open access

Vol 28, No 4 (2021)
Original Article
Submitted: 2021-04-13
Accepted: 2021-04-18
Published online: 2021-04-23
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Characteristics and outcomes of in-hospital cardiac arrest in COVID-19. A systematic review and meta-analysis

Lukasz Szarpak12, Magdalena Borkowska2, Frank W. Peacock3, Zubaid Rafique3, Aleksandra Gasecka45, Jacek Smereka67, Katarzyna Pytkowska1, Marta Jachowicz8, Lukasz Iskrzycki67, Natasza Gilis-Malinowska9, Milosz J. Jaguszewski9
DOI: 10.5603/CJ.a2021.0043
·
Pubmed: 33942278
·
Cardiol J 2021;28(4):503-508.
Affiliations
  1. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  2. Maria Sklodowska-Curie Białystok Oncology Center, Bialystok, Poland
  3. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, United States
  4. 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
  5. Department of Cardiology, University Medical Center Utrecht, The Netherlands
  6. Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
  7. Polish Society of Disaster Medicine, Warsaw, Poland
  8. Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  9. 1st Department of Cardiology, Medical University of Gdansk, Poland

open access

Vol 28, No 4 (2021)
Original articles — COVID-19
Submitted: 2021-04-13
Accepted: 2021-04-18
Published online: 2021-04-23

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.

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.

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Keywords

coronavirus disease 2019, SARS-CoV-2, pandemic, in-hospital cardiac arrest, cardiopulmonary resuscitation, outcome

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About this article
Title

Characteristics and outcomes of in-hospital cardiac arrest in COVID-19. A systematic review and meta-analysis

Journal

Cardiology Journal

Issue

Vol 28, No 4 (2021)

Article type

Original Article

Pages

503-508

Published online

2021-04-23

Page views

1222

Article views/downloads

900

DOI

10.5603/CJ.a2021.0043

Pubmed

33942278

Bibliographic record

Cardiol J 2021;28(4):503-508.

Keywords

coronavirus disease 2019
SARS-CoV-2
pandemic
in-hospital cardiac arrest
cardiopulmonary resuscitation
outcome

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

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