Outcomes of in-hospital cardiac arrest in COVID-19 patients: A proportional prevalence meta-analysis
Outcomes of in-hospital cardiac arrest in COVID-19 patients: A proportional prevalence meta-analysis
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DOI：
10.1002/ccd.29525
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发表时间：
2021-02-04
影响因子：
2.3
通讯作者：
Qureshi, Waqas T.
中科院分区：
文献类型：
--
作者：
Mir, Tanveer;Sattar, Yasar;Qureshi, Waqas T.
关于COVID-19患者院内心脏骤停（CA）结局的流行病学数据有限。方法在PubMed、EMBASE、Cochrane和Ovid中进行文献检索，以确定研究COVID-19患者院内心脏骤停结局的研究文章。主要终点是出院时的生存。次要结局包括自发循环恢复（ROSC）和心脏骤停类型。以95%置信区间（CI）计算结果发生率的合并百分比。结果共7891例新冠肺炎患者纳入研究。共有621例（总患病率为8%，95% CI为4-13%）心脏骤停患者。52例患者（总患病率3.0%;95% CI 0-10.0%）在出院时存活。202例患者（总患病率39%；95% CI 21.0-59.0%）实现ROSC。到ROSC的平均时间为7.74分钟（95% CI 7.51-7.98）。心脏骤停时最常见的节律是无脉性电活动（合并患病率46%；95% 13-80%），其次是无脉性电活动（合并患病率40%；95% CI 6-80%）。少数患者发生不稳定室性心律失常（总患病率为8%；95% CI为4-13%）。结论本研究汇总分析表明，尽管在复苏时获得了足够的ROSC，但COVID患者的院内心脏骤停后生存率很低。非震荡节律性心脏骤停是常见的提示非心脏原因，而心脏相关的病因是罕见的。需要进一步的研究来提高这些患者的生存率。
Background Limited epidemiological data are available on the outcomes of in-hospital cardiac arrest (CA) in COVID-19 patients.Methods We performed literature search of PubMed, EMBASE, Cochrane, and Ovid to identify research articles that studied outcomes of in-hospital cardiac arrest in COVID-19 patients. The primary outcome was survival at discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and types of cardiac arrest. Pooled percentages with a 95% confidence interval (CI) were calculated for the prevalence of outcomes.Results A total of 7,891 COVID patients were included in the study. There were 621 (pooled prevalence 8%, 95% CI 4-13%) cardiac arrest patients. There were 52 (pooled prevalence 3.0%; 95% CI 0.0-10.0%) patients that survived at the time of discharge. ROSC was achieved in 202 (pooled prevalence 39%;95% CI 21.0-59.0%) patients. Mean time to ROSC was 7.74 (95% CI 7.51-7.98) min. The commonest rhythm at the time of cardiac arrest was pulseless electrical activity (pooled prevalence 46%; 95% 13-80%), followed by asystole (pooled prevalence 40%; 95% CI 6-80%). Unstable ventricular arrhythmia occurred in a minority of patients (pooled prevalence 8%; 95% CI 4-13%).Conclusion This pooled analysis of studies showed that the survival post in-hospital cardiac arrest in COVID patients is dismal despite adequate ROSC obtained at the time of resuscitation. Nonshockable rhythm cardiac arrest is commoner suggesting a non-cardiac cause while cardiac related etiology is uncommon. Future studies are needed to improve the survival in these patients.