Effect of the COVID-19 pandemic on cardiac arrest resuscitation practices and outcomes in non-COVID-19 patients

Abstract

The effect of changes to cardiopulmonary resuscitation (CPR) procedures in response to Coronavirus disease 2019 (COVID-19) on in-hospital cardiac arrest (IHCA) management and outcomes are unreported. In this multicenter retrospective study, we showed that median time to arrival of resuscitation team has increased and proportion of patients receiving first-responder CPR has lowered during this pandemic. IHCA during the pandemic was independently associated with lower return of spontaneous circulation OR 0.63 (95% CI 0.43–0.91), despite adjustment for lowered patient comorbidity and increased time to resuscitation team arrival. Changes to resuscitation practice in this pandemic had effects on IHCA outcomes, even in patients without COVID-19.

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

“…Five studies reported IHCA outcomes in prevs. intra-COVID-19 periods [ 32 , 34 – 37 ] and 3 in COVID-19 period, dividing participants as SARS-CoV-2 positive vs. negative patients [ 33 , 36 , 38 ]. Each study was then screened for risk of bias and methodological quality using the Cochrane Collaboration tool for assessing the risk of bias ( Figs.…”

“…An interesting result comes from Tong et al [ 37 ], which states that even after regulating for decreased comorbidity and elevated time to resuscitation team arrival, under the pandemic circumstances, ROSC in IHCA was hugely affected and its rate was considerably lower. It is worth mentioning is that even patients who were not directly suffering from SARS-CoV-2 infection were also affected by the new resuscitation practice that was implemented in IHCA cases.…”

“…Firstly, there is the small number of studies included in the meta-analysis, however, compared to the author’s previous study, the number of patients included in the analysis was increased from 1,609 to 3,049 IHCA patients. The second limitation is the fact that in 4 studies, the authors truthfully point to IHCA data during the COVID-19 period, but do not classify these patients as SARS-CoV-2 positive and negative patients [ 32 , 34 , 35 , 37 ].…”

“…Finally, 7 studies published from 2020 to 2021 including 3,049 IHCA patients were included in this meta-analysis (Fig. 1) [32][33][34][35][36][37][38]. Detailed characteristics of the studies included in the meta-analysis are presented in Table 1.…”

“…Five studies reported IHCA outcomes in prevs. intra-COVID-19 periods [32,[34][35][36][37]] and 3 in COVID-19 period, dividing participants as SARS-CoV-2 positive vs. negative patients [33,36,38].…”