Vol 29, No 5 (2022)
Letter to the Editor
Published online: 2022-07-29

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Cardiac arrest outcomes in the COVID-19 era

Sina Salajegheh Tazerji12, Alla Navolokina3, Eryka Karbowska4, Fatemeh Shahabinejad5
Pubmed: 35912713
Cardiol J 2022;29(5):886-887.


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Cardiology Journal

2022, Vol. 29, No. 5, 886–887

DOI: 10.5603/CJ.a2022.0070

Copyright © 2022 Via Medica

ISSN 1897–5593

eISSN 1898018X

Cardiac arrest outcomes in the COVID-19 era

Sina Salajegheh Tazerji12Alla Navolokina3Eryka Karbowska4Fatemeh Shahabinejad5
1Department of Clinical Science, Faculty of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
2Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Teheran, Iran
3Department of Public Health and Social Medicine, International European University, Kyiv, Ukraine
4Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
5Kerman Medical University, Kerman, Iran

Address for correspondence: Dr. Sina Salajegheh Tazerji, Department of Clinical Science, Faculty of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran; Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Teheran, Iran, tel: +98 9356923189, e-mail: sina.salajegheh@gmail.com; sina.salajegheh@srbiau.ac.ir

Received: 28.06.2022 Accepted: 26.07.2022 Early publication date: 29.07.2022

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes coronavirus disease 2019 (COVID-19) has constituted a major challenge over the past 2 years and will continue to be challenging for healthcare professionals into the future [1, 2]. The SARS-CoV-2, as indicated by numerous scientific publications, causes havoc not only in the respiratory system, but also in the cardiovascular system. SARS-CoV-2 has an affinity for heart muscle cells; therefore, it also poses a risk of developing cardiological complications, including myocardial infarction, arrhythmias and heart failure. In addition, due to the damage to blood vessels and affects to blood clotting disorders, the risk of thromboembolic complications also increases [3]. Undoubtedly, however, the greatest risk is the risk of cardiac arrest.

It is true that the survival of patients in cardiac arrest are influenced by many factors, including factors related to the presence of comorbidities, the time from cardiac arrest to the initiation of resuscitation, and the quality of resuscitation. For both out-of-hospital cardiac arrest and in-hospital cardiac arrest, healthcare professionals should treat each patient as potentially infectious until COVID-19 has been ruled out and cardiopulmonary resuscitation (CRP) should therefore be performed wearing personal protective equipment for aerosol generating procedures [4]. In out-hospital cardiac arrest (OHCA) cases, due to the need to prepare medical personnel, including wearing personal protective equipment-aerosol generating procedure (PPE-AGP), the travel time to the patient is extended so his chances of survival decrease with each minute of not taking CRP [5]. On the other hand, the mere performance of medical procedures, including chest compression, or securing the airways by medical personnel wearing PPE-AGP, may reduce the effectiveness of individual medical procedures [6].

SARS-CoV-2 itself, as shown by numerous studies, also adversely affects the prognosis of patients with cardiac arrest. In a meta-analysis by Bielski et al. [7] regarding OHCA survival before and during the COVID-19 pandemic, the authors showed that the survival to hospital discharge was 11.5% and 8.2%, respectively, before the pandemic and during the pandemic. Bielski et al. [7] also showed a significant impact of COVID-19 on the 30-day survival rate in this group of patients, where during the COVID-19 pandemic this survival rate was 2.8% lower than in the corresponding period before the pandemic. In turn, Borkowska et al. [8] analyzing the departure of the ambulance service in the first months of the COVID-19 pandemic to patients with OHCA, indicates a very low percentage of return of spontaneous circulation, amounting to only 9.4%. In turn, Szarpak et al. [9] in the meta-analysis on in-hospital cardiac arrest, patients indicate a slightly higher survival of patients in the period preceding the pandemic than during COVID-19 (35.6% vs. 32.1%, respectively; p = 0.16).

In conclusion, when using PPE-AGP, medical personnel during CPR should use devices that will increase the effectiveness of resuscitation. Thus, in terms of airway management supraglottic ventilation devices or video laryngoscopes and mechanical chest compression systems should be used for chest compression [10].

Conflict of interest: None declared


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