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.
Keywords: SARS-CoV-2; cardiopulmonary resuscitation; coronavirus disease 2019; in-hospital cardiac arrest; outcome; pandemic.
【저자키워드】 SARS-CoV-2, Coronavirus disease 2019, pandemic, outcome, Cardiopulmonary resuscitation, in-hospital cardiac arrest, 【초록키워드】 COVID-19, coronavirus disease, Meta-analysis, Coronavirus disease 2019, coronavirus, pandemic, Randomized controlled trials, hospital, Cardiopulmonary, systematic review, Intervention, observational studies, observational study, Cardiac arrest, Cardiopulmonary resuscitation, outcomes, controlled trials, Patient, Study design, age, circulation, group, information, performance, patients, Analysis, cerebral, Odds ratio, COVID-19 patient, In-hospital, Participants, 95% CI, 95% confidence interval, overall mortality, return, hospital discharge, cohorts, Effect, reported, was performed, groups, statistically, PICOS, 【제목키워드】 COVID-19, Cardiac arrest, In-hospital,