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急性呼吸窘迫综合征与 COVID-19:系统评价和荟萃分析。

Acute Respiratory Distress Syndrome and COVID-19: A Scoping Review and Meta-analysis.

机构信息

Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.

出版信息

Adv Exp Med Biol. 2021;1321:211-228. doi: 10.1007/978-3-030-59261-5_18.

DOI:10.1007/978-3-030-59261-5_18
PMID:33656726
Abstract

Acute respiratory distress syndrome (ARDS) is a fatal complication of the new severe acute respiratory syndrome coronavirus (SARS-CoV-2), which causes COVID-19 disease. This scoping review was carried out with international, peer-reviewed research studies and gray literature published up to July 2020 in Persian and English languages. Using keywords derived from MESH, databases including Magiran, IranMedex, SID, Web of Sciences, PubMed, Embase via Ovid, Science Direct, and Google Scholar were searched. After screening titles and abstracts, the full texts of selected articles were evaluated, and those which passed the criteria were analyzed and synthesized with inductive thematic analysis. Study quality was also evaluated using a standard tool. The overall prevalence of ARDS was estimated using a random-effects model. This led to identification of 23 primary studies involving 2880 COVID-19 patients. All articles were observational with a cross-sectional, retrospective, case report, and cohort design with moderate to strong quality. The main findings showed that COVID-19-related ARDS has a high prevalence and is different to ARDS due to other etiologies. Elderly and patients with comorbidities and organ failure should be closely surveyed for respiratory organ indications for several weeks after the onset of respiratory symptoms. There is currently no definitive treatment for ARDS in COVID-19 disease, and supportive therapies and their effects are somewhat controversial.

摘要

急性呼吸窘迫综合征(ARDS)是新型严重急性呼吸综合征冠状病毒(SARS-CoV-2)的致命并发症,可引起 COVID-19 疾病。本范围综述纳入了截至 2020 年 7 月发表的国际同行评议的研究论文和灰色文献,使用源自 MESH 的关键词,检索了包括 Magiran、IranMedex、SID、Web of Sciences、PubMed、Embase via Ovid、Science Direct 和 Google Scholar 在内的数据库。经过筛选标题和摘要,评估了选定文章的全文,符合标准的文章采用归纳式主题分析进行分析和综合。还使用标准工具评估了研究质量。使用随机效应模型估计 ARDS 的总体患病率。这导致确定了 23 项涉及 2880 例 COVID-19 患者的主要研究。所有文章均为观察性研究,具有横断面、回顾性、病例报告和队列设计,质量从中等到较强。主要发现表明,COVID-19 相关 ARDS 的患病率较高,与其他病因引起的 ARDS 不同。老年患者和合并症以及器官衰竭患者应在呼吸道症状出现后数周内密切监测呼吸道器官的指征。目前 COVID-19 疾病中 ARDS 尚无明确的治疗方法,支持性治疗及其效果存在一定争议。

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