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Review
. 2023 Apr 10;12(8):2796.
doi: 10.3390/jcm12082796.

Outcome of In-Hospital Cardiac Arrest among Patients with COVID-19: A Systematic Review and Meta-Analysis

Dhan Bahadur Shrestha  1 , Yub Raj Sedhai  2 , Sagun Dawadi  3 , Bishal Dhakal  3 , Jurgen Shtembari  1 , Karan Singh  2 , Roshan Acharya  4 , Soney Basnyat  5 , Irfan Waheed  2 , Mohammad Saud Khan  6 , Mohammed Kazimuddin  6 , Nimesh K Patel  7 , Gautham Kalahasty  7 , Prashant Dattatraya Bhave  8 , Patrick Whalen  8 , Ghanshyam Shantha  8
Affiliations
Review

Outcome of In-Hospital Cardiac Arrest among Patients with COVID-19: A Systematic Review and Meta-Analysis

Dhan Bahadur Shrestha et al. J Clin Med. .

Abstract

Background: Outcomes following in-hospital cardiac arrest (IHCA) in patients with COVID-19 have been reported by several small single-institutional studies; however, there are no large studies contrasting COVID-19 IHCA with non-COVID-19 IHCA. The objective of this study was to compare the outcomes following IHCA between COVID-19 and non-COVID-19 patients.

Methods: We searched databases using predefined search terms and appropriate Boolean operators. All the relevant articles published till August 2022 were included in the analyses. The systematic review and meta-analysis were conducted as per Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. An odds ratio with a 95% confidence interval (CI) was used to measure effects.

Results: Among 855 studies screened, 6 studies with 27,453 IHCA patients (63.84% male) with COVID-19 and 20,766 (59.7% male) without COVID-19 were included in the analysis. IHCA among patients with COVID-19 has lower odds of achieving return of spontaneous circulation (ROSC) (OR: 0.66, 95% CI: 0.62-0.70). Similarly, patients with COVID-19 have higher odds of 30-day mortality following IHCA (OR: 2.26, 95% CI: 2.08-2.45) and have 45% lower odds of cardiac arrest because of a shockable rhythm (OR: 0.55, 95% CI: 0.50-0.60) (9.59% vs. 16.39%). COVID-19 patients less commonly underwent targeted temperature management (TTM) or coronary angiography; however, they were more commonly intubated and on vasopressor therapy as compared to patients who did not have a COVID-19 infection.

Conclusions: This meta-analysis showed that IHCA with COVID-19 has a higher mortality and lower rates of ROSC compared with non-COVID-19 IHCA. COVID-19 is an independent risk factor for poor outcomes in IHCA patients.

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

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Figure 2
Figure 2
Forest plot showing group difference for shockable rhythm among COVID-19 versus non-COVID-19 patients using fixed effect. [12,13,14,15,16,17].
Figure 3
Figure 3
Forest plot showing group differences for ROSC among COVID-19 versus non-COVID-19 patients using fixed effect model. [12,13,14,15,17].
Figure 4
Figure 4
Forest plot showing group differences on TTM use among COVID-19 versus non-COVID-19 patients using fixed effect model. [13,14,15,17].
Figure 5
Figure 5
Forest plot showing group differences on coronary angiogram among COVID-19 versus non-COVID-19 patients using fixed effect model. [13,14,15].
Figure 6
Figure 6
Forest plot showing group differences on 30-day mortality among COVID-19 versus non-COVID-19 patients using fixed effect model. [12,13,14,15,16].
See this image and copyright information in PMC

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