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In this Italian study, the authors sought to assess the association between out-of-hospital cardiac arrest (OHCA) during the COVID-19 pandemic compared with 2019 data. From February 21 to April 20, 2020, the cumulative incidence of COVID-19 and OHCA were 956/100,000 inhabitants and 21/100,000 inhabitants, respectively, which represented a 52% increase compared with 2019. There was a strong correlation between the difference in OHCA between 2020 and 2019 for the overall territory and for the provinces of Lodi, Cremona, Pavia, and Montova separately.
These findings highlight the importance of planning healthcare strategies during the pandemic, particularly related to OHCA.
This abstract is available on the publisher's site.
An increase in out-of-hospital cardiac arrest (OHCA) incidence has been reported in the very early phase of the COVID-19 epidemic, but a clear demonstration of a correlation between the increased incidence of OHCA and COVID-19 is missing so far. We aimed to verify whether there is an association between the OHCA difference compared with 2019 and the COVID-19 epidemic curve.
METHODS AND RESULTS
We included all the consecutive OHCAs which occurred in the Provinces of Lodi, Cremona, Pavia, and Mantova in the 2 months following the first documented case of COVID-19 in the Lombardia Region and compared them with those which occurred in the same time frame in 2019. The cumulative incidence of COVID-19 from 21 February to 20 April 2020 in the study territory was 956 COVID-19/100 000 inhabitants and the cumulative incidence of OHCA was 21 cases/100 000 inhabitants, with a 52% increase as compared with 2019 (490 OHCAs in 2020 vs. 321 in 2019). A strong and statistically significant correlation was found between the difference in cumulative incidence of OHCA between 2020 and 2019 per 100 000 inhabitants and the COVID-19 cumulative incidence per 100 000 inhabitants both for the overall territory (ρ 0.87, P < 0.001) and for each province separately (Lodi: ρ 0.98, P < 0.001; Cremona: ρ 0.98, P < 0.001; Pavia: ρ 0.87, P < 0.001; Mantova: ρ 0.81, P < 0.001).
The increase in OHCAs in 2020 is significantly correlated to the COVID-19 pandemic and is coupled with a reduction in short-term outcome. Government and local health authorities should seriously consider our results when planning healthcare strategies to face the epidemic, especially considering the expected recurrent outbreaks.
COVID-19 Kills at Home: The Close Relationship Between the Epidemic and the Increase of Out-of-Hospital Cardiac Arrests
Eur Heart J 2020 Jun 20;[EPub Ahead of Print], E Baldi, GM Sechi, C Mare, F Canevari, A Brancaglione, R Primi, C Klersy, A Palo, E Contri, V Ronchi, G Beretta, F Reali, P Parogni, F Facchin, U Rizzi, D Bussi, S Ruggeri, L Oltrona Visconti, S Savastano