• Jae Wan Cho, Haewon Jung, Mi Jin Lee, Sang Hun Lee, Suk Hee Lee, You Ho Mun, Han-Sol Chung, Yang Hun Kim, Gyun Moo Kim, Sin-Youl Park, Jae Cheon Jeon, Changho Kim, and WinCOVID-19 consortium.
• Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
• Resusc Plus. 2020 Sep 1; 3: 100015.

BackgroundIn February and March 2020, healthcare providers and citizens in Daegu, South Korea, experienced the onslaught of a large-scale community epidemic of COVID-19. This had a profound impact on patients who experienced out-of-hospital cardiac arrest (OHCA).MethodsWe conducted a retrospective observational study of 171 OHCA patients based on the multicenter WinCOVID registry. Demographic and clinical characteristics, overall survival, COVID-19 related data, as well as personal protective equipment (PPE) and resuscitation techniques used during the COVID-19 outbreak were evaluated and compared with outcomes from a 2018 historical cohort (n ​= ​158).ResultsAmong the interventions, high-level PPE was introduced and standard cardiopulmonary resuscitation was changed to chest compressions using mechanical devices. All OHCA patients were treated as confirmed or suspicious for COVID-19 regardless of symptoms. Furthermore, complete or partial closures of emergency centers and the number of medical personnel requiring self-isolation decreased in response to the introduction of isolated resuscitation units. However, the adjusted odds ratio and 95% confidence intervals for survival discharge and favorable neurologic outcome were 0.51 (0.25-0.97) and 0.45 (0.21-1.07) compared with those in the 2018 historical cohort.ConclusionsResponses to the COVID-19 pandemic included changes to current PPE strategies and introduction of isolated resuscitation units; the latter intervention reduced the number of unexpected closures and quarantines of emergency resources early on during the COVID-19 outbreak. Given the possibility of future outbreaks, we need to have revised resuscitation strategies and the capacity to commandeer emergency resources for OHCA patients.© 2020 The Author(s).

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