Characteristics and Outcomes of In-Hospital Cardiac Arrest in COVID-19 A Systematic Review and Meta-Analysis

Authors

Lukasz Szarpak
Magdalena Borkowska
Frank W Peacock
Zubaid Rafique
Aleksandra Gasecka
Jacek Smereka
Katarzyna Pytkowska
Marta Jachowicz
Lukasz Iskrzycki
Natasza Gilis-Malinowska
Milosz J Jaguszewski

Publication Date

1-1-2021

Journal

Cardiology Journal

DOI

10.5603/CJ.a2021.0043

PMID

33942278

PMCID

PMC8277004

PubMedCentral® Posted Date

7-6-2021

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

COVID-19, Cardiopulmonary Resuscitation, Heart Arrest, Hospitals, Humans, Pandemics, Patient Discharge, Randomized Controlled Trials as Topic, Retrospective Studies

Abstract

BACKGROUND: The purpose herein, was to perform a systematic review of interventional outcome studies in patients with in-hospital cardiac arrest before and during the coronavirus disease 2019 (COVID-19) pandemic period.

METHODS: A meta-analysis was performed of publications meeting the following PICOS criteria: (1) participants, patients > 18 years of age with cardiac arrest due to any causes; (2) intervention, cardiac arrest in COVID-19 period; (3) comparison, cardiac arrest in pre-COVID-19 period; (4) outcomes, detailed information for survival; (5) study design, randomized controlled trials, quasi-randomized or observational studies comparing cardiac arrest in COVID-19 and pre-COVID-19 period for their effects in patients with cardiac arrest.

RESULTS: Survival to hospital discharge for the pre-pandemic and pandemic period was reported in 3 studies (n =1432 patients) and was similar in the pre-pandemic vs. the pandemic period, 35.6% vs. 32.1%, respectively (odds ratio [OR] 1.72; 95% confidence interval [CI] 0.81-3.65; p = 0.16; I2 = 72%). Return of spontaneous circulation was reported by all 4 studies and were also similar in the pre and during COVID-19 periods, 51.9% vs. 48.7% (OR 1.27; 95% CI 0.78-2.07; p = 0.33; I2 = 71%), respectively. Pooled analysis of cardiac arrest recurrence was also similar, 24.9% and 17.9% (OR 1.60; 95% CI 0.99-2.57; p = 0.06; I2 = 32%) in the pre and during COVID-19 cohorts. Survival with Cerebral Performance Category 1 or 2 was higher in pre vs. during pandemic groups (27.3 vs. 9.1%; OR 3.75; 95% CI 1.26-11.20; p = 0.02). Finally, overall mortality was similar in the pre vs. pandemic groups, 65.9% and 67.2%, respectively (OR 0.67; 95% CI 0.33-1.34; p = 0.25; I2 = 76%).

CONCLUSIONS: Compared to the pre-pandemic period, in hospital cardiac arrest in COVID-19 patients was numerically higher but had statistically similar outcomes.