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Meta-Analysis
. 2022 Jan 1;99(1):1-8.
doi: 10.1002/ccd.29525. Epub 2021 Feb 4.

Outcomes of in-hospital cardiac arrest in COVID-19 patients: A proportional prevalence meta-analysis

Tanveer Mir  1 , Yasar Sattar  2 , Javeed Ahmad  3 , Waqas Ullah  4 , Layla Shanah  1 , M Chadi Alraies  5 , Waqas T Qureshi  6
Affiliations
Meta-Analysis

Outcomes of in-hospital cardiac arrest in COVID-19 patients: A proportional prevalence meta-analysis

Tanveer Mir et al. Catheter Cardiovasc Interv. .

Abstract

Background: Limited epidemiological data are available on the outcomes of in-hospital cardiac arrest (CA) in COVID-19 patients.

Methods: We performed literature search of PubMed, EMBASE, Cochrane, and Ovid to identify research articles that studied outcomes of in-hospital cardiac arrest in COVID-19 patients. The primary outcome was survival at discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and types of cardiac arrest. Pooled percentages with a 95% confidence interval (CI) were calculated for the prevalence of outcomes.

Results: A total of 7,891 COVID patients were included in the study. There were 621 (pooled prevalence 8%, 95% CI 4-13%) cardiac arrest patients. There were 52 (pooled prevalence 3.0%; 95% CI 0.0-10.0%) patients that survived at the time of discharge. ROSC was achieved in 202 (pooled prevalence 39%;95% CI 21.0-59.0%) patients. Mean time to ROSC was 7.74 (95% CI 7.51-7.98) min. The commonest rhythm at the time of cardiac arrest was pulseless electrical activity (pooled prevalence 46%; 95% 13-80%), followed by asystole (pooled prevalence 40%; 95% CI 6-80%). Unstable ventricular arrhythmia occurred in a minority of patients (pooled prevalence 8%; 95% CI 4-13%).

Conclusion: This pooled analysis of studies showed that the survival post in-hospital cardiac arrest in COVID patients is dismal despite adequate ROSC obtained at the time of resuscitation. Nonshockable rhythm cardiac arrest is commoner suggesting a non-cardiac cause while cardiac related etiology is uncommon. Future studies are needed to improve the survival in these patients.

Keywords: COVID-19; in-hospital cardiac arrest; mortality; pulseless electrical activity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart for selection of studies
FIGURE 2
FIGURE 2
(a) Proportion admitted COVID patients who had in‐hospital arrest. (b) Proportion of COVID patients who had CRP after in‐hospital cardiac arrest
FIGURE 3
FIGURE 3
(a) Pooled prevalence for PEA with 95%CI, rhythm at the time of cardiac arrest. (b) Pooled prevalence for Asystole with 95%CI, rhythm at the time of cardiac arrest. (c) Pooled prevalence for VT/VF with 95%CI, rhythm at the time of cardiac arrest
FIGURE 4
FIGURE 4
(a) Pooled prevalence for ROSC with 95%CI among patients who had CPR. (b) Pooled prevalence for mean time to ROSC after in‐hospital cardiac arrest after CPR
FIGURE 5
FIGURE 5
(a) Pooled prevalence for survival at discharge with rhythm at the time of cardiac arrest. 95%CI. (b) Pooled prevalence for overall mortality for patients admitted with COVID with 95% CI
See this image and copyright information in PMC

Comment in

  • Coding the COVID patient: Is it futile?
    Gorder K, Henry TD. Gorder K, et al. Catheter Cardiovasc Interv. 2022 Jan 1;99(1):9-10. doi: 10.1002/ccd.30035. Catheter Cardiovasc Interv. 2022. PMID: 34994512 Free PMC article.

References

    1. Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1091. - PMC - PubMed
    1. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person‐to‐person transmission: a study of a family cluster. Lancet. 2020;395:514‐523. - PMC - PubMed
    1. Koester RJ. Review of search and rescue response guidelines to COVID‐19. ISSN 2230–5734 Journal of SAR Com. 2020;4:214.
    1. Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID‐19: From the Emergency Cardiovascular Care Committee and Get With the Guidelines‐Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, The Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists: supporting organizations: American Association of Critical Care Nurses and National EMS Physicians. Circulation. 2020;141(25):e933‐e943. - PMC - PubMed
    1. Abella BS, Alvarado JP, Myklebust H, et al. Quality of cardiopulmonary resuscitation during in‐hospital cardiac arrest. JAMA. 2005;293:305‐310. - PubMed

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