Out-of-hospital cardiac arrest before and during the COVID-19 pandemic: a retrospective observational study

The Coronavirus Disease 2019 (COVID-19) pandemic significantly impacted the management of out-of-hospital cardiac arrest (OHCA), necessitating considerable reorganization within global healthcare systems. This study aims to assess the influence of the COVID-19 pandemic on the treatment outcomes and the rate of sustained prehospital return of spontaneous circulation (ROSC) until hospital admission in patients experiencing OHCA. We conducted a retrospective observational study to evaluate the survival outcomes of OHCA patients who received cardiopulmonary resuscitation (CPR) from emergency medical services (EMS) teams before and during the COVID-19 pandemic from 11 March 2018 to 10 March 2022. The patients were categorized into two cohorts: those who suffered OHCA prior to the pandemic (Pre-pandemic group) from 11 March 2018, to 10 March 2020, and those during the pandemic (Pandemic group), from 11 March 2020, to 10 March 2022. The study included 958 patients divided into the Pre-pandemic group (n = 434 patients) and Pandemic group (n = 524 patients) (p < 0.05). Analysis showed no significant differences between the groups in terms of age, gender, EMS response time, initial cardiac rhythm and adrenaline administration. Endotracheal intubation was more frequently performed in the Pre-pandemic group (χ2 = 8.737; df = 3; p = 0.033), as were the administrations of amiodarone (χ2 = 6.508; df = 1; p = 0.011) and saline solution (χ2 = 5.510; df = 1; p = 0.019). Rates of prehospital ROSC until hospital admission were significantly higher in the Pre-pandemic group (18.4%) compared to the Pandemic group (12.6%) (χ2 = 5.685; df = 1; p = 0.017). During the COVID-19 pandemic, there was an increase in OHCA incidents in our study region compared to before the pandemic period. Concurrently, we observed a significant reduction in the proportion of patients achieving and maintaining ROSC prehospital until hospital admission during the pandemic.

Coronavirus Disease 2019; Cardiopulmonary resuscitation; Sudden cardiac arrest; Survival

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