Rethinking cardiopulmonary resuscitation guidelines for cardiac arrest in patients with COVID-19

Abstract EN

COVID-19 has modified our approach to resuscitation and underscored the importance of staff protection.

The aim of this editorial is to review the published literature on cardiopulmonary resuscitation (CPR) in patients with COVID-19 and to outline the changes that have been made to our institutional protocol for cardiopulmonary resuscitation following cardiac arrest in suspected or confirmed cases of COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS CoV2) was first identified in Wuhan city, Hubei province, China in December 2019, which has brought normal life to a halt throughout the world1 .

COVID-19 symptoms range from mild respiratory symptoms to severe pneumonia and multi-organ failure2,3.

The high transmissibility of this virus coupled with asymptomatic infections initially prevented effective containment of the disease in Wuhan, leading to the spread of infection to other parts of China and subsequently to the rest of the world.

The current global statistics of the pandemic show that over 11 million people have been infected and there have been 500,000 deaths worldwide as of 5 July 20204 .

Measures adopted to control the spread of the virus were extensive testing, rapid isolation of cases, meticulous contact tracing, use of mobile phone applications for tracking cases, multilingual public awareness campaigns, and effective social distancing.

This enabled a flattening of the curve of the epidemic without imposing a full lockdown.

The overriding concern at that initial stage was the effect of unlimited and uncontrollable demand for ventilated ICU beds.

Therefore, in preparation for an unpredictable increase in the number of cases, two field hospitals with nearly 9,000 beds and over 250 new ICU beds were rapidly established in the Kingdom.

As of 5 July 2020, Bahrain has reported a total number of less than 30,000 confirmed cases of which around 25,000 have recovered and 96 have died4 .

The mortality rate of the virus in Bahrain is approximately 0.3% compared to the mortality rate of over 0.5-5% globally.