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

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Couper, Keith, Taylor-Phillips, Sian, Grove, Amy L., Freeman, Karoline, Osokogu, Osemeke, Court, Rachel A., 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. doi:10.1016/j.resuscitation.2020.04.022 ISSN 0300-9572.

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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2020.04....

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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.

Item Type: Journal Article
Subjects: Q Science > QR Microbiology
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): COVID-19 (Disease), Coronavirus infections, Coronaviruses , Coronaviruses -- Reproduction , Coronavirus infections -- Prevention, Communicable diseases, Heart -- Infections , Emerging infectious diseases -- Prevention, Cardiac arrest
Journal or Publication Title: Resuscitation
Publisher: Elsevier Ireland Ltd
ISSN: 0300-9572
Official Date: June 2020
Dates:
DateEvent
June 2020Published
20 April 2020Available
16 April 2020Accepted
Volume: 151
Page Range: pp. 59-66
DOI: 10.1016/j.resuscitation.2020.04.022
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Description:

Free access

Date of first compliant deposit: 29 April 2020
Date of first compliant Open Access: 20 April 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
CDF-2016-09-018[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR300060[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
DRF-2016-09-038[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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