PLoS ONE (Jan 2022)

Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis.

  • Vincent Issac Lau,
  • Sumeet Dhanoa,
  • Harleen Cheema,
  • Kimberley Lewis,
  • Patrick Geeraert,
  • David Lu,
  • Benjamin Merrick,
  • Aaron Vander Leek,
  • Meghan Sebastianski,
  • Brittany Kula,
  • Dipayan Chaudhuri,
  • Arnav Agarwal,
  • Daniel J Niven,
  • Kirsten M Fiest,
  • Henry T Stelfox,
  • Danny J Zuege,
  • Oleksa G Rewa,
  • Sean M Bagshaw

DOI
https://doi.org/10.1371/journal.pone.0269871
Journal volume & issue
Vol. 17, no. 6
p. e0269871

Abstract

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BackgroundAs the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs.MethodsWe searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology.ResultsOf 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], pConclusionsThere was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care.Systematic review registrationPROSPERO CRD42020201256 (Sept 2, 2020).