open access

Ahead of print
Original Article
Published online: 2021-04-23
Get Citation

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

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
DOI: 10.5603/CJ.a2021.0043
·
Pubmed: 33942278

open access

Ahead of print
Original articles
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: SHD 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: SHD 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.

Get Citation

Keywords

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

Supp./Additional Files (1)
Supplementary Digital File
Download
698KB
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

Ahead of print

Article type

Original Article

Published online

2021-04-23

DOI

10.5603/CJ.a2021.0043

Pubmed

33942278

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

References (22)
  1. Rodriguez-Morales AJ, Bonilla-Aldana DK, Balbin-Ramon GJ, et al. History is repeating itself: probable zoonotic spillover as the cause of the 2019 novel coronavirus epidemic. Infez Med. 2020; 28(1): 3–5.
  2. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20(5): 533–534.
  3. Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(24): 759–765.
  4. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475–481.
  5. Ayaz A, Arshad A, Malik H, et al. Risk factors for intensive care unit admission and mortality in hospitalized COVID-19 patients. Acute Crit Care. 2020; 35(4): 249–254.
  6. Armstrong RA, Kane AD, Kursumovic E, et al. Mortality in patients admitted to intensive care with COVID-19: an updated systematic review and meta-analysis of observational studies. Anaesthesia. 2021; 76(4): 537–548.
  7. Shao F, Xu S, Ma X, et al. In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China. Resuscitation. 2020; 151: 18–23.
  8. Moher D, Liberati A, Tetzlaff J, et al. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009; 6(7): e1000097.
  9. Sterne JAc, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355: i4919.
  10. McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021; 12(1): 55–61.
  11. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005; 5: 13.
  12. Miles JA, Mejia M, Rios S, et al. Characteristics and outcomes of in-hospital cardiac arrest events during the COVID-19 pandemic: a single-center experience from a new york city public hospital. Circ Cardiovasc Qual Outcomes. 2020; 13(11): e007303.
  13. Roedl K, Söffker G, Fischer D, et al. Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome - a retrospective cohort study. Scand J Trauma Resusc Emerg Med. 2021; 29(1): 30.
  14. Sultanian P, Lundgren P, Strömsöe A, et al. Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the swedish registry for cardiopulmonary resuscitation. Eur Heart J. 2021; 42(11): 1094–1106.
  15. Yuriditsky E, Mitchell OJL, Brosnahan SB, et al. Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19. Resusc Plus. 2020; 4: 100054.
  16. Perman SM, Stanton E, Soar J, et al. American Heart Association's Get With the Guidelines®—Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) Investigators. Location of In-Hospital Cardiac Arrest in the United States-Variability in Event Rate and Outcomes. J Am Heart Assoc. 2016; 5(10): e003638.
  17. Wampler DA, Collett L, Manifold CA, et al. Cardiac arrest survival is rare without prehospital return of spontaneous circulation. Prehosp Emerg Care. 2012; 16(4): 451–455.
  18. Sheth V, Chishti I, Rothman A, et al. Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City. Resuscitation. 2020; 155: 3–5.
  19. Moskowitz A, Holmberg MJ, Donnino MW, et al. In-hospital cardiac arrest: are we overlooking a key distinction? Curr Opin Crit Care. 2018; 24(3): 151–157.
  20. Cummins RO, Chamberlain DA, Abramson NS, et al. Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Circulation. 1991; 84(2): 960–975.
  21. Dzieciatkowski T, Szarpak L, Filipiak KJ, et al. COVID-19 challenge for modern medicine. Cardiol J. 2020; 27(2): 175–183.
  22. Smereka J, Szarpak L, Gadalla F, et al. Ethical and organizational dilemmas related to the treatment of COVID-19 patients. Disaster Emerg Med J. 2020.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl