Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis

• Published in: Scientific reports Vol. 12; no. 1; p. 800
• Main Authors: Masuda, Yoshio, Teoh, Seth En, Yeo, Jun Wei, Tan, Darren Jun Hao, Jimian, Daryl Lin, Lim, Shir Lynn, Ong, Marcus Eng Hock, Blewer, Audrey L., Ho, Andrew Fu Wah
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.01.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019; 692/700/1538; Aged; Aged, 80 and over; Cardiac arrest; Cardiopulmonary Resuscitation - mortality; Coronaviruses; COVID-19; COVID-19 - epidemiology; Defibrillators; Emergency medical services; Emergency Medical Services - methods; Female; Heart; Hospital systems; Hospitals; Humanities and Social Sciences; Humans; Male; Meta-analysis; Middle Aged; multidisciplinary; Out-of-Hospital Cardiac Arrest - epidemiology; Pandemics; Regression analysis; Science; Science (multidisciplinary); Survival
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-04749-9

Bystander cardiopulmonary resuscitation (BCPR), early defibrillation and timely treatment by emergency medical services (EMS) can double the chance of survival from out-of-hospital sudden cardiac arrest (OHCA). We investigated the effect of the COVID-19 pandemic on the pre-hospital chain of survival. We searched five bibliographical databases for articles that compared prehospital OHCA care processes during and before the COVID-19 pandemic. Random effects meta-analyses were conducted, and meta-regression with mixed-effect models and subgroup analyses were conducted where appropriate. The search yielded 966 articles; 20 articles were included in our analysis. OHCA at home was more common during the pandemic (OR 1.38, 95% CI 1.11–1.71, p = 0.0069). BCPR did not differ during and before the COVID-19 pandemic (OR 0.94, 95% CI 0.80–1.11, p = 0.4631), although bystander defibrillation was significantly lower during the COVID-19 pandemic (OR 0.65, 95% CI 0.48–0.88, p = 0.0107). EMS call-to-arrival time was significantly higher during the COVID-19 pandemic (SMD 0.27, 95% CI 0.13–0.40, p = 0.0006). Resuscitation duration did not differ significantly between pandemic and pre-pandemic timeframes. The COVID-19 pandemic significantly affected prehospital processes for OHCA. These findings may inform future interventions, particularly to consider interventions to increase BCPR and improve the pre-hospital chain of survival.