Long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS) outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis
DOI:
https://doi.org/10.2340/16501977-2694Keywords:
coronavirus infection, follow-up, follow-up studies, COVID-19, prevalence, lung function, exercise tolerance, post-traumatic stress disorder, depression, anxiety, fatigue, quality of life, SARS, MERS, ARDS.Abstract
Objective: To determine long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections after hospitalization or intensive care unit admission. Data sources: Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO were searched. Study selection: Original studies reporting clinical outcomes of adult SARS and MERS survivors 3 months after admission or 2 months after discharge were included. Data extraction: Studies were graded using the Oxford Centre for Evidence-Based Medicine 2009 Level of Evidence Tool. Meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to 6 months after hospital discharge, and beyond 6 months after discharge. Data synthesis: Of 1,169 identified studies, 28 were included in the analysis. Pooled analysis revealed that common complications up to 6 months after discharge were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15?45%); and reduced exercise capacity (mean 6-min walking distance 461 m, CI 450?473 m). The prevalences of post-traumatic stress disorder (39%, 95% CI 31?47%), depression (33%, 95% CI 20?50%) and anxiety (30%, 95% CI 10?61) beyond 6 months after discharge were considerable. Low scores on Short-Form 36 were identified beyond 6 months after discharge. Conclusion: Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Clinicians should anticipate and investigate similar long-term outcomes in COVID-19 survivors.Downloads
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Copyright (c) 2020 Hassaan Ahmed, Kajal Patel, Darren C. Greenwood, Stephen Halpin, Penny Lewthwaite, Abayomi Salawu, Lorna Eyre, Andrew Breen, Rory OConnor, Anthony Jones, Manoj Sivan
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