Center for Cardiac Arrest Prevention, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, California.
Ventura County Medical Examiner's Office, Ventura, California.
Heart Rhythm. 2023 Jul;20(7):947-955. doi: 10.1016/j.hrthm.2023.03.025. Epub 2023 Mar 23.
Early during the coronavirus disease 2019 (COVID-19) pandemic, higher sudden cardiac arrest (SCA) incidence and lower survival rates were reported. However, ongoing effects on SCA during the evolving pandemic have not been evaluated.
The purpose of this study was to assess the impact of COVID-19 on SCA during 2 years of the pandemic.
In a prospective study of Ventura County, California (2020 population 843,843; 44.1% Hispanic), we compared SCA incidence and outcomes during the first 2 years of the COVID-19 pandemic to the prior 4 years.
Of 2222 out-of-hospital SCA cases identified, 907 occurred during the pandemic (March 2020 to February 2022) and 1315 occurred prepandemic (March 2016 to February 2020). Overall age-standardized annual SCA incidence increased from 39 per 100,000 (95% confidence [CI] 37-41) prepandemic to 54 per 100,000 (95% CI 50-57; P <.001) during the pandemic. Among Hispanics, incidence increased by 77%, from 38 per 100,000 (95% CI 34-43) to 68 per 100,000 (95% CI 60-76; P <.001). Among non-Hispanics, incidence increased by 26%, from 39 per 100,000 (95% CI 37-42; P <.001) to 50 per 100,000 (95% CI 46-54). SCA incidence rates closely tracked COVID-19 infection rates. During the pandemic, SCA survival was significantly reduced (15% to 10%; P <.001), and Hispanics were less likely than non-Hispanics to receive bystander cardiopulmonary resuscitation (45% vs 55%; P = .005) and to present with shockable rhythm (15% vs 24%; P = .003).
Overall SCA rates remained consistently higher and survival outcomes consistently lower, with exaggerated effects during COVID infection peaks. This longer evaluation uncovered higher increases in SCA incidence among Hispanics, with worse resuscitation profiles. Potential ethnicity-specific barriers to acute SCA care warrant urgent evaluation and intervention.
在 2019 年冠状病毒病（COVID-19）大流行早期，报道称心搏骤停（SCA）的发病率更高，存活率更低。然而，在不断演变的大流行期间，SCA 的持续影响尚未得到评估。
本研究旨在评估 COVID-19 对大流行期间 2 年内 SCA 的影响。
在加利福尼亚州文图拉县（2020 年人口 843843；44.1%为西班牙裔）的一项前瞻性研究中，我们比较了 COVID-19 大流行期间（2020 年 3 月至 2022 年 2 月）和大流行前 4 年（2016 年 3 月至 2020 年 2 月）的 SCA 发病率和结局。
在确定的 2222 例院外 SCA 病例中，有 907 例发生在大流行期间（2020 年 3 月至 2022 年 2 月），1315 例发生在大流行前（2016 年 3 月至 2020 年 2 月）。总体年龄标准化的年度 SCA 发病率从大流行前的 39/100000（95%CI 37-41）增加到 54/100000（95%CI 50-57；P<0.001）。在西班牙裔人群中，发病率增加了 77%，从 38/100000（95%CI 34-43）增加到 68/100000（95%CI 60-76；P<0.001）。在非西班牙裔人群中，发病率增加了 26%，从 39/100000（95%CI 37-42；P<0.001）增加到 50/100000（95%CI 46-54）。SCA 发病率与 COVID-19 感染率密切相关。在大流行期间，SCA 的存活率显著降低（15%降至 10%；P<0.001），并且西班牙裔患者接受旁观者心肺复苏术（45%比 55%；P=0.005）和出现可除颤节律（15%比 24%；P=0.003）的可能性低于非西班牙裔患者。
总体而言，SCA 发生率持续较高，存活率持续较低，在 COVID-19 感染高峰期的影响更为明显。这种更长时间的评估发现西班牙裔人群的 SCA 发病率更高，复苏情况更差。急性 SCA 护理方面潜在的种族特异性障碍需要紧急评估和干预。
