The following is a summary of “Acute SARS-CoV-2 Infection and Incidence and Outcomes of Out-of-Hospital Cardiac Arrest,” published in the October 2023 issue of Infectious Diseases by Liu et al.
A retrospective cohort study in Seattle and King County, Washington, examined adults aged 18 or older experiencing nontraumatic OHCA between January 2018 and December 2021. The analysis focused on pre-pandemic (2018-2019) and pandemic (2020-2021) periods and their association with SARS-CoV-2 infection.
Researchers investigated OHCA incidence and patient outcomes, including survival to hospital discharge. They utilized mediation analysis to determine the impact of acute SARS-CoV-2 infection compared to conventional factors related to OHCA circumstances and resuscitation care on changes in OHCA incidence and outcomes during the pandemic.
The study involved 13,081 out-of-hospital cardiac arrest (OHCA) cases; 7,102 resulted in death upon EMS arrival, and EMS treated 5979. Among those treated, the median age was 64.0 years, 64.6% were male, and 17.2% survived hospital discharge. OHCA cases increased by 19.0% during the pandemic, with the incidence rising from 168.8 to 195.3 per 100,000 person-years.
During the pandemic, 6.2% of EMS-treated OHCA cases were acutely infected with SARS-CoV-2. A positive correlation existed between SARS-CoV-2 incidence and OHCA rates. Survival rates were lower during the pandemic, especially for OHCA patients with acute SARS-CoV-2 infection, indicating that infection contributed to 18.5% of the survival decline. Utstein elements contributed to 68.2% of this decline.
Researchers discovered that a significant part of the increased OHCA incidence and reduced survival during the pandemic wasn’t directly linked to SARS-CoV-2 infection but to indirect factors that posed challenges to OHCA prevention and treatment.
Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2810254