{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:52:30Z","timestamp":1792698750330,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Out-of-hospital cardiac arrest (OHCA) is a challenge for medical staff, especially in the COVID-19 period. The COVID-19 disease caused by the SARS-CoV-2 coronavirus is highly infectious, thus requiring additional measures during cardiopulmonary resuscitation (CPR). Since CPR is a highly aerosol-generating procedure, it carries a substantial risk of viral transmission. We hypothesized that patients with diagnosed or suspected COVID-19 might have worse outcomes following OHCA outcomes compared to non-COVID-19 patients. To raise awareness of this potential problem, we performed a systematic review and meta-analysis of studies that reported OHCA in the pandemic period, comparing COVID-19 suspected or diagnosed patients vs. COVID-19 not suspected or diagnosed group. The primary outcome was survival to hospital discharge (SHD). Secondary outcomes were the return of spontaneous circulation (ROSC), survival to hospital admission or survival with favorable neurological outcomes. Data including 4210 patients included in five studies were analyzed. SHD in COVID-19 and non-COVID-19 patients were 0.5% and 2.6%, respectively (odds ratio, OR = 0.25; 95% confidence interval, CI: 0.12, 0.53; p &lt; 0.001). Bystander CPR rate was comparable in the COVID-19 vs. not COVID-19 group (OR = 0.88; 95% CI: 0.63, 1.22; p = 0.43). Shockable rhythms were observed in 5.7% in COVID-19 patients compared with 37.4% in the non-COVID-19 group (OR = 0.19; 95% CI: 0.04, 0.96; p = 0.04; I2 = 95%). ROSC in the COVID-19 and non-COVID-19 patients were 13.3% vs. 26.5%, respectively (OR = 0.67; 95% CI: 0.55, 0.81; p &lt; 0.001). SHD with favorable neurological outcome was observed in 0% in COVID-19 vs. 3.1% in non-COVID-19 patients (OR = 1.35; 95% CI: 0.07, 26.19; p = 0.84). Our meta-analysis suggests that suspected or diagnosed COVID-19 reduces the SHD rate after OHCA, which seems to be due to the lower rate of shockable rhythms in COVID-19 patients, but not due to reluctance to bystander CPR. Future trials are needed to confirm these preliminary results and determine the optimal procedures to increase survival after OHCA in COVID-19 patients.<\/jats:p>","DOI":"10.3390\/jcm10061209","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T11:38:58Z","timestamp":1615808338000},"page":"1209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Impact of Coronavirus Disease 2019 on Out-of-Hospital Cardiac Arrest Survival Rate: A Systematic Review with Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"given":"Magdalena J.","family":"Borkowska","sequence":"first","affiliation":[{"name":"Department of Research Outcomes, Maria Sklodowska-Curie Bia\u0142ystok Oncology Centre, 15-027 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2555-593X","authenticated-orcid":false,"given":"Mi\u0142osz J.","family":"Jaguszewski","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Gdansk, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-567X","authenticated-orcid":false,"given":"Mariusz","family":"Koda","sequence":"additional","affiliation":[{"name":"Department of Research Outcomes, Maria Sklodowska-Curie Bia\u0142ystok Oncology Centre, 15-027 Bia\u0142ystok, Poland"},{"name":"Department of General Pathomorphology, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5083-7587","authenticated-orcid":false,"given":"Aleksandra","family":"Gasecka","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Szarpak","sequence":"additional","affiliation":[{"name":"Department of Research Outcomes, Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasza","family":"Gilis-Malinowska","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Medical University of Gdansk, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Safiejko","sequence":"additional","affiliation":[{"name":"Department of Research Outcomes, Maria Sklodowska-Curie Bia\u0142ystok Oncology Centre, 15-027 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0973-5455","authenticated-orcid":false,"given":"Lukasz","family":"Szarpak","sequence":"additional","affiliation":[{"name":"Department of Research Outcomes, Maria Sklodowska-Curie Bia\u0142ystok Oncology Centre, 15-027 Bia\u0142ystok, Poland"},{"name":"Department of Research Outcomes, Polish Society of Disaster Medicine, 05-090 Raszyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6563-0877","authenticated-orcid":false,"given":"Krzysztof J.","family":"Filipiak","sequence":"additional","affiliation":[{"name":"Department of General Pathomorphology, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1427-4796","authenticated-orcid":false,"given":"Jacek","family":"Smereka","sequence":"additional","affiliation":[{"name":"Department of Research Outcomes, Polish Society of Disaster Medicine, 05-090 Raszyn, Poland"},{"name":"Department of Emergency Medical Service, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1016\/S0735-1097(97)00355-0","article-title":"Out-of-hospital cardiac arrest in the 1990\u2019s: A population-based study in the Maastricht area on incidence, characteristics and survival","volume":"30","author":"Gorgels","year":"1997","journal-title":"J. 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