In hospital cardiac arrest in Intensive Care Unit versus non Intensive Care Unit patients with COVID 19. A systematic review and meta analysis

AimTo estimate the incidence of in-hospital cardiac arrest (IHCA) and return of spontaneous circulation (ROSC) in COVID-19 patients, as well as to compare the incidence and outcomes of IHCA in Intensive Care Unit (ICU) versus non-ICU patients with COVID-19. MethodsWe systematically reviewed the PubMed, Scopus and clinicaltrials.gov databases to identify relevant studies. ResultsEleven studies were included in our study. The pooled prevalence/incidence, pooled odds ratios (OR) and 95% Confidence Intervals (95% CI) were calculated, as appropriate. The quality of the included studies was assessed using appropriate tools. The pooled incidence of IHCA in COVID-19 patients was 7% [95% CI: 4 - 11%; P < 0.0001] and 44% [95% CI: 30 - 58%; P < 0.0001] achieved ROSC. Of those that survived, 58% [95% CI: 42 - 74%; P < 0.0001] had a good neurological outcome (Cerebral Performance Category 1 or 2) and the mortality at the last follow-up was 59% [95% CI: 37 - 81%; P < 0.0001]. A statistically significant higher percentage of ROSC [OR (95% CI): 5.088 (2.852, 9.079); P < 0.0001] was found among ICU patients versus those in the general wards. ConclusionThe incidence of IHCA amongst hospitalized COVID-19 patients is 7%, with 44% of them achieving ROSC. Patients in the ICU were more likely to achieve ROSC than those in the general wards, however the mortality did not differ. What this paper addsSection 1: What is already known on this subject O_LIMortality in COVID-19 patients ranges between 20% and 40%. C_LIO_LIit has been reported that patients with COVID-19 have a high incidence of IHCA and higher mortality. C_LIO_LIThis paper aimed to calculate the proportion of COVID-19 patients who experience IHCA and their outcome, as well as compare the outcome of IHCA between ICU and non-ICU patients. C_LI Section 2: What this study adds O_LIApproximately 7% of hospitalized COVID-19 patients suffer from IHCA and 44% of those achieve ROSC. C_LIO_LIThe rate of ROSC was higher in ICU patients, but the rate of mortality did not differe between ICU and non-ICU patients. C_LI