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Meta-Analysis
. 2021;28(6):816-824.
doi: 10.5603/CJ.a2021.0168.

Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis

Karol Bielski  1   2 , Katarzyna Makowska  3 , Adam Makowski  3 , Tomasz Kopiec  3 , Aleksandra Gasecka  3 , Mariola Malecka  4 , Michal Pruc  5 , Zubaid Rafique  6 , Frank W Peacock  6 , Andrea Denegri  7 , Lukasz Szarpak  8   9
Affiliations
Meta-Analysis

Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis

Karol Bielski et al. Cardiol J. 2021.

Abstract

Background: The main purposes of this meta-analysis are to update the information about the impact of coronavirus disease 2019 (COVID-19) pandemic on outcomes of in-hospital cardiac arrest (IHCA) and to investigate the impact of being infected by by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) on IHCA outcomes.

Methods: The current meta-analysis is an update and follows the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results: In analyses, pre- and intra-COVID-19 periods were observed for: shockable rhythms in 17.6% vs. 16.2% (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 0.71-1.72; p = 0.65), return of spontaneous circulation (ROSC) in 47.4% vs. 44.0% (OR: 1.36; 95% CI: 0.90-2.07; p = 0.15), 30-day mortality in 59.8% vs. 60.9% (OR: 0.95; 95% CI: 0.75-1.22; p = 0.69) and overall mortality 75.8% vs. 74.7% (OR: 0.80; 95% CI: 0.49-1.28; p = 0.35), respectively. In analyses, SARS-CoV-2 positive and negative patients were observed for: shockable rhythms in 9.6% vs. 19.8% (OR: 0.51; 95% CI: 0.35-0.73; p < 0.001), ROSC in 33.9% vs. 52.1% (OR: 0.47; 95% CI: 0.30-0.73; p < 0.001), 30-day mortality in 77.2% vs. 59.7% (OR: 2.08; 95% CI: 1.28-3.38; p = 0.003) and overall mortality in 94.9% vs. 76.7% (OR: 3.20; 95% CI: 0.98-10.49; p = 0.05), respectively.

Conclusions: Despite ROSC, 30-day and overall mortality rate were not statistically different in pre- vs. intra-COVID-19 periods, a lower incidence of ROSC and higher 20-day mortality rate were observed in SARS-CoV-2 (+) compared to SARS-CoV-2 (-) patients.

Keywords: COVID-19; SARS-CoV-2; cardiopulmonary resuscitation; coronavirus disease 2019; in-hospital cardiac arrest; meta-analysis; outcome; pandemic.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Flow diagram showing stages of the database search and study selection as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines; RCT — randomized controlled trials.
Figure 2
Figure 2
A summary table of review authors’ judgements for each risk of bias item for each study. Domains: D1 — bias due to confounding; D2 — bias due to selection of participants; D3 — bias in classification of interventions; D4 — bias due to deviations from intended interventions; D5 — bias due to missing data; D6 — bias in measurement of ourcomes; D7 — bias in selection of the reported result; Judgement: formula image Serious; formula image Moderate; formula image Low; formula image No information.
Figure 3
Figure 3
A plot of the distribution of review authors’ judgements across randomized studies for each risk of bias item.
See this image and copyright information in PMC

Comment in

  • Influence of COVID-19 on cardiac arrest outcomes.
    Zakordonets L, Stepanovskyy Y, Navolokina A. Zakordonets L, et al. Cardiol J. 2023;30(1):163-164. doi: 10.5603/CJ.a2022.0114. Epub 2022 Nov 24. Cardiol J. 2023. PMID: 36420628 Free PMC article. No abstract available.

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