Cardiac arrest and coronavirus disease 2019

Abstract

Purpose of reviewThe impact of the coronavirus disease 2019 (COVID-19) on the cardiovascular system has been highlighted since the very first weeks after the severe acute respiratory syndrome coronavirus 2 identification. We reviewed the influence of COVID-19 pandemic on cardiac arrest, both considering those occurred out of the hospital (OHCA) and in the hospital (IHCA). Recent findingsAn increase in OHCA incidence occurred in different countries, especially in those regions most burdened by the COVID-19, as this seems to be bounded to the pandemic trend. A change of OHCA patients' characteristics, with an increase of the OHCA occurred at home, a decrease in bystander cardiopulmonary resuscitation and automated external defibrillator use before Emergency Medical Service (EMS) arrival and an increase in non-shockable rhythms, have been highlighted. A dramatic drop in the OHCA patients' survival was pointed out in almost all the countries, regardless of the high or low-incidence of COVID-19 cases. Concerning IHCA, a reduction in survival was highlighted in patients with COVID-19 who sustained a cardiac arrest. SummaryCardiac arrest occurrence and survival were deeply affected by the pandemic. Informative campaigns to the population to call EMS in case of need and the re-allocation of the prehospital resources basing on the pandemic trend are needed to improve survival.

Impact of COVID-19 Pandemic on Patients with ST-Segment-Elevation Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest

“…To the best of our knowledge, this is the first study to evaluate clinical outcomes in STEMI complicated by OHCA during the COVID-19 pandemic as compared to pre-pandemic era. A decrease in the number of STEMI patients and a higher rate of OHCA counts were widely reported despite geographical location since the pandemic began [1][2][3][4]7,[21][22][23][24][25][26]. Several factors might partially explain these findings.…”

“…Importantly, such disturbing outcomes were noted irrespective of the geographical location and in low-and high-income countries with well-developed healthcare systems [7,9,26,[29][30][31]. Furthermore, alarming data suggested a decrease in bystander CPR, utilization of AED, and a higher rate of non-shockable rhythms [1,7,9]. Evaluation of CPR practices after the onset of the COVID-19 pandemic highlighted a decrease in the willingness to perform life-saving interventions despite SARS-CoV-2 status [7,9,[24][25][26].…”

“…The COVID-19 pandemic engenders profound changes in the functioning and effectiveness of the healthcare system [1][2][3][4]. A sudden surge of infected patients and mandatory swab tests with pandemic-specific protocols forced fragmentation of attention and resources of medical staff.…”