RESEARCH PAPER
Effect of SARS-CoV-2 infection on out-of-hospital cardiac arrest outcomes – systematic review and meta-analysis
1
Polish Society of Disaster Medicine, Warsaw, Poland
2
Baylor College of Medicine, Houston, United States
3
Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
4
York University, Toronto, ON, Canada
5
Bezmialem Vakif University, Fatih/Istanbul, Turkey
6
University Zürich, Zürich, Switzerland
7
International Academy of Ecology and Medicine, Kyiv, Ukraine
8
Institute of Rural Health, Lublin, Poland
9
Institute of Environmental Protection – National Research Institute, Warsaw, Poland
10
Medical University, Lublin, Poland
Ann Agric Environ Med. 2023;30(2):369-375
KEYWORDS
TOPICS
Biological agents posing occupational risk in agriculture, forestry, food industry and wood industry and diseases caused by these agents (zoonoses, allergic and immunotoxic diseases)State of the health of rural communities depending on various factors: social factors, accessibility of medical care, etc.
ABSTRACT
Introduction and objective:
The COVID-19 pandemic caused by the SARS-CoV-2 virus has recently presented the world with an unprecedented challenge. The purpose of this systematic review and meta-analysis is to investigate the relationship between SARS-CoV-2 infection and out-of-hospital cardiac arrest (OHCA) by comparing data from infected and non-infected individuals. The study adds to our understanding of the broader effects of the pandemic on public health and emergency care by examining the influence of COVID-19 on OHCA.
Material and methods:
A comprehensive systematic literature search was performed using PubMed, EMBASE, Scopus, Web of Science, the Cochrane Library and Google Scholar from 1 January 2020 – 24 May 2023. Incidence rates and odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) for risk factors were recorded from individual studies, and random-effects inverse variance modelling used to generate pooled estimates.
Results:
Six studies, involving 5,523 patients, met the criteria for inclusion in the meta-analysis. Survival to hospital admission, defined as admission to the emergency department with sustained return of spontaneous circulation (ROSC), among patients with and without on-going infection was 12.2% and 20.1%, respectively (p=0.09). Survival to hospital discharge/30-day survival rate was 0.8% vs. 6.2% (p<0.001). Two studies reported survival to hospital discharge in good neurological condition; however, the difference was not statistically significant (2.1% vs. 1.8%; p=0.37).
Conclusions:
Compared to the non-infected patients, the ongoing SARS-CoV-2 infection was associated with worse OHCA outcomes.
The COVID-19 pandemic caused by the SARS-CoV-2 virus has recently presented the world with an unprecedented challenge. The purpose of this systematic review and meta-analysis is to investigate the relationship between SARS-CoV-2 infection and out-of-hospital cardiac arrest (OHCA) by comparing data from infected and non-infected individuals. The study adds to our understanding of the broader effects of the pandemic on public health and emergency care by examining the influence of COVID-19 on OHCA.
Material and methods:
A comprehensive systematic literature search was performed using PubMed, EMBASE, Scopus, Web of Science, the Cochrane Library and Google Scholar from 1 January 2020 – 24 May 2023. Incidence rates and odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) for risk factors were recorded from individual studies, and random-effects inverse variance modelling used to generate pooled estimates.
Results:
Six studies, involving 5,523 patients, met the criteria for inclusion in the meta-analysis. Survival to hospital admission, defined as admission to the emergency department with sustained return of spontaneous circulation (ROSC), among patients with and without on-going infection was 12.2% and 20.1%, respectively (p=0.09). Survival to hospital discharge/30-day survival rate was 0.8% vs. 6.2% (p<0.001). Two studies reported survival to hospital discharge in good neurological condition; however, the difference was not statistically significant (2.1% vs. 1.8%; p=0.37).
Conclusions:
Compared to the non-infected patients, the ongoing SARS-CoV-2 infection was associated with worse OHCA outcomes.
ABBREVIATIONS
ACLS: advanced cardiovascular life support; ARDS: acute respiratory distress syndrome; CI: confidence interval; CPC: Cerebral Performance Categories; CPR: cardiopulmonary resuscitation; CVD: cardiovascular disease; EMS: emergency medical service; IHCA: in-hospital cardiac arrest; MD: mean difference; NOS: Newcastle Ottawa Scale; OHCA: out-of-hospital cardiac arrest; OR: odds ratio; ROSC: return of spontaneous circulation; PPE: personal protective equipment; PRISMA: preferred reporting items for systematic reviews and meta-analysis; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; SHA: survival to hospital admission; SHD: survival to hospital discharge; VTE: venous thromboembolism
ACKNOWLEDGEMENTS
The study was supported by the European Research Council (ERC) Research Net and by the Polish Society of Disaster Medicine in Warsaw, Poland.
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