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重症监护病房出院后流行病毒肺炎幸存者的长期结局:系统评价。

Long-term outcomes for epidemic viral pneumonia survivors after discharge from the intensive care unit: a systematic review.

机构信息

Clínica Florence, Salvador, BA, Brazil.

Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.

出版信息

Einstein (Sao Paulo). 2024 Feb;22(spe1):eRW0352. doi: 10.31744/einstein_journal/2024RW0352.

Abstract

OBJECTIVE

To review the long-term outcomes (functional status and psychological sequelae) of survivors of critical illnesses due to epidemic viral pneumonia before the COVID-19 pandemic and to establish a benchmark for comparison of the COVID-19 long-term outcomes.

METHODS

This systematic review of clinical studies reported the long-term outcomes in adults admitted to intensive care units who were diagnosed with viral epidemic pneumonia. An electronic search was performed using databases: MEDLINE®, Web of Science™, LILACS/IBECS, and EMBASE. Additionally, complementary searches were conducted on the reference lists of eligible studies. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The results were grouped into tables and textual descriptions.

RESULTS

The final analysis included 15 studies from a total of 243 studies. This review included 771 patients with Influenza A, Middle East Respiratory Syndrome, and Severe Acute Respiratory Syndrome. It analyzed the quality of life, functionality, lung function, mortality, rate of return to work, rehospitalization, and psychiatric symptoms. The follow-up periods ranged from 1 to 144 months. We found that the quality of life, functional capacity, and pulmonary function were below expected standards.

CONCLUSION

This review revealed great heterogeneity between studies attributed to different scales, follow-up time points, and methodologies. However, this systematic review identified negative long-term effects on patient outcomes. Given the possibility of future pandemics, it is essential to identify the long-term effects of viral pneumonia outbreaks. This review was not funded. Prospero database registration: (www.crd.york.ac.uk/prospero) under registration ID CRD42021190296.

摘要

目的

回顾 COVID-19 大流行前流行病毒性肺炎危重病幸存者的长期结局(功能状态和心理后遗症),并为 COVID-19 长期结局建立一个比较基准。

方法

本系统评价对因病毒性流行肺炎而入住重症监护病房的成年人的临床研究报告了长期结局。使用 MEDLINE®、Web of Science™、LILACS/IBECS 和 EMBASE 数据库进行电子搜索。此外,还对合格研究的参考文献进行了补充搜索。使用纽卡斯尔-渥太华量表评估研究质量。结果以表格和文字描述的形式进行分组。

结果

最终分析包括从总共 243 项研究中筛选出的 15 项研究。该综述纳入了 771 例甲型流感、中东呼吸综合征和严重急性呼吸综合征患者。分析了生活质量、功能、肺功能、死亡率、恢复工作率、再住院率和精神症状。随访时间从 1 到 144 个月不等。我们发现,生活质量、功能能力和肺功能均低于预期标准。

结论

本综述揭示了研究之间存在很大的异质性,这归因于不同的量表、随访时间点和方法学。然而,本系统评价确定了病毒性肺炎暴发对患者结局的长期负面影响。鉴于未来可能发生大流行,有必要确定病毒肺炎爆发的长期影响。本综述没有得到资助。Prospéro 数据库注册:(www.crd.york.ac.uk/prospero),注册 ID CRD42021190296。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c7e/11730323/e0b304dd4de9/2317-6385-eins-22-spe1-eRW0352-gf01.jpg

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