Abstract
Cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Because the COVID-19 pandemic may have impacted mortality and morbidity, both on an individual level and the health care system as a whole, our purpose was to determine rates of OHCA survival since the onset of the SARS-CoV2 pandemic. We conducted a systematic review and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes according to the PRISMA guidelines. We searched the literature using PubMed, Scopus, Web of Science and Cochrane Central Register for Controlled Trials databases from inception to September 2021 and identified 1775 potentially relevant studies, of which thirty-one articles totaling 88,188 patients were included in this meta-analysis. Prehospital return of spontaneous circulation (ROSC) in pre-COVID-19 and COVID-19 periods was 12.3% vs. 8.9%, respectively (OR = 1.40; 95%CI: 1.06–1.87; p < 0.001). Survival to hospital discharge in pre- vs. intra-COVID-19 periods was 11.5% vs. 8.2% (OR = 1.57; 95%CI: 1.37–1.79; p < 0.001). A similar dependency was observed in the case of survival to hospital discharge with the Cerebral Performance Category (CPC) 1–2 (6.7% vs. 4.0%; OR = 1.71; 95%CI: 1.35–2.15; p < 0.001), as well as in the 30-day survival rate (9.2% vs. 6.4%; OR = 1.63; 95%CI: 1.13–2.36; p = 0.009). In conclusion, prognosis of OHCA is usually poor and even worse during COVID-19.
Highlights
The COVID-19 pandemic has negatively impacted health systems around the world and adversely affected cardiopulmonary resuscitation of out-of-hospital cardiac arrests (OHCA) [1,2]
Studies included in this meta-analysis met the following PICOS criteria: (1) Participants: patients >18 years of age with out-of-hospital cardiac arrest due to any cause; (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, quasirandomized or observational studies comparing cardiac arrest during and before the COVID-19 period for their effects in patients with cardiac arrest
The data extracted from each study included the (1) study characteristics; (2) participant characteristics in each group; (3) survival outcomes (i.e., the return of spontaneous circulation, survival to hospital admission with spontaneous circulation (SHA), survival to hospital discharge or survival to hospital discharge with good neurological outcome defined as 1 or 2 grade in Cerebral Performance Categories Scale)
Summary
The COVID-19 pandemic has negatively impacted health systems around the world and adversely affected cardiopulmonary resuscitation of out-of-hospital cardiac arrests (OHCA) [1,2]. The risk is lower after the recent availability of effective COVID-19 vaccines, the lack of complete postvaccination protection and the emergence of new variants have made it necessary to alter protocols and provide protective equipment to medical personnel on an ongoing basis [7]. Others have proposed an early termination of resuscitation in patients with COVID-19 [9] These changes may have contributed to the recently increased number of out-ofhospital sudden cardiac arrest cases [3]. As there has been a tremendous amount of data reported since our prior publication, we performed an updated systematic review of the literature and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
