Kardiyak arrest dünya çapında en önemli ölüm nedenlerinden biridir. Koronavirüs hastalığı 2019 (COVID-19) pandemisi, kardiyak arrestlerin hem epidemiyolojisini hem de sonucunu etkileyerek, kardiyak arrest sonrası sağkalımı daha da azaltmaktadır. COVID-19'lu hastaların resüsitasyonu, kişisel koruyucu ekipman ihtiyacı, viral bulaşmayı önleme, ventilatör yönetimi zorlukları ve etkin ve kaliteli kardiyopulmoner resüsitasyon gerçekleştirmedeki zorluklar gibi bazı konular nedeniyle karmaşık bir sorun haline gelmiştir.

Bu derlemede pandemi döneminde, COVID-19'un hastane dışı kardiyak arrest ve hastane içi kardiyak arrest üzerindeki etkisine ilişkin kanıtları değerlendirmeyi amaçladık.

Cardiac arrest is one of the leading causes of death worldwide. The coronavirus disease 2019 (COVID-19) pandemic is impacting both the epidemiology and outcome of cardiac arrests, further reducing survival after cardiac arrest. Resuscitation of patients with COVID-19 has become a complex problem due to several issues, including the need for personal protective equipment, prevention of viral transmission, ventilator management challenges, and difficulties in performing effective and high-quality cardiopulmonary resuscitation.

In this review, we aimed to assess the evidence on the impact of COVID-19 on out-of-hospital cardiac arrest and in-hospital cardiac arrest during the pandemic.

1. Sandroni C., Skrifvars MB., Nolan JP. The impact of COVID-19 on the epidemiology, outcome and management of cardiac arrest. Intensive Care Med 2021;47(5):602-604.
2. https://resusitasyon.org/tr/erc-2021-kilavuz
3. Lim ZJ., Ponnapa Reddy M., Afroz A., Billah B., Shekar K., Subramaniam A. Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis. Resuscitation. 2020;157:248-258.
4. Ippolito M., Catalisano G., Marino C., Fucà R., Giarratano A., Baldi E., Einav S., Cortegiani A. Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis. Resuscitation. 2021 Jul;164:122-129.
5. Wiberg S., Holmberg MJ., Donnino MW., Kjaergaard J., Hassager C., Witten L. et.al. Age-dependent trends in survival after adult in-hospital cardiac arrest. Resuscitation 2020;151:189-196.
6. Chan PS., Girotra S., Tang Y., Al-Araji R., Nallamothu BK., McNally B. Outcomes for out-of-hospital cardiac arrest in the United States during the Coronavirus disease 2019 pandemic. JAMA Cardiol 2020;2:10.
7. Mitrani RD., Goldberger JJ. Cardiac Arrests During the COVID-19 Pandemic: The Perfect Storm. JACC Clin Electrophysiol. 2021;7(1):12-15.
8. Edwards JM., Nolan JP., Soar J., Smith GB., Reynolds E., Carnall J., et.al. Impact of the COVID-19 pandemic on in-hospital cardiac arrests in the UK. Resuscitation. 2022;173:4-11.
9. Aldabagh M., Wagle S., Cesa M., Yu A., Farooq M., Goldberg Y. Survival of In-Hospital Cardiac Arrest in COVID-19 Infected Patients. Healthcare (Basel) 2021;9(10):1315.
10. Sultanian P., Lundgren P., Strömsöe A., Aune S., Bergström G., Hagberg E., et.al. Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation. Eur Heart J 2021;42(11):1094-1106.
11. Ippolitoa M., Catalisanoa G., Marinoa C., Fuca`a R., Giarratano A., Baldi E et.al. Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta- analysis. Resuscıtatıon 2021;164:122-129.
12. Lott C., Truhlář A., Alfonzo A., Barelli A., González-Salvado V., Hinkelbein J., et.al. ERC Special Circumstances Writing Group Collaborators. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation. 2021;161:152-219.
13. Małysz M., Smereka J., Jaguszewski M., Dąbrowski M., Nadolny K., Ruetzler K., et.al. An optimal chest compression technique using personal protective equipment during resuscitation in the COVID-19 pandemic: a randomized crossover simulation study Kardiol Pol. 2020; 23:78(12):1254-1261.
14. Chan P S., Spertus J A., Kennedy K, Nallamothu B K, Starks M A, Girotra S. In-Hospital Cardiac Arrest Survival in the United States During and After the Initial Novel Coronavirus Disease 2019 Pandemic Surge. Circ Cardiovasc Qual Outcomes. 2022;15:e008420.
15. Aldabagh M., Wagle S., Cesa M., Yu A, Farooq M., Goldberg Y. Survival of In-Hospital Cardiac Arrest in COVID-19 Infected Patients. Healthcare 2021;9: 1315.
16. Merchant RM, Yang L, Becker LB., Berg RA., Nadkarni, V., Nichol, G. et.al. American Heart Association Get with the Guidelines-Resuscitation Investigators. Incidence of treated cardiac arrest in hospitalized patients in the United States. Crit. Care Med. 2011; 39:2401–2406.
17. Moreno Fernández-Ayala DJ, Navas P, López-Lluch G. Age-related mitochondrial dysfunction as a key factor in COVID-19 disease. Exp Gerontol. 2020;142:111147.
18. Liu K., Chen Y., Lin R., Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J. Infect. 2020;80:e14–e18.
19. Yang J.; Zheng Y., Gou X., Pu K., Chen Z., Guo, Q. et.al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis. Int. J. Infect. Dis. 2020; 94: 91–95.
20. Movahedi A., Mirhafez SR., Behnam-Voshani H., Reihani H., Ferns G.A., Malekzadeh J. 24-Hour survival after cardiopul- monary resuscitation is reduced in patients with diabetes mellitus. J. Cardiovasc. Thorac. Res. 2017; 9:175–178.
21. Zhu L., She ZG., Cheng X., Qin,- JJ., Zhang,XJ. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metab. 2020;31:1068–1077.e3.
22. Joseph L., Chan PS., Bradley SM,. Zhou Y., Graham G., Jones PG. Et.al. American Heart Association Get with the Guidelines-Resuscitation Investigators. Temporal changes in the racial gap in survival after in-hospital cardiac arrest. JAMA Cardiol. 2017;2:976-984.
23. Townsend M.J., Kyle TK., Stanford FC. Outcomes of COVID-19: Disparities in obesity and by ethnicity/race. Int. J. Obes. 2020;44:1807–1809.
24. Ranney, M.L.; Griffeth, V.; Jha, A.K. Critical Supply Shortages—The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic. N. Engl. J. Med. 2020, 382, e41.
25. Korkmaz,S., Kazgan,A., Çekiç S., Tartar AS., Balcı HN., Atmaca M. The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services. J. Clin. Neurosci. 2020; 80:131–136.
26. Özdemir L, Birbiçer H, Doruk H, Sagün A. Evaluation of Anxiety, Depression, and Work-Related Strain Inventory of Code Blue Teams in Turkey During the COVID-19 Pandemic: A Cross-Sectional Survey Study. Turk J Anaesthesiol Reanim. 2022;50(4):288-294.
27. Doruk N, Özdemir L, SagünA, Taşdelen B, Kök M, Yeşilmen E. Comparison of Two Different Early Warning Scores To Predict The Risk Of Cardiac Arrest in Patıents With Diagnosed COVID-19: Retrospective Analysis. TJR 2022;1(1):44-57.
28. Kaçar T, Demiraslan AT, Topçu İ, Keleş GT. COVID-19 Dönemine Ait Mavi Kod Uygulama Sonuçlarının Değerlendirilmesi. CBU-SBED 2022; 9(2): 234-238.
29. Arslan K., Şahin A S. Evaluation of Code Blue Calls in the Pre-Pandemic and Pandemic Period: A Tertiary Care Hospital Experience. İKSSTD 2022;14(3):214-220.
30. Kilicarslan N, Hande Gurbuz, Sermin Eminoglu, Sedef Elmas Arslan, Derya Karasu, Buket Ozyaprak, et.al. Comparison of Code Blue Practices Between the First Year of COVID-19 and the Previous Year. Med Bull Haseki 2022;60:211-219.

Şule Özbilgin*
DOKUZ EYLÜL ÜNİVERSİTESİ
0000-0002-2940-8988
Türkiye

Handan Birbiçer
MERSİN ÜNİVERSİTESİ
0000-0003-3510-9279
Türkiye