Out-of-Hospital Cardiac Arrest Response and Outcomes During the COVID-19 Pandemic

OBJECTIVES The purpose of this study was to evaluate the potential impact of the coronavirus disease-2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) responses and outcomes in 2 U.S. communities with relatively low infection rates. BACKGROUND Studies in areas with high COVID-19 infection rates indicate that the pandemic has had direct and indirect effects on community responses to OHCA and negative impacts on survival. Data from areas with lower infection rates are lacking. METHODS Cases of OHCA in Multnomah County, Oregon, and Ventura County, California, with attempted resuscitation by emergency medical services (EMS) from March 1 to May 31, 2020, and from March 1 to May 31, 2019, were evaluated. RESULTS In a comparison of 231 OHCA in 2019 to 278 in 2020, the proportion of cases receiving bystander cardiopulmonary resuscitation (CPR) was tower in 2020 (61% to 51%, respectively; p 0.02), and bystander use of automated external defibrillators (AEDs) declined (5% to 1%, respectively; p 0.02). EMS response time increased (6.6 +/- 2.0 min to 7.6 +/- 3.0 min, respectively; p < 0.001), and fewer OHCA cases survived to hospital discharge (14.7% to 7.9%, respectively; p = 0.02). Incidence rates did not change significantly (p > 0.07), and coronavirus infection rates were tow (Multnomah County, 143/100,000; Ventura County, 127/100,000 as of May 31) compared to rates of similar to 1,600 to 3,000/100,000 in the New York City region at that time. CONCLUSIONS The community response to OHCA was altered from March to May 2020, with less bystander CPR, delays in EMS response time, and reduced survival from OHCA. These results highlight the pandemic's indirect negative impact on OHCA, even in communities with relatively low incidence of COVID-19 infection, and point to potential opportunities for countering the impact. (C) 2021 by the American College of Cardiology Foundation.

Automated summary

This study evaluated the impact of the COVID-19 pandemic on out-of-hospital cardiac arrest responses and outcomes in two U.S. communities with relatively low infection rates. The results show that the pandemic led to decreased bystander CPR and AED use, longer EMS response time, and reduced survival rates in these communities.