A systematic review and meta-analysis of the impact of the pandemic on dispatcher-assisted cardiopulmonary resuscitation

Introduction: The influence of the COVID-19 pandemic on the incidence and effectiveness of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) in the context of out-of-hospital cardiac arrests (OHCA) remains an area of ambiguity and requires further elucidation. The study aims to conduct a systematic review and meta-analysis of the DA-CPR among pre- vs. during COVID-19 periods. Material and methods: This search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic review of the current literature was performed to identify articles that evaluated the impact of the pandemic on DA-CPR. English-language literature was searched up to December 11, 2023, in three databases, including MEDLINE (via PubMed), Embase, and the Cochrane Library. Results: Six studies with 605,354 patients (431,308 patients with OHCA from before the pandemic period and 174,046 OHCA patients from the COVID-19 pandemic period) were included. Pooled analysis showed that DA-CPR before and during the COVID-19 period varied and amounted to 61.4% vs. 62.4%, respectively (OR = 0.94; 95% CI: 0.90 to 0.99; p = 0.02). Moreover, dispatchers recognized cardiac arrest by phone in 61.8% of cases in the pre-pandemic period as well as in the pandemic period (OR = 0.98; 95%CI: 0.95 to 1.01; p = 0.17). Conclusions: This systematic review and meta-analysis suggest the resilience and adaptability of emergency response systems in maintaining DA-CPR effectiveness despite the challenges posed by the pandemic.