Clinical Characteristics, Treatment, and Outcomes of Critically Ill Patients With COVID-19: A Scoping Review.
Clinical Characteristics, Treatment, and Outcomes of Critically Ill Patients With COVID-19: A Scoping Review.
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DOI：
10.1016/j.mayocp.2020.10.022
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发表时间：
2021-01
影响因子：
8.9
通讯作者：
Barwise AK
中科院分区：
文献类型：
--
作者：
Huang C;Soleimani J;Herasevich S;Pinevich Y;Pennington KM;Dong Y;Pickering BW;Barwise AK
关于2019冠状病毒病（COVID-19）的研究越来越多，但尚未对重症人群的现有数据进行综合。我们进行了范围审查，以综合COVID-19重症患者的临床特征、治疗和临床结局。在2020年1月1日至2020年5月15日期间，我们通过对世界卫生组织和LitCovid数据库进行COVID-19的日常搜索，确定了描述危重患者的高质量临床研究，样本量超过20例患者。两名评审员独立审查了所有摘要（2785篇独特文章）、全文（218篇文章）和摘要数据（92项研究）。92项研究包括61项来自亚洲，16项来自欧洲，10项来自北美和南美，5项多国研究。所有地区重症人群之间的显著相似性包括老年男性感染和患有严重疾病的比例较高，合并症（高血压，糖尿病和心血管疾病）的频率较高，胸部成像结果异常以及继发于呼吸衰竭的死亡。与亚洲相比，欧洲和美国的地区差异包括新发现的并发症（如肺栓塞）和流行病学风险因素（如肥胖），胸部计算机断层扫描较少，以及有创机械通气的使用增加（重症监护室患者为70%至100% vs 15%至47%）。未来的研究方向应包括机制验证研究，以更好地了解器官损伤和大规模的合作临床研究，以评估抗病毒药物，抗生素，白细胞介素6受体阻滞剂和干扰素的疗效和安全性。目前建立的预测模型还需要在中国以外的其他地区进一步验证。
A growing number of studies on coronavirus disease 2019 (COVID-19) are becoming available, but a synthesis of available data focusing on the critically ill population has not been conducted. We performed a scoping review to synthesize clinical characteristics, treatment, and clinical outcomes among critically ill patients with COVID-19. Between January 1, 2020, and May 15, 2020, we identified high-quality clinical studies describing critically ill patients with a sample size of greater than 20 patients by performing daily searches of the World Health Organization and LitCovid databases on COVID-19. Two reviewers independently reviewed all abstracts (2785 unique articles), full text (218 articles), and abstracted data (92 studies). The 92 studies included 61 from Asia, 16 from Europe, 10 from North and South America, and 5 multinational studies. Notable similarities among critically ill populations across all regions included a higher proportion of older males infected and with severe illness, high frequency of comorbidities (hypertension, diabetes, and cardiovascular disease), abnormal chest imaging findings, and death secondary to respiratory failure. Differences in regions included newly identified complications (eg, pulmonary embolism) and epidemiological risk factors (eg, obesity), less chest computed tomography performed, and increased use of invasive mechanical ventilation (70% to 100% vs 15% to 47% of intensive care unit patients) in Europe and the United States compared with Asia. Future research directions should include proof-of-mechanism studies to better understand organ injuries and large-scale collaborative clinical studies to evaluate the efficacy and safety of antivirals, antibiotics, interleukin 6 receptor blockers, and interferon. The current established predictive models require further verification in other regions outside China.
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DOI：
10.1164/rccm.202002-0445oc
发表时间：
2020-06-01
影响因子：
24.7
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