Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis

Teoh, Seth En; Yeo, Jun Wei; Tan, Darren Jun Hao; Jimian, Daryl Lin; Lim, Shir Lynn; Ong, Marcus Eng Hock; Blewer, Audrey L; Ho, Andrew Fu Wah

doi:10.1038/s41598-021-04749-9

Cited by 26 publications

(21 citation statements)

References 50 publications

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“…Second, we have not further stratified the patient’s clinical status before PCI. Third, an increase in out-of-hospital cardiac arrest and death was reported in some countries during the early COVID-19 epidemic, [ 27 , 28 ] and this may affect our study results. However, due to the limitation of the data, we could not analyze this in the study.…”

Section: Discussionmentioning

confidence: 90%

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea: An observational study

et al. 2022

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The coronavirus disease 2019 (COVID-19) resulted in a marked decrease in the number of patient visits for acute myocardial infarction and delayed patient response and intervention in several countries. This study evaluated the effect of the COVID-19 pandemic on the number of patients, patient response time (pain-to-door), and intervention time (door-to-balloon) for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Patients with STEMI or NSTEMI visiting a hospital in South Korea who underwent primary coronary intervention during the COVID-19 pandemic (January 29, 2020, to December 31, 2020) were compared with those in the equivalent period from 2018 to 2019. Patient response and intervention times were compared for the COVID-19 pandemic window (2020) and the equivalent period from 2018 to 2019. We observed no decrease in the number of patients with STEMI (P = .88) and NSTEMI (P = 1.00) during the COVID-19 pandemic compared to that in the previous years. Patient response times (STEMI: P = .39; NSTEMI: P = .59) during the overall COVID-19 pandemic period did not differ significantly. However, we identified a significant decrease in door-to-balloon time among patients with STEMI (14%; P < .01) during the early COVID-19 pandemic. We found that the number of patients with STEMI and NSTEMI was consistent during the COVID-19 pandemic and that no time delays in patient response and intervention occurred. However, the door-to-balloon time among patients with STEMI significantly reduced during the early COVID-19 pandemic, which could be attributed to decreased emergency care utilization during the early pandemic.

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Section: Discussionmentioning

confidence: 90%

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea: An observational study

et al. 2022

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“… Structural/ Systemic 72 Masuda et. al 84 Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis Meta-analysis Peer-reviewed Literature US ● Out-of-hospital sudden cardiac arrest was more common throughout the COVID-19 pandemic, with an odds ratio of 1.38. ● Defibrillation by bystanders while waiting for an EMS response was significantly lower (OR = 0.69).…”

Section: Resultsmentioning

confidence: 99%

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Ventura¹,

Denton²,

David³

et al. 2022

OAEM

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This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Egger’s test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P < 0.10 or I^2 > 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, ie, COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease responses.

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“…It is important to note OHCA cases may be underestimated due to limitations in data collection [ 45 ] and paucity of viral testing. There are conflicting studies regarding changes in bystander CPR and defibrillator usage, either remaining unchanged or decreasing throughout the pandemic [ 30 , 39 , 41 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical update on COVID-19 for the emergency clinician: Cardiac arrest in the out-of-hospital and in-hospital settings

Brady¹,

Chavez²,

Gottlieb³

et al. 2022

The American Journal of Emergency Medicine

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Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis

Cited by 26 publications

References 50 publications

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea: An observational study

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea: An observational study

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Clinical update on COVID-19 for the emergency clinician: Cardiac arrest in the out-of-hospital and in-hospital settings

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