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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
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WRAP-COVID-19-cardiac-arrest-rescuers-Perkins-2020.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (2219Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.resuscitation.2020.04....
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 | ||||||||||||
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| Subjects: | Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of 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: |
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| 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 | ||||||||||||
| Description: | Free access |
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| RIOXX Funder/Project Grant: |
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