Mortality and morbidity in critically ill COVID-19 patients: A systematic review and meta-analysis

Background: The COVID-19 pandemic has caused 14.83 million deaths globally. This systematic review and meta-analysis aimed to provide a pooled estimate of the overall mortality and morbidity of critically ill COVID-19 patients. Method: Four electronic databases, Medline/PubMed, the Cochrane Library, the WHO COVID-19 database, and the Web of Science, were used to identify relevant studies. Two authors independently screened the studies, evaluated the eligibility criteria and resolved discrepancies through discussion with the third author. The pooled effect size was computed using STATA software version 14. The Cochran Q test and I2 test were utilized to assess heterogeneity across the studies. Additionally, subgroup analysis, sensitivity analysis, and publication bias were evaluated. It is registered in Prospero with Prospero ID CRD42020212146. Results: A total of 1003 published articles were screened from various databases, and 24 studies involving a total of 142,291 critically ill COVID-19 participants were selected for inclusion in the review. Among the participants, 67 % were male, and the mean age was 63.43 + SD3.33 years. The mortality rate reported in the individual studies ranged from 4.5 % to 69.5 %. The findings from the analysis revealed that the overall pooled mortality rate was 34 % (95 % confidence interval: 31 %-37 %). Additionally, the findings showed that 62 % of critically ill COVID-19 patients required mechanical ventilation, while 68.7 % of these patients had chronic disease comorbidities. Conclusion: Critically ill COVID-19 patients face a high-risk risk of death, with an estimate of about one in three patients dying from the virus. Notably, a substantial portion of critically ill COVID-19 patients (62 %) require mechanical ventilation; surprisingly, more than two-thirds of patients with COVID-19 have chronic disease comorbidities, highlighting the importance of managing comorbidities in this population. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).