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Cardiol J . Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis

tetano

Editor, Senior Moderator
Cardiol J


. 2021;28(6):816-824.
doi: 10.5603/CJ.a2021.0168.
Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis


Karol Bielski[SUP] 1 2 [/SUP], Katarzyna Makowska[SUP] 3 [/SUP], Adam Makowski[SUP] 3 [/SUP], Tomasz Kopiec[SUP] 3 [/SUP], Aleksandra Gasecka[SUP] 3 [/SUP], Mariola Malecka[SUP] 4 [/SUP], Michal Pruc[SUP] 5 [/SUP], Zubaid Rafique[SUP] 6 [/SUP], Frank W Peacock[SUP] 6 [/SUP], Andrea Denegri[SUP] 7 [/SUP], Lukasz Szarpak[SUP] 8 9 [/SUP]



Affiliations

Abstract

Background: The main purposes of this meta-analysis are to update the information about the impact of coronavirus disease 2019 (COVID-19) pandemic on outcomes of in-hospital cardiac arrest (IHCA) and to investigate the impact of being infected by by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) on IHCA outcomes.
Methods: The current meta-analysis is an update and follows the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Results: In analyses, pre- and intra-COVID-19 periods were observed for: shockable rhythms in 17.6% vs. 16.2% (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 0.71-1.72; p = 0.65), return of spontaneous circulation (ROSC) in 47.4% vs. 44.0% (OR: 1.36; 95% CI: 0.90-2.07; p = 0.15), 30-day mortality in 59.8% vs. 60.9% (OR: 0.95; 95% CI: 0.75-1.22; p = 0.69) and overall mortality 75.8% vs. 74.7% (OR: 0.80; 95% CI: 0.49-1.28; p = 0.35), respectively. In analyses, SARS-CoV-2 positive and negative patients were observed for: shockable rhythms in 9.6% vs. 19.8% (OR: 0.51; 95% CI: 0.35-0.73; p < 0.001), ROSC in 33.9% vs. 52.1% (OR: 0.47; 95% CI: 0.30-0.73; p < 0.001), 30-day mortality in 77.2% vs. 59.7% (OR: 2.08; 95% CI: 1.28-3.38; p = 0.003) and overall mortality in 94.9% vs. 76.7% (OR: 3.20; 95% CI: 0.98-10.49; p = 0.05), respectively.
Conclusions: Despite ROSC, 30-day and overall mortality rate were not statistically different in pre- vs. intra-COVID-19 periods, a lower incidence of ROSC and higher 20-day mortality rate were observed in SARS-CoV-2 (+) compared to SARS-CoV-2 (-) patients.

Keywords: COVID-19; SARS-CoV-2; cardiopulmonary resuscitation; coronavirus disease 2019; in-hospital cardiac arrest; meta-analysis; outcome; pandemic.
 
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