| Title:
|
Supportive Care for Patient with Respiratory Diseases: An Umbrella Review |
| Abstract:
|
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 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 COVID-19, SARS, 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 (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. |
| Published:
|
4/17/2020 |
| DOI:
|
10.1101/2020.04.13.20064360 |
| DOI_URL:
|
http://doi.org/10.1101/2020.04.13.20064360 |
| Author Name:
|
Luo, X |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/luo_x |
| Author Name:
|
Lv, M |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/lv_m |
| Author Name:
|
Wang, X |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/wang_x |
| Author Name:
|
Long, X |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/long_x |
| Author Name:
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Ren, M |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/ren_m |
| Author Name:
|
Zhang, X |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/zhang_x |
| Author Name:
|
Liu, Y |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/liu_y |
| Author Name:
|
Li, W |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/li_w |
| Author Name:
|
Zhou, Q |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/zhou_q |
| Author Name:
|
Ma, Y |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/ma_y |
| Author Name:
|
Fukuoka, T |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/fukuoka_t |
| Author Name:
|
Ahn, H S |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/ahn_h_s |
| Author Name:
|
Lee, M S |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/lee_m_s |
| Author Name:
|
Luo, Z |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/luo_z |
| Author Name:
|
Liu, E |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/liu_e |
| Author Name:
|
Chen, Y |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/chen_y |
| sha:
|
4f2aabf24cff753d3578d004f31e18bb788a7af6 |
| license:
|
medrxiv |
| source_x:
|
MedRxiv; WHO |
| source_x_url:
|
https://www.who.int/ |
| url:
|
http://medrxiv.org/cgi/content/short/2020.04.13.20064360v1?rss=1
https://doi.org/10.1101/2020.04.13.20064360 |
| has_full_text:
|
TRUE |
| Keywords Extracted from Text Content:
|
COVID-19
patients
patient
SinoMed
CBM
Wuhan seafood
medRxiv
P>0
SARS-CoV-2
medRxiv preprint Figure 2
Geneva
Wuhan,
Coronavirus
patients
M Lv
coronavirus disease 2019
CBM
coronavirus
lung tissue
COVID-19
preprint
COVID-19-patients
H1N1
PubMed
lungs
Wuhan coronavirus
5,12-28
VII
https://www.biorxiv.org/
cancer
https://doi.org/10.1101/2020.04
ECMO
patient
H1N1 patients
bioRxiv
medRxiv preprint |
| Extracted Text Content in Record:
|
First 5000 Characters: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 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 COVID-19, SARS, 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.
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.
The aim of supportive care is to prevent or treat the symptoms of a disease, side effects caused by treatment of a disease, and psychological and social problems related to a disease or its treatment as early as possible (1) . Supportive care can also be called comfort care, palliative care, or symptom management. Supportive care can improve the quality of life of patients who have a serious or life-threatening disease, such as cancer (2) . Besides, for patients with respiratory diseases, supportive care also is an important and effective part of the management (3) . A systematic review related to severe acute respiratory syndrome (SARS) treatment suggested that meticulous supportive care is the only form of treatment that can be recommended (4) . Another systematic review showed that continuous monitoring of vital signs outside the critical care setting is feasible and may provide a benefit in terms of improved patient outcomes and cost efficiency (5) . According to the World Health Organization (WHO) guidelines there is currently no treatment recommended for coronavirus infections except supportive care as needed (6) .
All rights reserved. No reuse allowed without permission.
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted April 17, 2020. . https://doi.org/10.1101/2020.04. 13.20064360 doi: medRxiv preprint In early 2020, a pneumonia caused by a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China, and rapidly spread to more than 100 countries around the world (7) . As of 12 April 2020, more than 1,690,000 cases and more than 100,000 deaths have been confirmed according to the WHO (8) . The disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID- 19) , has had been declared a global pandemic (9) However, there is so far no effective treatment or vaccine to curb the spread of the epidemic. Thus, we conducted this overview to identify the available and effective forms of supportive care for patients with respiratory diseases. We hope this review will help physicians working on COVID-19 to understand more about supportive care and make decisions on treatment selection for COVID-19.
We performed a systematic search of Medline via PubMed, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Data and CBM (China Biology Medicine disc ) from their inception to 31 March 2020 with the terms All rights reserved. No reuse allowed without permission.
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted April 17, 2020. . https://doi.org/10.1101/2020.04. 13.20064360 doi: medRxiv preprint ("COVID-19" OR "SARS-CoV-2" OR "2019 novel coronavirus" OR "2019-nCoV" OR "Wuhan coronavirus" OR "novel coronavirus" OR "Wuhan seafood market pneumonia virus" OR "MERS" OR "SARS" OR "Severe Acute Respiratory Syndrome" OR "Middle East Respiratory Syndrome Coronavirus" OR "Influenza") AND ("Meta-analysis" OR "Systematic Review" OR "rapid review") (The details of the search strategy can be found in the Supplementary Material 1). Search strategies for other databases are adapted from PubMed. In addition, we searched Google Scholar as well as reference lists of the identified articles, to find additional studies. Three preprint services, including medRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) and SSRN (https://www.ssrn.com/index.cfm/en/) were also searched to find relevant studies.
We included systematic reviews and meta-analyses related to supportive treatment for patient with respiratory diseases including COVID-19, SARS, MERS and influenza published in English and Chinese wi |
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