Uncovering the effects of COVID-19 on in-hospital cardiac arrest – a living systematic review and meta-analysis

Abstract

Introduction and Objective.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic and had a negative impact on the entire health care system. To understand the effect of COVID-19 on outcomes of in-hospital cardiac arrest (IHCA), a systematic review and meta-analysis of studies was designed to compare the pre-and intra-pandemic periods of adult patients who suffered cardiac arrest, and additionally by performing a sub-analysis related to COVID-19 positive vs. negative patients in the same group of patients. Materials and method. To evaluate the impact of COVID-19 on IHCA outcomes a systematic review and meta-analysis was performed. Pubmed (MEDLINE), Scopus, Embase, Web of Science, and Cochrane database were searched for articles published from 1 January 2020 -8 April 2023. Results. Return of spontaneous circulation events among IHCA patients in pre-COVID-19 and COVID-19 pandemic periods varied and amounted to 64.0% vs. 60.0%, respectively (OR=1.23; 95%CI: 1.19 to 1.26; p<0.001). Re-arrest occurrence was 4.5% vs. 4.9%, respectively (OR=1.24; 95%CI: 1.00 to 1.53; p=0.05). Survival to hospital discharge (SHD) was 25.1% compared to 20.9% for COVID-19 period (OR = 1.17; 95%CI: 0.96 to 1.41; p=0.12). During the COVID-19 period, SHD in COVID-19 positive patients was 14.0% compared to 25.9% for patients without 95%CI: 0.28 to 1.86; p=0.50). 30-day survival rate among COVID-19 positive vs. negative patients was 62.6% vs. 58.3%, respectively (OR =0.99; 95%CI: 0.23 to 4.24; p=0.99). Conclusions. Patients with SARS-CoV-2 infection had reduced rates of ROSC and SDH, as well as poorer neurologic outcomes and increased in hospital re-arrests during the COVID-19 period. However, the 30-day survival rate was similar in SARS-CoV-2 positive and negative patients.

The impact of the COVID-19 pandemic on airway management with supraglottic airway devices among out-of-hospital cardiac arrests: a systematic review and meta-analysis

“…The COVID-19 pandemic leads to deaths and has significant effects on other health indicators, particularly in emergencies. Overburdened healthcare systems have had an impact on out-of-hospital cardiac arrest (OHCA) [4,5]. There has been an increase in OHCA in recent years, which is believed to be linked to COVID-19-related illnesses, patients' difficulty getting preventive or general medical treatment, and their unwillingness to seek care due to the risk of COVID-19 transmission in hospitals [6,7].…”