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Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis.

Publication ,  Journal Article
Teoh, SE; Masuda, Y; Tan, DJH; Liu, N; Morrison, LJ; Ong, MEH; Blewer, AL; Ho, AFW
Published in: Ann Intensive Care
December 7, 2021

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics. METHODS: PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes [annual incidence, mortality, and case fatality rate (CFR)], secondary outcomes [field termination of resuscitation (TOR), return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge], and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). RESULTS: The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality [95% confidence interval (95%CI) 1.51-2.51]. There was increased field TOR (OR = 2.46, 95%CI 1.62-3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55-0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48-0.89), and survival to discharge (OR = 0.52, 95%CI 0.40-0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60-0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02-1.33). CONCLUSION: Compared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

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Published In

Ann Intensive Care

DOI

ISSN

2110-5820

Publication Date

December 7, 2021

Volume

11

Issue

1

Start / End Page

169

Location

Germany

Related Subject Headings

  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Teoh, S. E., Masuda, Y., Tan, D. J. H., Liu, N., Morrison, L. J., Ong, M. E. H., … Ho, A. F. W. (2021). Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis. Ann Intensive Care, 11(1), 169. https://doi.org/10.1186/s13613-021-00957-8
Teoh, Seth En, Yoshio Masuda, Darren Jun Hao Tan, Nan Liu, Laurie J. Morrison, Marcus Eng Hock Ong, Audrey L. Blewer, and Andrew Fu Wah Ho. “Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis.Ann Intensive Care 11, no. 1 (December 7, 2021): 169. https://doi.org/10.1186/s13613-021-00957-8.
Teoh SE, Masuda Y, Tan DJH, Liu N, Morrison LJ, Ong MEH, et al. Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis. Ann Intensive Care. 2021 Dec 7;11(1):169.
Teoh, Seth En, et al. “Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis.Ann Intensive Care, vol. 11, no. 1, Dec. 2021, p. 169. Pubmed, doi:10.1186/s13613-021-00957-8.
Teoh SE, Masuda Y, Tan DJH, Liu N, Morrison LJ, Ong MEH, Blewer AL, Ho AFW. Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis. Ann Intensive Care. 2021 Dec 7;11(1):169.
Journal cover image

Published In

Ann Intensive Care

DOI

ISSN

2110-5820

Publication Date

December 7, 2021

Volume

11

Issue

1

Start / End Page

169

Location

Germany

Related Subject Headings

  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences