Preparedness of personal protective equipment and implementation of new CPR strategies for patients with out-of-hospital cardiac arrest in the COVID-19 era

Cho, Jae Wan; Jung, Haewon; Lee, Mi Jin; Lee, Suk Hee; Mun, You Ho; Chung, Han Sol; Kim, Yang Hun; Kim, Gyun Moo; Park, Sin-Youl; Jeon, Jae Cheon; Kim, Changho

doi:10.1016/j.resplu.2020.100015

Cited by 27 publications

(78 citation statements)

References 25 publications

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“…1-2). OHCAs during the COVID-19 pandemic were more likely to occur at home in Italy (90% during the pandemic vs. 83% in the non-pandemic period; P = 0.005) 6 and France (90% vs. 77%; P < 0.001) 7 while in the other studies were similar 9 , 10 , 23 (Supplemental Fig. 3).…”

Section: Resultsmentioning

confidence: 73%

“…8 A multivariate analysis confirmed that patients with OHCA during the COVID-19 pandemic were 41% less likely to achieve ROSC (OR, 0.59; 95% CI, 0.50-0.70; P < 0.001) in New York City. 8 The other two studies reported a non-statistically significant reduction in ROSC rates during the pandemic 9 , 23 ( Fig. 2 A).…”

Section: Resultsmentioning

confidence: 88%

“…Survival at hospital discharge was reported in three studies 6 , 7 , 23 and survival with good neurologic outcome only in one. 23 In France, patients suffering an OHCA during the COVID-19 pandemic were less likely to survive: rates of survival at hospital discharge declined from 5.4% to 3.1% ( P < 0.001). 7 A non-statistically significant reduction in survival rate was observed in Italy 6 and South Korea 23 ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were conducted in Europe, 6 , 7 , 9 two in the USA, 8 , 10 and one in Asia. 23 Main characteristics of included studies are described in Table 1 .

Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Patients treated during the COVID-19 pandemic who survived to hospital discharge with a good neurological outcome were 2.9% vs. 5.7% during the non-pandemic period in South Korea ( P = 0.09). 23 …”

Section: Resultsmentioning

confidence: 99%

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Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review

et al. 2020

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Introduction In addition to the directly attributed mortality, COVID-19 is also likely to increase mortality indirectly. In this systematic review, we investigate the direct and indirect effects of COVID-19 on out-of-hospital cardiac arrests. Methods We searched PubMed, BioMedCentral, Embase and the Cochrane Central Register of Controlled Trials for studies comparing out-of-hospital cardiac arrests occurring during the pandemic and a non-pandemic period. Risk of bias was assessed with the ROBINS-I tool. The primary endpoint was return of spontaneous circulation. Secondary endpoints were bystander-initiated cardiopulmonary resuscitation, survival to hospital discharge, and survival with favourable neurological outcome. Results We identified six studies. In two studies, rates of return of spontaneous circulation and survival to hospital discharge decreased significantly during the pandemic. Especially in Europe, bystander-witnessed cases, bystander-initiated cardiopulmonary resuscitation and resuscitation attempted by emergency medical services were reduced during the pandemic. Also, ambulance response times were significantly delayed across all studies and patients presenting with non-shockable rhythms increased in two studies. In 2020, 3.9-5.9% of tested patients were SARS-CoV-2 positive and 4.8-26% had suggestive symptoms (fever and cough or dyspnoea). Conclusions Out-of-hospital cardiac arrests had worse short-term outcomes during the pandemic than a non-pandemic period suggesting direct effects of COVID-19 infection and indirect effects from lockdown and disruption of healthcare systems. Patients at high risk of deterioration should be identified outside the hospital to promptly initiate treatment and reduce fatalities. Study registration PROSPERO CRD42020195794.

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Section: Resultsmentioning

confidence: 73%

Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

“…Three studies were conducted in Europe, 6 , 7 , 9 two in the USA, 8 , 10 and one in Asia. 23 Main characteristics of included studies are described in Table 1 .

Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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