Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis

Annals of Intensive Care

Nan Liu¹  Audrey L. Blewer²  Laurie J. Morrison³  Marcus Eng Hock Ong⁴  Andrew Fu Wah Ho⁵  Darren Jun Hao Tan⁶  Yoshio Masuda⁶  Seth En Teoh⁶ 

[1] Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore;Department of Family Medicine and Community Health, and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA;Division of Emergency Medicine, Department of Medicine, Li Ka Shing Knowledge Institute, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada;Office C, Department of Emergency Medicine, Singapore General Hospital, 1 Outram Rd, 169608, Singapore, Singapore;Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore;Office C, Department of Emergency Medicine, Singapore General Hospital, 1 Outram Rd, 169608, Singapore, Singapore;Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, Singapore, Singapore;Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;

关键词: Cardiac arrest;    COVID-19;    Pandemic;    Coronavirus;    Emergency medical services;    Resuscitation;    Ambulance;    Sudden cardiac death;    Out of hospital;    OHCA;    Epidemiology;   

DOI  :  10.1186/s13613-021-00957-8

来源: Springer

【 摘 要 】

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics.MethodsPubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes [annual incidence, mortality, and case fatality rate (CFR)], secondary outcomes [field termination of resuscitation (TOR), return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge], and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879).ResultsThe COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality [95% confidence interval (95%CI) 1.51–2.51]. There was increased field TOR (OR = 2.46, 95%CI 1.62–3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55–0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48–0.89), and survival to discharge (OR = 0.52, 95%CI 0.40–0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60–0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02–1.33).ConclusionCompared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

【 授权许可】

CC BY