Dataset Information

Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis.

ABSTRACT:

Background

The impact of COVID-19 on pre-hospital and hospital services and hence on the prevalence and outcomes of out-of-hospital cardiac arrests (OHCA) remain unclear. The review aimed to evaluate the influence of the COVID-19 pandemic on the incidence, process, and outcomes of OHCA.

Methods

A systematic review of PubMed, EMBASE, and pre-print websites was performed. Studies reporting comparative data on OHCA within the same jurisdiction, before and during the COVID-19 pandemic were included. Study quality was assessed based on the Newcastle-Ottawa Scale.

Results

Ten studies reporting data from 35,379 OHCA events were included. There was a 120% increase in OHCA events since the pandemic. Time from OHCA to ambulance arrival was longer during the pandemic (p?=?0.036). While mortality (OR?=?0.67, 95%-CI 0.49-0.91) and supraglottic airway use (OR?=?0.36, 95%-CI 0.27-0.46) was higher during the pandemic, automated external defibrillator use (OR?=?1.78 95%-CI 1.06-2.98), return of spontaneous circulation (OR?=?1.63, 95%CI 1.18-2.26) and intubation (OR?=?1.87, 95%-CI 1.12--3.13) was more common before the pandemic. More patients survived to hospital admission (OR?=?1.75, 95%-CI 1.42-2.17) and discharge (OR?=?1.65, 95%-CI 1.28-2.12) before the pandemic. Bystander CPR (OR?=?1.18, 95%-CI 0.95-1.46), unwitnessed OHCA (OR?=?0.84, 95%-CI 0.66-1.07), paramedic-resuscitation attempts (OR?=?1.19 95%-CI 1.00-1.42) and mechanical CPR device use (OR?=?1.57 95%-CI 0.55-4.55) did not defer significantly.

Conclusions

The incidence and mortality following OHCA was higher during the COVID-19 pandemic. There were significant variations in resuscitation practices during the pandemic. Research to define optimal processes of pre-hospital care during a pandemic is urgently required.

Review registration

PROSPERO (CRD42020203371).

SUBMITTER: Lim ZJ

PROVIDER: S-EPMC7603976 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis.

Lim Zheng Jie ZJ Ponnapa Reddy Mallikarjuna M Afroz Afsana A Billah Baki B Shekar Kiran K Subramaniam Ashwin A

Resuscitation 20201101

<h4>Background</h4>The impact of COVID-19 on pre-hospital and hospital services and hence on the prevalence and outcomes of out-of-hospital cardiac arrests (OHCA) remain unclear. The review aimed to evaluate the influence of the COVID-19 pandemic on the incidence, process, and outcomes of OHCA.<h4>Methods</h4>A systematic review of PubMed, EMBASE, and pre-print websites was performed. Studies reporting comparative data on OHCA within the same jurisdiction, before and during the COVID-19 pandemic ...[more]

PMID: 33137418

Similar Datasets

Project description:BackgroundThough variable, many major metropolitan cities reported profound and unprecedented increases in out-of-hospital cardiac arrest (OHCA) in early 2020. This study examined the relative magnitude of those increases and their relationship to COVID-19 prevalence.MethodsEMS (9-1-1 system) medical directors for 50 of the largest U.S. cities agreed to provide the aggregate, de-identified, pre-existing monthly tallies of OHCA among adults (age >18 years) occurring between January and June 2020 within their respective jurisdictions. Identical comparison data were also provided for corresponding time periods in 2018 and 2019. Equivalent data were obtained from the largest cities in Italy, United Kingdom and France, as well as Perth, Australia and Auckland, New Zealand.FindingsSignificant OHCA escalations generally paralleled local prevalence of COVID-19. During April, most U.S. cities (34/50) had >20% increases in OHCA versus 2018-2019 which reflected high local COVID-19 prevalence. Thirteen observed 1·5-fold increases in OHCA and three COVID-19 epicenters had >100% increases (2·5-fold in New York City). Conversely, cities with lesser COVID-19 impact observed unchanged (or even diminished) OHCA numbers. Altogether (n = 50), on average, OHCA cases/city rose 59% during April (p = 0·03). By June, however, after mitigating COVID-19 spread, cities with the highest OHCA escalations returned to (or approached) pre-COVID OHCA numbers while cities minimally affected by COVID-19 during April (and not experiencing OHCA increases), then had marked OHCA escalations when COVID-19 began to surge locally. European, Australian, and New Zealand cities mirrored the U.S. experience.InterpretationMost metropolitan cities experienced profound escalations of OHCA generally paralleling local prevalence of COVID-19. Most of these patients were pronounced dead without COVID-19 testing.FundingNo funding was involved. Cities provided de-identified aggregate data collected routinely for standard quality assurance functions.

Dataset Information

Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis.

Background

Methods

Results

Conclusions

Review registration

Publications

Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis.

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