Evaluation of the impact of the COVID-19 Pandemic on Nonhospital Cardiac Arrest Rates

Abstract

Objective: This study aimed to investigate whether the coronavirus disease 2019 (COVID-19) pandemic resulted in delayed access to acute medical conditions and an increase in nonhospital cardiac arrests. Material and Methods: In this retrospective cross-sectional study, emergency department admissions of nonhospital cardiac arrest patients during the pre-pandemic period (11/03/2019-31/01/2020) and the pandemic period (11/03/2020-31/01/2021) were examined. Demographic data, comorbidities, pre-arrest complaints and onset of complaints, return of spontaneous circulation, and duration of stay in the emergency department were compared. Results: Although there was a 49% decrease in general hospital admissions and a 28% decrease in emergency department admissions between the two defined periods, there was a 38% increase in out-of-hospital cardiac arrests during the pandemic period. There was no statistically significant difference between the patients who underwent cardiopulmonary resuscitation in both periods in terms of gender (p=0.06), age (p=0.15), and comorbidity (p=0.14). Pre-arrest chest pain and dyspnea were more common in the pandemic period than in the pre-pandemic period (p=0.02). Patients who achieved spontaneous return during the pandemic period had longer intensive care unit waiting times (p<0.001). Conclusions: Limitations such as the risk of transmission of the COVID-19 disease, the desire to protect social distance, and curfews caused people with chronic diseases to delay their follow-up and avoid the need to seek emergency health care in case of acute exacerbations.