COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review.

Couper, Keith, Taylor-Phillips, Sian, Grove, Amy, Freeman, Karoline, Osokogu, Osemeke, Court, Rachel, Mehrabian, Amin, Morley, Peter T, Nolan, Jerry P, Soar, Jasmeet and Perkins, Gavin D (2020) COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review. Resuscitation, 151. pp. 59-66. ISSN 1873-1570. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.journals.elsevier.com/resuscitation/

Abstract

BACKGROUND

There may be a risk of COVID-19 transmission to rescuers delivering treatment for cardiac arrest. The aim of this review was to identify the potential risk of transmission associated with key interventions (chest compressions, defibrillation, cardiopulmonary resuscitation) to inform international treatment recommendations.

METHODS

We undertook a systematic review comprising three questions: (1) aerosol generation associated with key interventions; (2) risk of airborne infection transmission associated with key interventions; and (3) the effect of different personal protective equipment strategies. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the World Health Organization COVID-19 database on 24th March 2020. Eligibility criteria were developed individually for each question. We assessed risk of bias for individual studies, and used the GRADE process to assess evidence certainty by outcome.

RESULTS

We included eleven studies: two cohort studies, one case control study, five case reports, and three manikin randomised controlled trials. We did not find any direct evidence that chest compressions or defibrillation either are or are not associated with aerosol generation or transmission of infection. Data from manikin studies indicates that donning of personal protective equipment delays treatment delivery. Studies provided only indirect evidence, with no study describing patients with COVID-19. Evidence certainty was low or very low for all outcomes.

CONCLUSION

It is uncertain whether chest compressions or defibrillation cause aerosol generation or transmission of COVID-19 to rescuers. There is very limited evidence and a rapid need for further studies. Review registration: PROSPERO CRD42020175594.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WC Communicabable diseases
WF Respiratory system. Respiratory medicine
WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
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Depositing User: Jamie Edgar
Date Deposited: 25 Jun 2020 10:44
Last Modified: 25 Jun 2020 10:44
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3202

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