ABSTRACT
Introduction: A surge in incidence of out-of-hospital cardiac arrest (OHCA) has been reported during COVID-19 outbreak in certain countries. However, limited data exists on a comparison of outcomes among COVID-19 positive OHCA patients vs. non-COVID-19 OHCA patients. Therefore, we aimed to perform a meta-analysis comparing characteristics and outcome of COVID-19 OHCA vs COVID-19 negative OHCA patients. Methods: We reviewed PubMed/Medline, SCOPUS, and EMBASE until April 2021 using relevant keywords COVID-19, SARS-CoV-2, “out of hospital cardiac arrest” or OHCA to identify studies that included outcomes data on OHCA with COVID-19 positive and negative status. Random-effects models were obtained to perform a meta-analysis. I statistics was used for heterogeneity. Results: Of 5789 OHCA patients included from 6 studies, patients who were COVID-19 positive comprised of 61.46% males while COVID-19 negative patients included 63.37% of males (p=0.2). COVID-19 OHCA patients were younger (Mean±SD, 68.94±17.93 vs 70.23±17.93, p=0.03) compared to COVID-19 negative patients. Incidence of OHCA at home/private address was higher (OR=1.92, 95%CI:1.52-2.43), while shockable rhythm (OR=0.34, 95%-CI:0.24-0.46) and use of AED (OR=0.77, 95%CI 0.61-0.97) were less frequently noted in COVID-19 patients (p<0.0001). As shown in Fig. 1, return of spontaneous circulation did not differ significantly (OR=1.01, 95%CI:0.85-1.20, p<0.92);however, survival to admission (OR=0.64, 95%CI:0.48-0.86, p<0.01), and survival to discharge (OR=0.28, 95%CI:0.13-0.59, p<0.01) were significantly lower in COVID-19 OHCA admissions compared to non-COVID-19 OHCA admissions. Conclusions: This meta-analysis demonstrated that the SARS-CoV-2 infection in OHCA patients was associated with poorer outcomes as compared to COVID-19 negative OHCA admissions. Future studies are warranted to assess long-term residual effects of COVID-19 on OHCA risk and outcomes.