Outcomes and Resource Use of COVID-19 Patients Admitted to the Intensive Care Unit: A Systematic Review

BACKGROUND: The COVID-19 infection is a major cause of hospital admission and represents a challenge to resource management during ICU stay. We aimed to describe the clinical course, resource use and outcomes of COVID-19 pneumonia requiring ICU admission. METHODS: We performed a systematic search of peer-reviewed publications in MEDLINE, EMBASE and Cochrane Library up to May 10 th , 2020. Preprints and reports were also included if they meet the inclusion criteria. Data were extracted on characteristics of study populations, resource use, and outcomes. FINDINGS: From 31 articles included, a total of 50,881 patients were evaluated and 24,411 patients were admitted in the ICU. Most of patients admitted in ICU were male (57%) and the mean age was 56 (95% IC 48.5 – 59.8) years-old. Hospital and ICU mortality was 8.4% and 30% respectively, and the length of stay was 9.0 (95% IC 6.3 – 12.0) days and 8.0 (95% IC 5.1 – 11.0) days, respectively. Mortality in patients with ARDS was 93%. Mechanical ventilation was used in 10,544 patients (54% of those admitted in ICU) and mortality was 56.4%. The length of MV stay was 8.4 (95% IC 1.6 – 13.7) days. The main resources described was the use of non-invasive ventilation, extracorporeal membrane oxygenation, renal replacement therapy and vasopressors. INTERPRETATION: This systematic review based on over 50,000 patients demonstrates that COVID-19 infection is associated with substantial resource use in the ICU, high mortality and prolonged length of ICU stay. FUNDING STATEMENT: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was performed with institutional departmental funding. DECLARATION OF INTERESTS: The authors state that they have no competing interest with the subject.