus and grey literature for observational studies reporting data on all-cause mortality of intubated patients with COVID-19 recruited both during first and subsequent waves of the pandemic. We considered studies published after August 31^st, 2020 up to July 12^th, 2021. The primary outcome of the meta-analysis was all-cause mortality. We used a random effects model to calculate pooled risk ratio (RR) and 95% confidence intervals (CI).
Results: : By incorporating data of 363660 patients from 43 countries included in 28 studies, we found that all-cause mortality of intubated patients with COVID-19 increased from first to subsequent waves (from 62.2% to 72.6%; RR 0.90, 95% CI 0.85-0.94, p <0.00001). This finding was independent of the geo-economic variation of the included studies and persisted in several pre-specified subgroup and sensitivity analyses.
Conclusions: : The robust finding of this meta-analysis suggests that mortality of intubated patients with COVID-19 did not improve over time. Future research should target this group of patients to further optimize their management.

Keywords: acute respiratory distress syndrome; acute respiratory failure; coronavirus; intensive care unit; mechanical ventilation.