The COVID-19 pandemic's impact on out-of-hospital cardiac arrest incidence and survival outcomes: a systematic review

ABSTRACT

Background: The COVID-19 pandemic has overwhelmed healthcare systems, strained ambulance services and, directly or indirectly, affected community responses to patients who experience cardiac arrests outside hospitals. Previous observational studies have shown a notable rise in Out-of-Hospital Cardiac Arrest (OHCA) cases during the pandemic in different parts of the world compared to the same period in 2019, including the United Kingdom and the United States 1, 2. This systematic review’s intention is to shed light on the incidence and survival outcomes of adult OHCA patients. Methods: A comprehensive review of MEDLINE, EMBASE, the Cochrane Library, Web of Science, WHO’s Global Index Medicus, WHO’s Global Research Literature on Coronavirus 2019 and medRxiv up to 8 September 2021 was conducted to identify articles and preprints that reported OHCA figures before and during the COVID-19 pandemic. Primary outcomes were OHCA incidence, Return of Spontaneous Circulation (ROSC) and survival to hospital discharge. Results: Twenty-one studieswere included in the final analysis, out of 2877 potentially eligible records. There were 12,619 OHCA cases during the COVID-19 pandemic, compared with 8353 OHCA cases in the same period of 2019, representing a 51.1% increase in OHCA incidence during the pandemic. In terms of survival outcomes, ROSC and survival to hospital discharge rates were substantially reduced during the pandemic compared to the pre-pandemic period. Conclusion: The pandemic has had an impact on the incidence and survival outcomes among adult OHCA patients compared to the prepandemic period. Moreover, the pandemic has delayed ambulance care processes and disrupted community responses to OHCA. 1. Fothergill RT et al. Out-of-hospital cardiac arrest in London during the COVID-19 pandemic. Resusc Plus. 2021;5100066. 2. Lai PH et al. Characteristics associated with out-of-hospital cardiac arrests and resuscitations during the Novel Coronavirus Disease 2019 pandemic in New York City. JAMA Cardiol. 2020;5(10)1154– 63.(Table Presented)(Table Presented)