Rate of Intensive Care Unit admission and outcomes among patients with coronavirus: A systematic review and Meta-analysis

Abstract

Background: The rate of ICU admission among patients with coronavirus varied from 3% to 100% and the mortality was as high as 86% of admitted patients. The objective of the systematic review was to investigate the rate of ICU admission, mortality, morbidity, and complications among patients with coronavirus.

Methods: A comprehensive strategy was conducted in PubMed/Medline; Science direct and LILACS from December 2002 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting rate of ICU admission, the prevalence of mortality and its determinants among ICU admitted patients with coronavirus were included and the rest were excluded.

Result: A total of 646 articles were identified from different databases and 50 articles were selected for evaluation. Thirty-seven Articles with 24983 participants were included. The rate of ICU admission was 32% (95% CI: 26 to 38, 37 studies and 32, 741 participants). The Meta-Analysis revealed that the pooled prevalence of mortality in patients with coronavirus disease in ICU was 39% (95% CI: 34 to 43, 37 studies and 24, 983 participants).

Conclusion: The Meta-Analysis revealed that approximately one-third of patients admitted to ICU with severe Coronavirus disease and more than thirty percent of patients admitted to ICU with a severe form of COVID-19 for better care died which warns the health care stakeholders to give attention to intensive care patients.

Registration: This Systematic review and Meta-Analysis was registered in Prospero international prospective register of systemic reviews (CRD42020177095) on April 9/2020.

Fig 1. Prisma flow chart.

Fig 2. Forest plot for the prevalence of ICU admission patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 3. Forest plot for subgroup analysis prevalence of ICU admission patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 4. Forest plot for the prevalence of ICU mortality among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 5. Forest plot for subgroup analysis of the prevalence of ICU mortality among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 6. Forest plot for the prevalence of ICU Comorbidity among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 7. Forest plot for subgroup analysis of the prevalence of ICU Comorbidity among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 8. Forest plot for of prevalence of ICU Complication among patients with coronavirus: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

ICU: Intensive Care Unit.

Fig 9. Funnel plot to assess publication bias.

The vertical line indicates the effect size whereas the diagonal line indicates the precision of individual studies with a 95% confidence interval.