• Resuscitation · Jan 2024

    Meta Analysis

    The impact of COVID-19 pandemic on out-of-hospital cardiac arrest: an individual patient data meta-analysis.

    • Enrico Baldi, Catherine Klersy, Paul Chan, Jonathan Elmer, Jocasta Ball, Catherine R Counts, Fernando Rosell Ortiz, Rachael Fothergill, Angelo Auricchio, Andrea Paoli, Nicole Karam, Bryan McNally, Christian Martin-Gill, Ziad Nehme, Christopher J Drucker, José Ignacio Ruiz Azpiazu, Adam Mellett-Smith, Ruggero Cresta, Tommaso Scquizzato, Xavier Jouven, Roberto Primi, Rabab Al-Araji, Francis X Guyette, Michael R Sayre, Antonio Daponte Codina, Claudio Benvenuti, Eloi Marijon, Simone Savastano, and OHCA-COVID study group.
    • Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: enrico.baldi@unipv.it.
    • Resuscitation. 2024 Jan 1; 194: 110043110043.

    AimPrior studies have reported increased out-of-hospital cardiac arrests (OHCA) incidence and lower survival during the COVID-19 pandemic. We evaluated how the COVID-19 pandemic affected OHCA incidence, bystander CPR rate and patients' outcomes, accounting for regional COVID-19 incidence and OHCA characteristics.MethodsIndividual patient data meta-analysis of studies which provided a comparison of OHCA incidence during the first pandemic wave (COVID-period) with a reference period of the previous year(s) (pre-COVID period). We computed COVID-19 incidence per 100,000 inhabitants in each of 97 regions per each week and divided it into its quartiles.ResultsWe considered a total of 49,882 patients in 10 studies. OHCA incidence increased significantly compared to previous years in regions where weekly COVID-19 incidence was in the fourth quartile (>136/100,000/week), and patients in these regions had a lower odds of bystander CPR (OR 0.49, 95%CI 0.29-0.81, p = 0.005). Overall, the COVID-period was associated with an increase in medical etiology (89.2% vs 87.5%, p < 0.001) and OHCAs at home (74.7% vs 67.4%, p < 0.001), and a decrease in shockable initial rhythm (16.5% vs 20.3%, p < 0.001). The COVID-period was independently associated with pre-hospital death (OR 1.73, 95%CI 1.55-1.93, p < 0.001) and negatively associated with survival to hospital admission (OR 0.68, 95%CI 0.64-0.72, p < 0.001) and survival to discharge (OR 0.50, 95%CI 0.46-0.54, p < 0.001).ConclusionsDuring the first COVID-19 pandemic wave, there was higher OHCA incidence and lower bystander CPR rate in regions with a high-burden of COVID-19. COVID-19 was also associated with a change in patient characteristics and lower survival independently of COVID-19 incidence in the region where OHCA occurred.Copyright © 2023 Elsevier B.V. All rights reserved.

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