ABSTRACT
Background: Acute respiratory distress syndrome (ARDS) occurs commonly in intensive care units. The reported mortality rates in studies evaluating ARDS are highly variable. Objective: To investigate mortality rates due to ARDS from before the 2009 H1N1 influenza pandemic began until the start of coronavirus disease 2019 (COVID-19) pandemic. Design: We performed a systematic search and then ran a proportional meta-analysis for mortality. We ran our analysis in three ways: for randomised controlled trials only, for observational studies only, and for randomised controlled trials and observational studies combined. Data sources: MEDLINE and Embase, using a highly sensitive criterion and limiting the search to studies published from January 2009 to December 2019. Review methods: Two of us independently screened titles and s to first identify studies and then complete full text reviews of selected studies. We assessed risk of bias using the Cochrane RoB-2 (a risk-of-bias tool for randomised trials) and the Cochrane ROBINS-1 (a risk-of-bias tool for non-randomised studies of interventions). Results: We screened 5844 citations, of which 102 fully met our inclusion criteria. These included 34 randomised controlled trials and 68 observational studies, with a total of 24 158 patients. The weighted pooled mortality rate for all 102 studies published from 2009 to 2019 was 39.4% (95% CI, 37.0–41.8%). Mortality was higher in observational studies compared with randomised controlled trials (41.8% [95% CI, 38.9–44.8%] v 34.5% [95% CI, 30.6–38.5%];P = 0.005). Conclusions: Over the past decade, mortality rates due to ARDS were high. There is a clear distinction between mortality in observational studies and in randomised controlled trials. Future studies need to report mortality for different ARDS phenotypes and closely adhere to evidence-based medicine. PROSPERO registration: CRD42020149712 (April 2020). © 2022, College of Intensive Care Medicine. All rights reserved.
ABSTRACT
COVID -19 disease (Coronavirus) is a contemporary strain of coronavirus species which has initially appeared in Wuhan city, China. Over the few months it has spread to various regions of the world. It is observed that COVID-19 is able to get transmitted from human to human contact, by means of droplets sustained in the air as aerosols, fomites etc. WHO (World Health Organization) has declared the current outbreak to be a public health emergency globally. Asthe disease is life threatening, there is a crucial need for effective drugs. Optimistic nurture remains the backbone of the therapy. Despite the COVID-19 patients having benign or mild courses, up to 5% -10% can have serious;probably life alarming courses, there is a crucial need for effective drugs. There have been several clinical trials persisting, various immune regulating and antiviral agents for assessments of COVID-19 in those investigations and some of them would be reported in later couple of days. Although the critical need to find an efficient antiviral medication for COVID-19 through randomized controlled investigation, certain agents are being utilized all over the world, established on either envisioned evidence, in vitro or experimental studies. Presently, the research investigation on SARS COVID-2 is in the initial stages. Based on ongoing published information, this review article consistently summarizes the pathological analysis, clinical symptoms, prevention and treatment of COVID-19. Generally, maximum used therapeutic agents in India and all over the world includes hydroxychloroquine, chloroquine, remdesivir, favipiravir, lopinavir and Nitazoxanide. This review reports about Ivermectin to have an activity against SARS-COVID-19 in vitro, which is permitted for some other treatments of human diseases. It is assumed that this review willencourage the nation to recognize and handle COVID-19 and contribute for prospective studies.