tetano
Editor, Senior Moderator
Ann Transl Med
. 2020 May;8(10):621.
doi: 10.21037/atm-20-3298.
Supportive Care for Patient With Respiratory Diseases: An Umbrella Review
Xufei Luo[SUP] 1 2 [/SUP], Meng Lv[SUP] 1 2 [/SUP], Xiaoqing Wang[SUP] 3 4 5 [/SUP], Xin Long[SUP] 3 4 5 [/SUP], Mengjuan Ren[SUP] 1 [/SUP], Xianzhuo Zhang[SUP] 6 [/SUP], Yunlan Liu[SUP] 1 [/SUP], Weiguo Li[SUP] 3 4 5 [/SUP], Qi Zhou[SUP] 6 [/SUP], Yanfang Ma[SUP] 2 [/SUP], Toshio Fukuoka[SUP] 7 8 [/SUP], Hyeong Sik Ahn[SUP] 9 10 [/SUP], Myeong Soo Lee[SUP] 11 12 [/SUP], Zhengxiu Luo[SUP] 3 4 5 [/SUP], Enmei Liu[SUP] 3 4 5 [/SUP], Xiaohui Wang[SUP] 1 [/SUP], Yaolong Chen[SUP] 1 2 13 14 15 [/SUP], COVID-19 Evidence and Recommendations Working Group
Affiliations
Abstract
Background: Supportive treatment is an important and effective part of the management for patients with life-threatening diseases. This study aims to identify and evaluate the forms of supportive care for patients with respiratory diseases.
Methods: An umbrella review of supportive care for patient with respiratory diseases was undertaken. We comprehensively searched the following databases: Medline, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Data and CBM (SinoMed) from their inception to 31 March 2020, and other sources to identify systematic reviews and meta-analyses related to supportive treatments for patient with respiratory diseases including Coronavirus Disease 2019 (COVID-19), severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. We assessed the methodological quality using the AMSTAR score and the quality of the evidence for the primary outcomes of each included systematic review and meta-analysis.
Results: We included 18 systematic reviews and meta-analyses in this study. Most studies focused on the respiratory and circulatory support. Ten studies were of high methodological quality, five studies of medium quality, and three studies of low quality. According to four studies extracorporeal membrane oxygenation did not reduce mortality in adults [odds ratio/relative risk (OR/RR) ranging from 0.71 to 1.28], but two studies reported significantly lower mortality in patients receiving venovenous extracorporeal membrane oxygenation than in the control group (OR/RR ranging from 0.38 to 0.73). Besides, monitoring of vital signs and increasing the number of medical staff may also reduce the mortality in patients with respiratory diseases.
Conclusions: Our overview suggests that supportive care may reduce the mortality of patients with respiratory diseases to some extent. However, the quality of evidence for the primary outcomes in the included studies was low to moderate. Further systematic reviews and meta-analyses are needed to address the evidence gap regarding the supportive care for SARS, MERS and COVID-19.
Keywords: Coronavirus Disease 2019 (COVID-19); influenza; severe acute respiratory syndrome (SARS); supportive care; umbrella review.
. 2020 May;8(10):621.
doi: 10.21037/atm-20-3298.
Supportive Care for Patient With Respiratory Diseases: An Umbrella Review
Xufei Luo[SUP] 1 2 [/SUP], Meng Lv[SUP] 1 2 [/SUP], Xiaoqing Wang[SUP] 3 4 5 [/SUP], Xin Long[SUP] 3 4 5 [/SUP], Mengjuan Ren[SUP] 1 [/SUP], Xianzhuo Zhang[SUP] 6 [/SUP], Yunlan Liu[SUP] 1 [/SUP], Weiguo Li[SUP] 3 4 5 [/SUP], Qi Zhou[SUP] 6 [/SUP], Yanfang Ma[SUP] 2 [/SUP], Toshio Fukuoka[SUP] 7 8 [/SUP], Hyeong Sik Ahn[SUP] 9 10 [/SUP], Myeong Soo Lee[SUP] 11 12 [/SUP], Zhengxiu Luo[SUP] 3 4 5 [/SUP], Enmei Liu[SUP] 3 4 5 [/SUP], Xiaohui Wang[SUP] 1 [/SUP], Yaolong Chen[SUP] 1 2 13 14 15 [/SUP], COVID-19 Evidence and Recommendations Working Group
Affiliations
- PMID: 32566558
- PMCID: PMC7290632
- DOI: 10.21037/atm-20-3298
Abstract
Background: Supportive treatment is an important and effective part of the management for patients with life-threatening diseases. This study aims to identify and evaluate the forms of supportive care for patients with respiratory diseases.
Methods: An umbrella review of supportive care for patient with respiratory diseases was undertaken. We comprehensively searched the following databases: Medline, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Data and CBM (SinoMed) from their inception to 31 March 2020, and other sources to identify systematic reviews and meta-analyses related to supportive treatments for patient with respiratory diseases including Coronavirus Disease 2019 (COVID-19), severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. We assessed the methodological quality using the AMSTAR score and the quality of the evidence for the primary outcomes of each included systematic review and meta-analysis.
Results: We included 18 systematic reviews and meta-analyses in this study. Most studies focused on the respiratory and circulatory support. Ten studies were of high methodological quality, five studies of medium quality, and three studies of low quality. According to four studies extracorporeal membrane oxygenation did not reduce mortality in adults [odds ratio/relative risk (OR/RR) ranging from 0.71 to 1.28], but two studies reported significantly lower mortality in patients receiving venovenous extracorporeal membrane oxygenation than in the control group (OR/RR ranging from 0.38 to 0.73). Besides, monitoring of vital signs and increasing the number of medical staff may also reduce the mortality in patients with respiratory diseases.
Conclusions: Our overview suggests that supportive care may reduce the mortality of patients with respiratory diseases to some extent. However, the quality of evidence for the primary outcomes in the included studies was low to moderate. Further systematic reviews and meta-analyses are needed to address the evidence gap regarding the supportive care for SARS, MERS and COVID-19.
Keywords: Coronavirus Disease 2019 (COVID-19); influenza; severe acute respiratory syndrome (SARS); supportive care; umbrella review.