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Prevalence and Risk Factors of Intensive Care Unit-acquired Weakness in Patients With COVID-19: A Systematic Review
Ya-Chi Chuang1, Sz-Iuan Shiu2,3,4, Yu-Chun Lee1,5,6
1Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Journal of Intensive Care Medicine
|August 14, 2024
Summary
Intensive care unit acquired weakness (ICUAW) affects 55% of COVID-19 patients, with older age and hypertension as key risk factors. Early identification and intervention are crucial for improving patient outcomes and recovery from critical illness.
Area of Science:
- Critical Care Medicine
- Neurology
- Infectious Diseases
Background:
- Intensive care unit acquired weakness (ICUAW) is a significant neuromuscular complication in critically ill patients.
- Limited data exists on the prevalence and risk factors of ICUAW specifically within the COVID-19 patient population.
Purpose of the Study:
- To determine the pooled prevalence of ICUAW in COVID-19 patients.
- To identify significant risk factors associated with the development of ICUAW in this population.
Main Methods:
- A systematic literature search was conducted across multiple databases (PubMed, Embase, Cochrane Library, Web of Science, PEDro, EBSCOhost/CINAHL) up to January 31, 2024.
- Meta-analysis using the Freeman-Tukey double-arcsine transformation for prevalence and odds ratios for risk factors.
Main Results:
- The pooled prevalence of ICUAW among 868 COVID-19 patients across eight studies was 55%.
- Identified risk factors included older age, pre-existing hypertension, prone positioning, neuromuscular blocking agent (NMBA) use, tracheostomy, and renal replacement therapy (RRT).
Conclusions:
- ICUAW presents a high prevalence in COVID-19 patients.
- Older age, hypertension, prone positioning, NMBA use, tracheostomy, and RRT are significant risk factors.
- Interdisciplinary teams should focus on high-risk patients for prevention and early treatment strategies.
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