Early intubation and clinical outcomes in patients with severe COVID-19: a systematic review and meta-analysis

Table 2 GRADE summary of findings table of in-hospital mortality, ICU LOS, duration of mechanical ventilation, and hospital LOS

Outcomes	Anticipated absolute effects (95% CI)		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)
Outcomes	Risk with late intubation	Risk with early intubation	Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)
In-hospital mortality	528 per 1,000	480 per 1,000 (396 to 581)	RR 0.91 (0.75 to 1.10)	795 (8 observational studies)	⨁◯◯◯ Very low^a
In-hospital mortality	Parish, et al. [32] reported that early intubation was not significantly associated with differences in in-hospital mortality (hazard ratio 1.09, 95% CI 0.94 to 1.26, P = 0.26)			1,628 (1 observational study)	⨁◯◯◯ Very low^a
ICU length of stay	The mean ICU LOS was 0	MD 1.77 lower (4.61 lower to 1.07 higher)	-	978 (9 observational studies)	⨁◯◯◯ Very low^b,c
Duration of mechanical ventilation	The mean ventilator duration was 0	MD 0.03 lower (1.79 lower to 1.72 higher)	-	1,066 (9 observational studies)	⨁◯◯◯ Very low^b
Hospital length of stay	The mean hospital LOS was 0	MD 4.32 lower (7.2 lower to 1.44 lower)	-	738 (6 observational studies)	⨁◯◯◯ Very low^b

CI confidence interval, MD mean difference, RR relative risk, ICU intensive care unit, LOS length of stay
GRADE Working Group grades of evidence: High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect
^aDowngrade for risk of bias concern in the domains of target group selection and confounder
^bDowngrade for risk of bias concern in the domains of possibility of target group comparisons, target group selection, and confounder
^cLarge I² statistics

ISSN: 2047-783X