Original Articles Open access

Out of hospital cardiac arrest during COVID-19 pandemic: A retrospective study from north east of Italy

Authors

Published
27 September 2022
Section
Original Articles
DOI
10.4081/ecj.2022.10436

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak affected the epidemiology and the outcomes of Out-Of Hospital Cardiac Arrest (OHCA). We performed a retrospective observational study in the Western district of Vicenza (Veneto, Italy) to evaluate patients affected by non-traumatic OHCA and we analyzed epidemiological and clinical characteristics associated with sustained Return Of Spontaneous Circulation (ROSC). We collected 114 cases from January 2019 to May 2021 and we compared data of the pre-pandemic period (2019) with the pandemic one (2020-2021). During the pandemic we found an increase of bystander CPR, of OHCA with a cardiac cause and of shockable presenting rhythms. All these observations weren’t associated with an increase of sustained ROSC, which could be determined by both the reorganization of the health care system with the reduction of medical screenings and by the interruption of training courses reducing the efficacy of cardiopulmonary resuscitation. On the other hand, the higher percentage of presenting shockable rhythm reinforces the importance of bystander rule and of short time to start CPR.

Keywords

References

  1. Marijon E, Karam N, Jost D, et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: A population based study. Lancet Public Healt 2020;5:e437-43. DOI: https://doi.org/10.1016/S2468-2667(20)30117-1
  2. Lai PH, Lancet EA, Weiden MD, et al. Characteristics associated with out-of-hospital cardiac arrest and resuscitations during novel coronavirus disease 2019 pandemic in New York city 2020;5:1154-63. DOI: https://doi.org/10.1001/jamacardio.2020.2488
  3. Squizzato T, Landoni G, Paoli A, et al. Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: a systematic review. Resuscitation 2020;157:241-7. DOI: https://doi.org/10.1016/j.resuscitation.2020.10.020
  4. Baldi E, Sechi GM, Mare C, et al. Out-of-hospital cardiac arrest during COVID-19 outbreak in Italy. N Engl J Med 2020;383:496-8. DOI: https://doi.org/10.1056/NEJMc2010418
  5. Uy-Evanado A, Chugh HS, Sargsyan A, et al. Out-of-hospital cardiac arrest response and outcomes during the COVID-19 pandemic. JACC Clin Electrophysiol 2021;7:6-11. DOI: https://doi.org/10.1016/j.jacep.2020.08.010
  6. U.O.C. Servizo Epidemiologico regionale e Registri: Epidemia da COVID-19 in Veneto: Mortalità generale nel periodo Gennaio-Novembre. Mortalità per causa nel primo picco epidemico. U.O.C. Servizio EpidemiologicoRegionale e Registri. https://www.ser-veneto.it/public/Mortalit%C3%A0_agg20201214.pdf
  7. Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes 2010;3:63-81. DOI: https://doi.org/10.1161/CIRCOUTCOMES.109.889576
  8. Hasselqvist-Ax I, Riva G, Herlitz J, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arest. N Engl J Med 2015;372:2307-15. DOI: https://doi.org/10.1056/NEJMoa1405796
  9. Al-Jeabory M, Safiejko K, Bialka S, et al. Impact of COVID-19 on bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest: is it as bad as we think? Cardiol J 2020;27:884-5. DOI: https://doi.org/10.5603/CJ.a2020.0179
  10. Panchal AR, Berg KM, Hirsch KG, et al. American Heart Association focused uptodate on advanced cardiovascular life support: use of advanced airways, vasopressors and extracorporeal cardiopulmonary resuscitation during cardiac arrest: an update to American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2019;140:e881-e94. DOI: https://doi.org/10.1161/CIR.0000000000000732
  11. Edelson DP, Sasson C, Chan PS, et al. Interim guidance for basic and advanced life support in adults, children, and neonates with suspected or confirmed COVID-19: from the emergency cardiovascular care committee and get with the guidelines-resuscitation adult and pediatric task forces of the American heart association. Circulation 2020;141:e933-43.
  12. Latsios G, Leopoulou M, Synetos A, et al. The role of automated compression devices in out-of and in hospital cardiac arrest. Can we spare rescuers’ hands? Emergency Care Journal 2021;17:9525. DOI: https://doi.org/10.4081/ecj.2021.9525
  13. Zhu N, Chen Q, Jiang Z et al. A meta-analysis of the resuscitative effects of the mechanical and manual chest compression in out-of-hospital cardiac arrest patients. Crit Care 2019;23:100. DOI: https://doi.org/10.1186/s13054-019-2389-6
  14. Landi A, De Servi S. Temporal trends in out-of-hospital cardiac arrest during the COVID-19 outbreak. Am J Emerg Med 2021;45:553-4. DOI: https://doi.org/10.1016/j.ajem.2020.07.045
  15. Hons MR, Hons CPG, Hons NC et al. Impact of coronavirus disease 2019 pandemic on the incidence and management of out-of-hospital cardiac arrest in patients presenting with acute myocardial infarction in England. L Am Heart Assoc 2020;9:e018379. DOI: https://doi.org/10.1161/JAHA.120.018379
  16. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complication in COVID-19. Am J Emeg Med 2020;38:1504-07. DOI: https://doi.org/10.1016/j.ajem.2020.04.048

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.

PlumX Metrics

License

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.