Impact of COVID-19 pandemic on out-of-hospital cardiac arrest survival rate

Abstract

Impact of COVID-19 pandemic on out-of-hospital cardiac arrest survival rateWe read with great interest an article by Ball et al. 1 Authors showed that in early during the pandemic, rates of sustained ROSC for OHCA and overall survival were lower in COVID-19 period. To verify the results obtained by Ball, a systematic review and meta-analysis were performed.The detailed study procedure is presented in the Supplementary file. The analysis of the obtained results revealed many potential causes of increased OHCA patients' mortality in the COVID-19 era. First, as Chan and other authors bystanders point out, during the COVID-19 pandemic, they are much more afraid of undertaking cardiac resuscitation, which translates into a delay in the commencement of emergency procedures, thus reducing its effectiveness and increasing both pre-hospital and inpatient audacity [OR = 0.95; 95% CI: 0.79, 1.16; P = 0.64; I 2 = 94%].Another potential reason for reducing the survival rate of patients during the COVID-19 pandemic is the longer travel time to the patient [MD = 1.11; 95% CI: 0.67, 1.55; P < 0.001; I 2 = 100%], which is related to each time need to disinfect an ambulance after transporting a patient with suspected COVID-19. Subsequently, this limits the number of ambulances available at a time, and to conduct resuscitation in protective suits, which, as many studies show, reduce the effectiveness of medical procedures, including chest compression. 2À4 Many studies show that in patients with COVID-19, microclots are often observed in both the central nervous system and the heart muscle. They can cause many areas of ischemia in the heart, thus increasing mortality. The above-described potential causes of increased insolence because of OHCA in the era of COVID-19 pandemic translate into survival to hospital admission [OR = 0.56; 95% CI = 0.

The impact of COVID-19 on incidence and outcomes from out-of-hospital cardiac arrest (OHCA) in Texas

“…We found survival to hospital admission and hospital discharge to decrease, while good neurologic outcomes remained unchanged. Our study found rates of survival to hospital admission (OR = 0.56–0.65) and survival to hospital discharge (OR = 0.46–0.68) to be slightly higher than what is reported in the literature [ 13 , 19 , 24 , 25 ]. While the rates of good neurologic scores did not change significantly in our study, conflicting research exists, demonstrating worse or unchanged CPC scores compared to the pre-COVID-19 period [ 12 , 26 ].…”

Should basic life support–defibrillator training be compulsory for newly licensed Italian physicians? An observational study

“…The importance of effective CPR was also recently emphasized during the COVID-19 pandemic, 7–9 a period during which there was a reduction in basic life support–defibrillator (BLSD) courses 10 to increase provider safety 11 . However, the real impact of reduced BLSD training on OHCA mortality is unclear, although a concomitant increase in OHCA mortality was reported during the COVID-19 pandemic 12 .…”

Impact of Coronavirus Disease 2019 on Out-of-Hospital Cardiac Arrest Survival Rate: A Systematic Review with Meta-Analysis

“…As of 19 February 2021, 110,349,428 cases of COVID-19 infection have been reported worldwide, with a mortality rate of 2.2% [9]. There is accumulating evidence that SARS-CoV-2 infection leads to endothelial damage and causes microvascular thrombosis, which increases the risk of SCA and impairs patient prognosis [10][11][12]. SARS-CoV-2 may also indirectly affect SCA outcomes by altering the capacity of the community and EMS teams to respond to OHCA, as exemplified by numerous studies indicating extended EMS travel time in the COVID-19 period compared to the pre-COVID-19 period [13,14].…”