Clin Exp Emerg Med.  2021 Jun;8(2):137-144. 10.15441/ceem.21.008.

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

• Ahn JY
• Ryoo HW
• Cho JW
• Kim JH
• Lee SH
• Jang TC

• KMID: 2517610
• DOI: http://doi.org/10.15441/ceem.21.008

Abstract

Objective
This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city.
Methods
This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre- and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis.
Results
This study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05–0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02–0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods.
Conclusion
During the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

Keyword

COVID-19; Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Prognosis