The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19.
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
13
01
2021
revised:
04
03
2021
accepted:
15
03
2021
entrez:
17
5
2021
pubmed:
18
5
2021
medline:
18
5
2021
Statut:
epublish
Résumé
Though variable, many major metropolitan cities reported profound and unprecedented increases in out-of-hospital cardiac arrest (OHCA) in early 2020. This study examined the relative magnitude of those increases and their relationship to COVID-19 prevalence. EMS (9-1-1 system) medical directors for 50 of the largest U.S. cities agreed to provide the aggregate, de-identified, pre-existing monthly tallies of OHCA among adults (age >18 years) occurring between January and June 2020 within their respective jurisdictions. Identical comparison data were also provided for corresponding time periods in 2018 and 2019. Equivalent data were obtained from the largest cities in Italy, United Kingdom and France, as well as Perth, Australia and Auckland, New Zealand. Significant OHCA escalations generally paralleled local prevalence of COVID-19. During April, most U.S. cities (34/50) had >20% increases in OHCA versus 2018-2019 which reflected high local COVID-19 prevalence. Thirteen observed 1·5-fold increases in OHCA and three COVID-19 epicenters had >100% increases (2·5-fold in New York City). Conversely, cities with lesser COVID-19 impact observed unchanged (or even diminished) OHCA numbers. Altogether ( Most metropolitan cities experienced profound escalations of OHCA generally paralleling local prevalence of COVID-19. Most of these patients were pronounced dead without COVID-19 testing. No funding was involved. Cities provided de-identified aggregate data collected routinely for standard quality assurance functions.
Sections du résumé
BACKGROUND
BACKGROUND
Though variable, many major metropolitan cities reported profound and unprecedented increases in out-of-hospital cardiac arrest (OHCA) in early 2020. This study examined the relative magnitude of those increases and their relationship to COVID-19 prevalence.
METHODS
METHODS
EMS (9-1-1 system) medical directors for 50 of the largest U.S. cities agreed to provide the aggregate, de-identified, pre-existing monthly tallies of OHCA among adults (age >18 years) occurring between January and June 2020 within their respective jurisdictions. Identical comparison data were also provided for corresponding time periods in 2018 and 2019. Equivalent data were obtained from the largest cities in Italy, United Kingdom and France, as well as Perth, Australia and Auckland, New Zealand.
FINDINGS
RESULTS
Significant OHCA escalations generally paralleled local prevalence of COVID-19. During April, most U.S. cities (34/50) had >20% increases in OHCA versus 2018-2019 which reflected high local COVID-19 prevalence. Thirteen observed 1·5-fold increases in OHCA and three COVID-19 epicenters had >100% increases (2·5-fold in New York City). Conversely, cities with lesser COVID-19 impact observed unchanged (or even diminished) OHCA numbers. Altogether (
INTERPRETATION
CONCLUSIONS
Most metropolitan cities experienced profound escalations of OHCA generally paralleling local prevalence of COVID-19. Most of these patients were pronounced dead without COVID-19 testing.
FUNDING
BACKGROUND
No funding was involved. Cities provided de-identified aggregate data collected routinely for standard quality assurance functions.
Identifiants
pubmed: 33997730
doi: 10.1016/j.eclinm.2021.100815
pii: S2589-5370(21)00095-X
pmc: PMC8102707
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100815Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
None of the authors or contributing investigators have any conflict of interest with respect to this observational, epidemiological, population-based cross-sectional research study which was based on routinely-collected public agency data sets.
Références
JAMA. 2020 Jun 23;323(24):2518-2520
pubmed: 32437497
Acad Emerg Med. 2020 Aug;27(8):693-699
pubmed: 32557999
Ann Intern Med. 2020 Aug 18;173(4):268-277
pubmed: 32374815
Crit Care Explor. 2020 Aug 24;2(9):e0194
pubmed: 32904031
JAMA Cardiol. 2020 Jul 1;5(7):802-810
pubmed: 32211816
Lancet Respir Med. 2020 Jul;8(7):681-686
pubmed: 32473124
Int J Infect Dis. 2020 Aug;97:299-302
pubmed: 32544670
JAMA Cardiol. 2020 Oct 1;5(10):1154-1163
pubmed: 32558876
Circulation. 2020 Aug 4;142(5):507-509
pubmed: 32496811
Am J Emerg Med. 2021 May;43:260-266
pubmed: 33008702
Crit Care Explor. 2020 Dec 21;2(12):e0287
pubmed: 33381763
J Thromb Thrombolysis. 2021 Jan;51(1):40-46
pubmed: 32613385
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
Eur Radiol. 2020 Nov;30(11):6170-6177
pubmed: 32518989
N Engl J Med. 2020 Jul 30;383(5):496-498
pubmed: 32348640
Circulation. 2020 Jul 7;142(1):7-9
pubmed: 32286863
JAMA Netw Open. 2021 Jan 4;4(1):e2032331
pubmed: 33404614
Circulation. 2020 Oct 20;142(16_suppl_2):S337-S357
pubmed: 33081530
JAMA Cardiol. 2020 Nov 1;5(11):1281-1285
pubmed: 32730555
JAMA Cardiol. 2020 Jul 1;5(7):831-840
pubmed: 32219363
Eur Heart J. 2020 Jun 1;41(32):3045-3054
pubmed: 32562486
Resuscitation. 2020 Jun;151:18-23
pubmed: 32283117
JACC Clin Electrophysiol. 2021 Jan;7(1):6-11
pubmed: 33478713
JAMA Cardiol. 2021 Mar 1;6(3):296-303
pubmed: 33188678
Resusc Plus. 2021 Mar;5:100066
pubmed: 33521706
J Am Coll Emerg Physicians Open. 2020 Jun 04;1(4):445-452
pubmed: 33000069
Resuscitation. 2019 Feb;135:162-167
pubmed: 30412719
Lancet Public Health. 2020 Aug;5(8):e437-e443
pubmed: 32473113
Crit Care Explor. 2020 Oct 15;2(10):e0214
pubmed: 33134932