The influence of covid-19 on out-hospital cardiac arrest survival outcomes: An updated systematic review and meta-analysis

Karol Bielski, Agnieszka Szarpak, Miłosz Jaroslaw Jaguszewski, Tomasz Kopiec, Jacek Smereka, Aleksandra Gasecka, Przemysław Wolak, Grazyna Nowak-Starz, Jaroslaw Chmielewski, Zubaid Rafique, Frank William Peacock, Lukasz Szarpak

Research output: Contribution to journalReview articleAcademicpeer-review

33 Citations (Scopus)

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.

Original languageEnglish
Article number5573
JournalJournal of clinical medicine
Volume10
Issue number23
DOIs
Publication statusPublished - 1 Dec 2021

Keywords

  • Cardiopulmonary resuscitation
  • Coronavirus disease 2019
  • Out-of-hospital cardiac arrest
  • Outcome
  • Pandemic
  • SARS-CoV-2

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