Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an out-of-hospital cardiac arrest in the COVID-19 pandemic treated by emergency medical service (EMS) teams. Methods: All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened. Results: In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined. Conclusions: The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.

Observational analysiS of out-of-hospital Cardiac Arrest occurRence and temporal variability patterns in subpopulation of southern POLand from 2006 to 2018: OSCAR-POL registry

“…Furthermore, preliminary data from the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic also presented a potential relationship with increased OHCA occurrence [29]. Borkowska et al [30] presented results regarding OHCA during the coronavirus disease 2019 (COVID-19) pandemic and reported that during March and April 2020 the OHCA incidence within Masovia Voivodeship was 12.2 per 100,000 inhabitants, which is lower in comparison to previous Polish studies [2][3][4]. However, it should be noticed that in March and April 2020 in Poland the epidemic was just starting to develop, the number of confirmed SARS-CoV-2 infections was very low and the first government restrictions were being implemented.…”

Impact of COVID-19 pandemic on out-of-hospital cardiac arrest survival rate

“…Subsequently, this limits the number of ambulances available at a time, and to conduct resuscitation in protective suits, which, as many studies show, reduce the effectiveness of medical procedures, including chest compression. 2 , 3 , 4 …”

Impact of Coronavirus Disease 2019 on Out-of-Hospital Cardiac Arrest Survival Rate: A Systematic Review with Meta-Analysis

“…To the best of our knowledge, this was the first meta-analysis focused on OHCA in the pandemic period comparing COVID-19 suspected or diagnosed patients to non-COVID-19 patients. Previous studies analyzed the first months of the pandemic with the corresponding periods in the years preceding the pandemic [ 38 , 39 , 40 , 41 ], making them more prone to bias. In contrast, this meta-analysis was based on the analysis of the incidence of OHCA during the COVID-19 pandemic, increasing the reliability of the results.…”