Researchers from the Albert Einstein College of Medicine, NYU School of Medicine and FDNY published a study June 19 in JAMA Cardiology that sought to evaluate the impact of the COVID-19 pandemic on out-of-hospital cardiac arrests and death.
The population-based, cross-sectional study compared patients with out-of-hospital cardiac arrest receiving resuscitation by the NYC 9-1-1 EMS system from March 1 to April 25, 2020, compared with March 1 to April 25, 2019.
Researchers discovered that the number of patients who underwent resuscitation was three-fold higher during the 2020 COVID-19 period compared with during the comparison period in 2019. Patients with out-of-hospital cardiac arrest during 2020 were older, less likely to be white, and more likely to have specific comorbidities such as hypertension, diabetes and physical limitations, as well as substantial reductions in return and sustained return of spontaneous circulation.
Compared with 2019, the odds of asystole increased in the COVID-19 period, as did the odds of pulseless electrical activity. Compared with 2019, the COVID-19 period had substantial reductions in return of spontaneous circulation (ROSC) and sustained ROSC, with fatality rates exceeding 90%. These associations remained statistically significant after adjustment for potential confounders.
The authors concluded that out-of-hospital cardiac arrests and deaths during the COVID-19 pandemic significantly increased compared with the same period the previous year and were associated with older age, nonwhite race/ethnicity, hypertension, diabetes, physical limitations, and nonshockable presenting rhythms. Identifying patients with the greatest risk for out-of-hospital cardiac arrest and death during the COVID-19 pandemic should allow for early, targeted interventions in the outpatient setting that could lead to reductions in out-of-hospital deaths, the authors stated.