• Enrico Baldi, Giuseppe Maria Sechi, Claudio Mare, Fabrizio Canevari, Antonella Brancaglione, Roberto Primi, Catherine Klersy, Alessandra Palo, Enrico Contri, Vincenza Ronchi, Giorgio Beretta, Francesca Reali, Pierpaolo Parogni, Fabio Facchin, Ugo Rizzi, Daniele Bussi, Simone Ruggeri, Oltrona Visconti Luigi L Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Simone Savastano, and Lombardia CARe researchers.
• Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy.
• Eur. Heart J. 2020 Jun 1; 41 (32): 3045-3054.

AimsAn increase in out-of-hospital cardiac arrest (OHCA) incidence has been reported in the very early phase of the COVID-19 epidemic, but a clear demonstration of a correlation between the increased incidence of OHCA and COVID-19 is missing so far. We aimed to verify whether there is an association between the OHCA difference compared with 2019 and the COVID-19 epidemic curve.Methods And ResultsWe included all the consecutive OHCAs which occurred in the Provinces of Lodi, Cremona, Pavia, and Mantova in the 2 months following the first documented case of COVID-19 in the Lombardia Region and compared them with those which occurred in the same time frame in 2019. The cumulative incidence of COVID-19 from 21 February to 20 April 2020 in the study territory was 956 COVID-19/100 000 inhabitants and the cumulative incidence of OHCA was 21 cases/100 000 inhabitants, with a 52% increase as compared with 2019 (490 OHCAs in 2020 vs. 321 in 2019). A strong and statistically significant correlation was found between the difference in cumulative incidence of OHCA between 2020 and 2019 per 100 000 inhabitants and the COVID-19 cumulative incidence per 100 000 inhabitants both for the overall territory (ρ 0.87, P < 0.001) and for each province separately (Lodi: ρ 0.98, P < 0.001; Cremona: ρ 0.98, P < 0.001; Pavia: ρ 0.87, P < 0.001; Mantova: ρ 0.81, P < 0.001).ConclusionThe increase in OHCAs in 2020 is significantly correlated to the COVID-19 pandemic and is coupled with a reduction in short-term outcome. Government and local health authorities should seriously consider our results when planning healthcare strategies to face the epidemic, especially considering the expected recurrent outbreaks.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

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