Clinical features, comorbidities, complications and treatment options in severe and non-severe COVID-19 patients: A systemic review and meta-analysis.
Mohan Giri, Anju Puri, Ting Wang and 1 others
PMID 34482663WHAT IT FOUND
Severe COVID-19 was more likely in patients with hypertension, diabetes, cardiovascular disease, COPD, cancer or kidney disease.
Breathlessness and fatigue also marked severity, while fever, cough, headache and sore throat did not clearly separate groups.
Key findings
01Dyspnoea and fatigue were higher in severe patients, while fever, cough, sore throat and headache were not.
02Hypertension, diabetes, cardiovascular disease, cancer, COPD and chronic kidney disease were more common in severe patients.
03Severe patients were more likely to have ARDS, shock and acute kidney injury, and to receive antibiotics, glucocorticoids, CRRT, NIV and IMV.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most included studies were retrospective and all were from China, so the results may not apply to other settings. Only 12 studies were included, and some pooled results had very high heterogeneity, so the estimates are unstable. Severe and non-severe groups were defined differently across studies, including ICU status, elevated TnT level, cardiac injury, SpO2 and ARDS. The treatment comparisons are observational associations, not trials, so they cannot show whether any treatment helped or harmed patients. Many patients received several treatments at the same time, so the contribution of a single drug or support cannot be separated.
Declared interests
All authors declared no conflict of interest.
The easy way to misread this
Do not read the higher use of antibiotics, glucocorticoids, CRRT, NIV or IMV in severe patients as proof that these treatments work. The study was a meta-analysis of observational comparisons, and sicker patients were more likely to receive these therapies, so it cannot separate the effects of the treatments from the effects of disease severity.