1. Influence of the Covid-19 pandemic on out-of-hospital cardiac arrest. A Spanish nationwide prospective cohort study
- Author
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Fernando Rosell Ortiz, Patricia Fernández del Valle, Emily C. Knox, Xavier Jiménez Fábrega, José M. Navalpotro Pascual, Inmaculada Mateo Rodríguez, José I. Ruiz Azpiazu, José A. Iglesias Vázquez, Alfredo Echarri Sucunza, Daniel F. Alonso Moreno, Ana B. Forner Canos, María J. García-Ochoa Blanco, Nuria López cabeza, Belén Mainar Gómez, Susana Batres Gómez, José A. Cortés Ramas, María I. ceniceros Rozalén, Francisco A. Guirao Salas, Begoña Fernández martínez, Antonio Daponte Codina, Francisco José Mellado Vergel, Sonia Royo, Bernardo Aguilo, Elvira Prieto Cuervo, Juan Jose Garcia Lindez, Marta Sansegundo Campo, Ignacio del Campo Arenal, Carmen del Pozo Pérez, Margarita Baez del Pozo, Marta de la Cruz Martínez, Angels Mora Vives, Francisco José Carmona Jiménez, Silvia Solà Muñoz, Xavier Escalada Roig, Carmen Escriche, María Remedios Belmonte Gómez, Antonio José Fernández Barril, Juan Ramírez Márquez, Gabina Pérez López, Pedro Dacal Pérez, Antonio Rodríguez Rivera, Elena Pastor González, María luz Sabin Gómez, Carmen Camacho Leis, Francisco Alfonso Peinado Vallejo, Alfredo Carrillo Moya, Yago Muñecas Cuesta, Belén Muñoz Isabel, Manuel José González León, Juan Ignacio Les González, Antonia Sáez Jiménez, José Muñoz Pastor, María Teresa López Pérez, Maitane Tainta Laspalas, Cristian Fernández Barreras, Mª Mar Vaqueriza Iturriza, Mario Jiménez Mercado, Blanca Alberro Aranzasti, Amelie Le Gall, María Lourdes Bragado-Blas, and Basilio Teja-Ruiz
- Subjects
Male ,Emergency Medical Services ,Resuscitation ,medicine.medical_specialty ,Survival ,Coronavirus disease 2019 (COVID-19) ,Aftercare ,030204 cardiovascular system & hematology ,Emergency Nursing ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Pandemic ,medicine ,Humans ,Prospective Studies ,Registries ,Prospective cohort study ,Pandemics ,Aged ,Out-of hospital cardiac arrest ,SARS-CoV-2 ,business.industry ,Incidence ,Incidence (epidemiology) ,Multilevel model ,Attendance ,COVID-19 ,Covid 19 ,030208 emergency & critical care medicine ,Middle Aged ,Cardiopulmonary Resuscitation ,Spain ,Emergency medicine ,Emergency ,Clinical Paper ,Emergency Medicine ,Female ,Emergency services ,business ,Cardiology and Cardiovascular Medicine ,Out-of-Hospital Cardiac Arrest - Abstract
Aims: The influence of the COVID-19 pandemic on attendance to out-of-hospital cardiac arrest (OHCA) has only been described in city or regional settings. The impact of COVID-19 across an entire country with a high infection rate is yet to be explored. Methods: The study uses data from 8629 cases recorded in two time-series (2017/2018 and 2020) of the Spanish national registry. Data from a nonCOVID-19 period and the COVID-19 period (February 1st-April 30th 2020) were compared. During the COVID-19 period, data a further analysis comparing non-pandemic and pandemic weeks (defined according to the WHO declaration on March 11th, 2020) was conducted. The chi-squared analysis examined differences in OHCA attendance and other patient and resuscitation characteristics. Multivariate logistic regression examined survival likelihood to hospital admission and discharge. The multilevel analysis examined the differential effects of regional COVID-19 incidence on these same outcomes. Results: During the COVID-19 period, the incidence of resuscitation attempts declined and survival to hospital admission (OR = 1.72; 95%CI = 1.46-2.04; p < 0.001) and discharge (OR = 1.38; 95%CI = 1.07-1.78; p = 0.013) fell compared to the non-COVID period. This pattern was also observed when comparing non-pandemic weeks and pandemic weeks. COVID-19 incidence impinged significantly upon outcomes regardless of regional variation, with low, medium, and high incidence regions equally affected. Conclusions: The pandemic, irrespective of its incidence, seems to have particularly impeded the pre-hospital phase of OHCA care. Present findings call for the need to adapt out-of-hospital care for periods of serious infection risk. Study registration number: ISRCTN10437835.
- Published
- 2020