Chen Chun-Yu, Lee En-Pei, Chang Yu-Jun, Yang Wen-Chieh, Lin Mao-Jen, Wu Han-Ping
Department of Pediatric Emergency, China Medical University Children's Hospital, China Medical University, Taichung City, Taiwan.
Department of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan.
Front Pediatr. 2022 Apr 25;10:846410. doi: 10.3389/fped.2022.846410. eCollection 2022.
Out-of-hospital cardiac arrest (OHCA) in children is a critical condition with a poor prognosis. After the coronavirus disease 2019 (COVID-19) pandemic developed, the epidemiology and clinical characteristics of the pediatric emergency department (PED) visits have changed. This study aimed to analyze the impact of the COVID-19 pandemic on pediatric OHCA in the PED.
From January 2018 to September 2021, we retrospectively collected data of children (18 years or younger) with a definite diagnosis of OHCA admitted to the PED. Patient data studied included demographics, pre-/in-hospital information, treatment modalities; and outcomes of interest included sustained return of spontaneous circulation (SROSC) and survival to hospital-discharge (STHD). These were analyzed and compared between the periods before and after the COVID-19 pandemic.
A total of 97 patients with OHCA (68 boys and 29 girls) sent to the PED were enrolled in our study. Sixty cases (61.9%) occurred in the pre-pandemic period and 37 during the pandemic. The most common age group was infants (40.2%) ( = 0.018). Asystole was the most predominant cardiac rhythm (72.2%, = 0.048). Eighty patients (82.5%) were transferred by the emergency medical services, 62 (63.9%) gained SROSC, and 25 (25.8%) were STHD. During the COVID-19 pandemic, children with non-trauma OHCA had significantly shorter survival duration and prolonged EMS scene intervals (both < 0.05).
During the COVID-19 pandemic, children with OHCA had a significantly lower rate of SROSC and STHD than that in the pre-pandemic period. The COVID-19 pandemic has changed the nature of PED visits and has affected factors related to ROSC and STHD in pediatric OHCA.
儿童院外心脏骤停（OHCA）是一种预后较差的危急状况。2019年冠状病毒病（COVID-19）大流行出现后，儿科急诊科（PED）就诊的流行病学和临床特征发生了变化。本研究旨在分析COVID-19大流行对PED中儿童OHCA的影响。
2018年1月至2021年9月，我们回顾性收集了确诊为OHCA并入住PED的18岁及以下儿童的数据。研究的患者数据包括人口统计学、院前/院内信息、治疗方式；感兴趣的结局包括自主循环持续恢复（SROSC）和出院存活（STHD）。对这些数据在COVID-19大流行前后的时间段进行了分析和比较。
共有97例OHCA患儿（68例男孩和29例女孩）被送往PED并纳入本研究。60例（61.9%）发生在大流行前时期，37例发生在大流行期间。最常见的年龄组是婴儿（40.2%）（P = 0.018）。心搏停止是最主要的心律（72.2%，P = 0.048）。80例患者（82.5%）由紧急医疗服务机构转运，62例（63.9%）实现了SROSC，25例（25.8%）出院存活。在COVID-19大流行期间，非创伤性OHCA儿童的存活时间显著缩短，紧急医疗服务现场间隔时间延长（均P < 0.05）。
在COVID-19大流行期间，OHCA儿童的SROSC和STHD发生率显著低于大流行前时期。COVID-19大流行改变了PED就诊的性质，并影响了儿童OHCA中与ROSC和STHD相关的因素。
