Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

Abstract

Objective This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city.Methods This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre-and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. ResultsThis study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05-0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02-0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. ConclusionDuring the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis

“…After full-text assessment for eligibility, 14 were excluded because they did not meet the inclusion criteria. Finally, thirty-one articles, including 88,188 patients, were included in this meta-analysis [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. A flow diagram showing stages of database search and study selection is shown in Figure 1 .…”

“…Twenty-seven studies reported OHCA outcomes in pre- vs. intra-COVID-19 periods [ 23 , 24 , 26 , 27 , 28 , 29 , 31 , 33 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], and OHCA outcomes in SARS-CoV-2-positive vs. -negative patients were reported in seven trials [ 25 , 30 , 32 , 34 , 36 , 43 , 51 ]. Characteristics of the individual studies are presented in Tables S1 and S2 .…”

“…The Cochrane risk of bias of the included studies is shown in Figures S1 and S2 . The overall risk of bias was judged as low in twenty-nine studies [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 53 ], and reviewers indicate some concerns on the other two [ 33 , 47 ].…”

“…A flow diagram showing stages of database search and study selection is shown in Figure 1. Twenty-seven studies reported OHCA outcomes in pre-vs. intra-COVID-19 periods [23,24,[26][27][28][29]31,33,35,[37][38][39][40][41][42][44][45][46][47][48][49][50][51][52][53], and OHCA outcomes in SARS-CoV-2-positive vs. -negative patients were reported in seven trials [25,30,32,34,36,43,51]. Characteristics of the individual studies are presented in Tables S1 and S2.…”

“…The Cochrane risk of bias of the included studies is shown in Figures S1 and S2. The overall risk of bias was judged as low in twenty-nine studies [23][24][25][26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][46][48][49][50][51][52][53], and reviewers indicate some concerns on the other two [33,47].…”