tetano
Editor, Senior Moderator
PLoS One
. 2022 Jun 24;17(6):e0269871.
doi: 10.1371/journal.pone.0269871. eCollection 2022.
Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis
Vincent Issac Lau[SUP] 1 [/SUP], Sumeet Dhanoa[SUP] 2 [/SUP], Harleen Cheema[SUP] 2 [/SUP], Kimberley Lewis[SUP] 3 4 [/SUP], Patrick Geeraert[SUP] 2 [/SUP], David Lu[SUP] 2 [/SUP], Benjamin Merrick[SUP] 2 [/SUP], Aaron Vander Leek[SUP] 2 [/SUP], Meghan Sebastianski[SUP] 5 [/SUP], Brittany Kula[SUP] 6 [/SUP], Dipayan Chaudhuri[SUP] 3 4 [/SUP], Arnav Agarwal[SUP] 3 7 [/SUP], Daniel J Niven[SUP] 8 9 [/SUP], Kirsten M Fiest[SUP] 8 9 [/SUP], Henry T Stelfox[SUP] 8 9 10 [/SUP], Danny J Zuege[SUP] 8 9 [/SUP], Oleksa G Rewa[SUP] 1 9 11 [/SUP], Sean M Bagshaw[SUP] 1 9 11 [/SUP]
Affiliations
Abstract
Background: As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs.
Methods: We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology.
Results: Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty).
Conclusions: There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care.
Systematic review registration: PROSPERO CRD42020201256 (Sept 2, 2020).
. 2022 Jun 24;17(6):e0269871.
doi: 10.1371/journal.pone.0269871. eCollection 2022.
Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis
Vincent Issac Lau[SUP] 1 [/SUP], Sumeet Dhanoa[SUP] 2 [/SUP], Harleen Cheema[SUP] 2 [/SUP], Kimberley Lewis[SUP] 3 4 [/SUP], Patrick Geeraert[SUP] 2 [/SUP], David Lu[SUP] 2 [/SUP], Benjamin Merrick[SUP] 2 [/SUP], Aaron Vander Leek[SUP] 2 [/SUP], Meghan Sebastianski[SUP] 5 [/SUP], Brittany Kula[SUP] 6 [/SUP], Dipayan Chaudhuri[SUP] 3 4 [/SUP], Arnav Agarwal[SUP] 3 7 [/SUP], Daniel J Niven[SUP] 8 9 [/SUP], Kirsten M Fiest[SUP] 8 9 [/SUP], Henry T Stelfox[SUP] 8 9 10 [/SUP], Danny J Zuege[SUP] 8 9 [/SUP], Oleksa G Rewa[SUP] 1 9 11 [/SUP], Sean M Bagshaw[SUP] 1 9 11 [/SUP]
Affiliations
- PMID: 35749400
- DOI: 10.1371/journal.pone.0269871
Abstract
Background: As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs.
Methods: We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology.
Results: Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty).
Conclusions: There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care.
Systematic review registration: PROSPERO CRD42020201256 (Sept 2, 2020).