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

Karol Bielski1,2, Katarzyna Makowska3, Adam Makowski3

  • 1Research Unit, Polonia University, Czestochowa, Poland.

Cardiology Journal
|January 5, 2022
PubMed

Insights

The coronavirus disease 2019 (COVID-19) pandemic did not significantly alter in-hospital cardiac arrest (IHCA) outcomes. However, patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection experienced worse IHCA outcomes, including lower return of spontaneous circulation and higher mortality.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic has raised concerns regarding its impact on various medical outcomes.
  • In-hospital cardiac arrest (IHCA) is a critical event with significant morbidity and mortality.
  • Understanding the influence of the pandemic and SARS-CoV-2 infection on IHCA is crucial for clinical management.

Purpose of the Study:

  • To provide an updated meta-analysis on the effects of the COVID-19 pandemic on IHCA outcomes.
  • To specifically investigate the impact of SARS-CoV-2 infection on IHCA survival and success rates.

Main Methods:

  • This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Comparative analyses were performed for pre- and intra-COVID-19 periods.
  • Outcomes were compared between SARS-CoV-2 positive and negative patients.

Main Results:

  • No statistically significant differences were observed in shockable rhythms, return of spontaneous circulation (ROSC), 30-day mortality, or overall mortality between pre- and intra-COVID-19 periods.
  • Patients with SARS-CoV-2 infection showed a significantly lower incidence of shockable rhythms (9.6% vs. 19.8%) and ROSC (33.9% vs. 52.1%) compared to SARS-CoV-2 negative patients.
  • SARS-CoV-2 positive patients had a statistically significant higher 30-day mortality (77.2% vs. 59.7%) and a trend towards higher overall mortality (94.9% vs. 76.7%).

Conclusions:

  • The COVID-19 pandemic itself did not lead to statistically significant changes in IHCA outcomes when comparing pre- and intra-pandemic periods.
  • SARS-CoV-2 infection is associated with poorer IHCA outcomes, characterized by reduced ROSC and increased mortality.
  • These findings highlight the detrimental effect of SARS-CoV-2 on cardiac arrest resuscitation efforts and patient survival.
Abstract

Keywords:
COVID-19SARS-CoV-2cardiopulmonary resuscitationcoronavirus disease 2019in-hospital cardiac arrestmeta-analysisoutcomepandemic

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