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

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 prevs. 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.