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

Yi-Tseng Tsai, Han-Chang Ku, Sujeewa Dilhani Maithreepala, Yi-Jing Tsai, Li-Fan Chen, Nai-Ying Ko and Sriyani Padmalatha Konara Mudiyanselage ()
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Yi-Tseng Tsai: Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
Han-Chang Ku: Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
Sujeewa Dilhani Maithreepala: Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
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
Sriyani Padmalatha Konara Mudiyanselage: Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan

IJERPH, 2022, vol. 19, issue 22, 1-15

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.

Keywords: acute respiratory distress syndrome; coronavirus infection; risk factor (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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