• Shir Lynn Lim, Nur Shahidah, Seyed Ehsan Saffari, Qin Xiang Ng, Ho Andrew Fu Wah AFW 0000-0003-4338-3876 Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore. , Benjamin Sieu-Hon Leong, Shalini Arulanandam, Fahad Javaid Siddiqui, and Ong Marcus Eng Hock MEH Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore. .
• Department of Cardiology, National University Heart Center, Singapore 119228, Singapore.
• Int J Environ Res Public Health. 2021 Mar 31; 18 (7).

AbstractThis study aimed to evaluate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) in Singapore. We used data from the Singapore Civil Defence Force to compare the incidence, characteristics and outcomes of all Emergency Medical Services (EMS)-attended adult OHCA during the pandemic (January-May 2020) and pre-pandemic (January-May 2018 and 2019) periods. Pre-hospital return of spontaneous circulation (ROSC) was the primary outcome. Binary logistic regression was used to calculate the adjusted odds ratios (aOR) for the characteristics of OHCA. Of the 3893 OHCA patients (median age 72 years, 63.7% males), 1400 occurred during the pandemic period and 2493 during the pre-pandemic period. Compared with the pre-pandemic period, OHCAs during the pandemic period more likely occurred at home (aOR: 1.48; 95% CI: 1.24-1.75) and were witnessed (aOR: 1.71; 95% CI: 1.49-1.97). They received less bystander CPR (aOR: 0.70; 95% CI: 0.61-0.81) despite 65% of witnessed arrests by a family member, and waited longer for EMS (OR ≥ 10 min: 1.71, 95% CI 1.46-2.00). Pre-hospital ROSC was less likely during the pandemic period (aOR: 0.67; 95% CI: 0.53-0.84). The pandemic saw increased OHCA incidence and worse outcomes in Singapore, likely indirect effects of COVID-19.

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