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Higher Risk of Acute Respiratory Distress Syndrome and Risk Factors among Patients with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression

Author

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  • Yi-Tseng Tsai

    (Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
    Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan)

  • Han-Chang Ku

    (Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
    Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan)

  • Sujeewa Dilhani Maithreepala

    (Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
    Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka)

  • Yi-Jing Tsai

    (Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan)

  • Li-Fan Chen

    (Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan)

  • Nai-Ying Ko

    (Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
    Department of Nursing, National Cheng Kung University Hospital, College of Medicine, Tainan 704, Taiwan)

  • Sriyani Padmalatha Konara Mudiyanselage

    (Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
    Operation Theatre Department, The National Hospital of Sri Lanka, Colombo 00700, Sri Lanka)

Abstract

Objective: To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review, meta-analysis and meta-regression. Setting and Participants: Hospitals or nursing homes and patients with acute respiratory distress syndrome after COVID-19. Methods: The literature review was systematically conducted on Embase, MEDLINE, CINAHL, and Web of Science, in addition to manual searches and reference list checking from 1 January 2019 to 2 March 2022. The search terms included coronavirus, acute respiratory syndrome, acute respiratory distress syndrome and observational studies. Three reviewers independently appraised the quality of the studies and extracted the relevant data using the Joanna Briggs Institute abstraction form and critical appraisal tools. A study protocol was registered in PROSPERO (CRD42022311957). Eligible studies were meta-analyzed and underwent meta-regression. Results: A total of 12 studies were included, with 148,080 participants. The risk ratio (RR) of ARDS was 23%. Risk factors were age ≥ 41–64 years old (RR = 15.3%, 95% CI =0.14−2.92, p = 0.03); fever (RR = 10.3%, 95% CI = 0.03−2.03, p = 0.04); multilobe involvement of the chest (RR = 33.5%, 95% CI = 0.35–6.36, p = 0.02); lymphopenia (RR = 25.9%, 95% CI = 1.11–4.08, p = 0.01); mechanical ventilation with oxygen therapy (RR = 31.7%, 95% CI = 1.10–5.25, p = 0.002); European region (RR = 16.3%, 95% CI = 0.09–3.17, p = 0.03); sample size ≤ 500 (RR = 18.0%, 95% CI = 0.70–2.89, p = 0.001). Conclusions and Implications: One in four patients experienced ARDS after having COVID-19. The age group 41–64 years old and the European region were high-risk groups. These findings can be used by policymakers to allocate resources for respiratory care facilities and can also provide scientific evidence in the design of protocols to manage COVID-19 worldwide.

Suggested Citation

  • Yi-Tseng Tsai & Han-Chang Ku & Sujeewa Dilhani Maithreepala & Yi-Jing Tsai & Li-Fan Chen & Nai-Ying Ko & Sriyani Padmalatha Konara Mudiyanselage, 2022. "Higher Risk of Acute Respiratory Distress Syndrome and Risk Factors among Patients with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression," IJERPH, MDPI, vol. 19(22), pages 1-15, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:22:p:15125-:d:974713
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    References listed on IDEAS

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    1. Lakshya Singhal & Yash Garg & Philip Yang & Azade Tabaie & A Ian Wong & Akram Mohammed & Lokesh Chinthala & Dipen Kadaria & Amik Sodhi & Andre L Holder & Annette Esper & James M Blum & Robert L Davis , 2021. "eARDS: A multi-center validation of an interpretable machine learning algorithm of early onset Acute Respiratory Distress Syndrome (ARDS) among critically ill adults with COVID-19," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-17, September.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Winkelmann, Juliane & Webb, Erin & Williams, Gemma A. & Hernández-Quevedo, Cristina & Maier, Claudia B. & Panteli, Dimitra, 2022. "European countries' responses in ensuring sufficient physical infrastructure and workforce capacity during the first COVID-19 wave," Health Policy, Elsevier, vol. 126(5), pages 362-372.
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