AHA: Out-of-Hospital Cardiac Arrest Outcomes Worse During COVID-19

TUESDAY, Nov. 24, 2020 — Outcomes for out-of-hospital cardiac arrest (OHCA) were worse during the early weeks of the COVID-19 pandemic in the United States than in a similar time period in 2019, according to a study published online Nov. 14 in JAMA Cardiology to coincide with the American Heart Association Scientific Sessions 2020, held virtually from Nov. 13 to 17.

Paul S. Chan, M.D., from Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, and colleagues evaluated the association between the COVID-19 pandemic and OHCA outcomes in both areas of low and moderate COVID-19 disease burden (measured by COVID-19 mortality rate at the county level). Results were compared to those from a similar time period (March 16 to April 30) in 2019.

The researchers identified 9,863 OHCAs in 2020 versus 9,440 in 2019. Rates of sustained return of spontaneous circulation (ROSC) were lower during the pandemic than in 2019 (23.0 versus 29.8 percent; adjusted rate ratio, 0.82; 95 percent confidence interval, 0.78 to 0.87; P < 0.001). In communities with high or very high COVID-19 mortality, sustained ROSC rates were lower by 21 to 33 percent, respectively, during the pandemic versus 2019. In communities with very low and low COVID-19 mortality rates, sustained ROSC were also lower (11 and 15 percent, respectively). Among 7,085 total patients with complete hospital survival data, survival to discharge was lower during the pandemic versus 2019 (6.6 versus 9.8 percent; adjusted rate ratio, 0.83; 95 percent confidence interval, 0.69 to 1.00; P = 0.048), driven by communities with moderate to very high COVID-19 mortality (interaction P = 0.049).

“Recommendations are believed to be essential for protecting frontline health care workers from unnecessary exposure in communities severely affected by the COVID-19 pandemic but may also decrease the likelihood of a successful resuscitation,” the authors write.

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