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Abstract
<p class="first" id="d37299040e86">The emergence of coronavirus disease 2019 (COVID-19)
has led to high demand for intensive
care services worldwide. However, the mortality of patients admitted to the intensive
care unit (ICU) with COVID-19 is unclear. Here, we perform a systematic review and
meta-analysis, in line with PRISMA guidelines, to assess the reported ICU mortality
for patients with confirmed COVID-19. We searched MEDLINE, EMBASE, PubMed and Cochrane
databases up to 31 May 2020 for studies reporting ICU mortality for adult patients
admitted with COVID-19. The primary outcome measure was death in intensive care as
a proportion of completed ICU admissions, either through discharge from the ICU or
death. The definition thus did not include patients still alive on ICU. Twenty-four
observational studies including 10,150 patients were identified from centres across
Asia, Europe and North America. In-ICU mortality in reported studies ranged from 0
to 84.6%. Seven studies reported outcome data for all patients. In the remaining studies,
the proportion of patients discharged from ICU at the point of reporting varied from
24.5 to 97.2%. In patients with completed ICU admissions with COVID-19 infection,
combined ICU mortality (95%CI) was 41.6% (34.0-49.7%), I2 = 93.2%). Sub-group analysis
by continent showed that mortality is broadly consistent across the globe. As the
pandemic has progressed, the reported mortality rates have fallen from above 50% to
close to 40%. The in-ICU mortality from COVID-19 is higher than usually seen in ICU
admissions with other viral pneumonias. Importantly, the mortality from completed
episodes of ICU differs considerably from the crude mortality rates in some early
reports.
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