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A look back at the first wave of COVID-19 in China: A systematic review and meta-analysis of mortality and health care resource use among severe or critical patients.
Zhang, Mengmeng; Hu, Peng; Xu, Xiaowei; Ai, Jingwen; Li, Yang; Bao, Yun; Tangamornsuksan, Wimonchat; Chan, Alain; Xie, Shelley; Hu, Hao; Liang, Shuting; Zhang, Wenhong; Xie, Feng.
  • Zhang M; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
  • Hu P; Department of Infectious Disease, The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China.
  • Xu X; Department of Infectious Disease, The First Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Ai J; Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China.
  • Li Y; Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China.
  • Bao Y; Institute of Clinical Research and Evidence-Based Medicine, Gansu Provincial Hospital, Lanzhou, Gansu, China.
  • Tangamornsuksan W; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
  • Chan A; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand.
  • Xie S; China Medical Affairs, Gilead Sciences.
  • Hu H; China Medical Affairs, Gilead Sciences.
  • Liang S; Global Value and Access, Gilead Sciences.
  • Zhang W; Global Medical Affairs Research, Gilead Sciences.
  • Xie F; Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China.
PLoS One ; 17(3): e0265117, 2022.
Article in English | MEDLINE | ID: covidwho-1742021
ABSTRACT

BACKGROUND:

To investigate the mortality and health care resource use among patients with severe or critical coronavirus disease of 2019 (COVID-19) in the first wave of pandemic in China.

METHODS:

We performed a systematic review and meta-analysis to investigate the mortality, discharge rate, length of hospital stay, and use of invasive ventilation in severe or critical COVID-19 cases in China. We searched electronic databases for studies from China with no restrictions on language or interventions patients received. We screened records, extracted data and assessed the quality of included studies in duplicate. We performed the meta-analysis using random-effect models through a Bayesian framework. Subgroup analyses were conducted to examine studies by disease severity, study location and patient enrolment start date. We also performed sensitivity analysis using various priors, and assessed between-study heterogeneity and publication bias for the primary outcomes.

RESULTS:

Out of 6,205 titles and abstracts screened, 500 were reviewed in full text. A total of 42 studies were included in the review, of which 95% were observational studies (n = 40). The pooled 28-day and 14-day mortalities among severe or critical patients were 20.48% (7,136 patients, 95% credible interval (CrI), 13.11 to 30.70) and 10.83% (95% CrI, 6.78 to 16.75), respectively. The mortality declined over time and was higher in patients with critical disease than severe cases (1,235 patients, 45.73%, 95% CrI, 22.79 to 73.52 vs. 3,969 patients, 14.90%, 95% CrI, 4.70 to 39.57) and patients in Hubei compared to those outside Hubei (6,719 patients, 26.62%, 95% CrI, 13.11 to 30.70 vs. 244 patients, 5.88%, 95% CrI 2.03 to 14.11). The length of hospital stay was estimated at 18.48 days (6,847 patients, 95% CrI, 17.59 to 21.21), the 28-day discharge rate was 50.48% (3,645 patients, 95% CrI, 26.47 to 79.53), and the use of invasive ventilation rate was 13.46% (4,108 patients, 95% CrI, 7.61 to 22.31).

CONCLUSIONS:

Our systematic review and meta-analysis found high mortality among severe and critical COVID-19 cases. Severe or critical COVID-19 cases consumed a large amount of hospital resources during the outbreak.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Care / Pandemics / SARS-CoV-2 / COVID-19 / Length of Stay Type of study: Randomized controlled trials / Reviews / Systematic review Limits: Humans Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0265117

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Care / Pandemics / SARS-CoV-2 / COVID-19 / Length of Stay Type of study: Randomized controlled trials / Reviews / Systematic review Limits: Humans Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0265117