Fothergill Rachael T, Smith Adam L, Wrigley Fenella, Perkins Gavin D
London Ambulance Service NHS Trust, 220 Waterloo Road, London, SE1 8SD, UK.
Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
Resusc Plus. 2021 Mar;5:100066. doi: 10.1016/j.resplu.2020.100066. Epub 2020 Dec 21.
There is an emerging potential link between the COVID-19 pandemic and incidence and outcomes from out-of-hospital cardiac arrest (OHCA). We aimed to describe the incidence, characteristics and outcomes from OHCA in London, UK during the first wave of the pandemic.
We examined data for all OHCA patients attended by the London Ambulance Service from 1st March to 30th April 2020 and compared our findings to the previous year. We also compared OHCA characteristics and short-term outcomes for those suspected or confirmed to have COVID-19 with those who were not. Additionally, we investigated the relationship between daily COVID-19 cases and OHCA incidents.
We observed an 81% increase in OHCAs during the pandemic, and a strong correlation between the daily number of COVID-19 cases and OHCA incidents (r = 0.828, p < 0.001). We report an increase in OHCA occurring in a private location (92.9% vs 85.5%, p < 0.001) and an increased bystander CPR (63.3% vs 52.6%, p < 0.001) during the pandemic, as well as fewer resuscitation attempts (36.4% vs 39.6%, p = 0.03) and longer EMS response times (9.3 vs 7.2 min, p < 0.001). Survival at 30 days post-arrest was poorer during the pandemic (4.4% vs 10.6%, p < 0.001) and amongst patients where COVID-19 was considered likely (1.0% vs 6.3%, p < 0.001).
During the first wave of the COVID-19 pandemic in London, we saw a dramatic rise in the incidence of OHCA, accompanied by a significant reduction in survival. The pattern of increased incidence and mortality closely reflected the rise in confirmed COVID-19 infections in the city.
2019冠状病毒病（COVID-19）大流行与院外心脏骤停（OHCA）的发生率及预后之间可能存在新的潜在联系。我们旨在描述英国伦敦在大流行第一波期间OHCA的发生率、特征及预后。
我们研究了伦敦救护车服务机构在2020年3月1日至4月30日期间接诊的所有OHCA患者的数据，并将我们的研究结果与上一年进行比较。我们还比较了疑似或确诊感染COVID-19的患者与未感染患者的OHCA特征及短期预后。此外，我们调查了每日COVID-19病例数与OHCA事件之间的关系。
我们观察到在大流行期间OHCA增加了81%，且COVID-19每日病例数与OHCA事件之间存在很强的相关性（r = 0.828，p < 0.001）。我们报告称，在大流行期间，OHCA发生在私人场所的比例增加（92.9%对85.5%，p < 0.001），旁观者进行心肺复苏的比例增加（63.3%对52.6%，p < 0.001），同时复苏尝试次数减少（36.4%对39.6%，p = 0.03），急救医疗服务（EMS）响应时间延长（9.3分钟对7.2分钟，p < 0.001）。在大流行期间，心脏骤停后30天的生存率较低（4.4%对10.6%，p < 0.001），在被认为可能感染COVID-19的患者中生存率更低（1.0%对6.3%，p < 0.001）。
在伦敦COVID-19大流行的第一波期间，我们看到OHCA的发生率急剧上升，同时生存率显著降低。发生率和死亡率增加的模式与该市确诊的COVID-19感染病例数的上升密切相关。
