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

• Published in: Clinical and experimental emergency medicine Vol. 8; no. 2; pp. 137 - 144
• Main Authors: Ahn, Jae Yun, Ryoo, Hyun Wook, Cho, Jae Wan, Kim, Jung Ho, Lee, Sang-Hun, Jang, Tae Chang
• Format: Journal Article
• Language: English
• Published: The Korean Society of Emergency Medicine 01.06.2021; 대한응급의학회
• Subjects: cardiopulmonary resuscitation; covid-19; Original; out-of-hospital cardiac arrest; prognosis; 응급의학
• ISSN: 2383-4625; 2383-4625
• DOI: 10.15441/ceem.21.008

OBJECTIVEThis 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. METHODSThis 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.