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COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests

2020; Oxford University Press; Volume: 41; Issue: 32 Linguagem: Inglês

10.1093/eurheartj/ehaa508

1522-9645

Enrico Baldi, Giuseppe Maria Sechi, Claudio Mare, Fabrizio Canevari, Antonella Brancaglione, Roberto Primi, Catherine Klersy, Alessandra Palo, Enrico Contri, Vincenza Ronchi, G. Beretta, Francesca Reali, Pierpaolo Parogni, Fabio Facchin, Ugo Rizzi, Daniele Bussi, Simone Ruggeri, Luigi Oltrona Visconti, Simone Savastano, Sara Compagnoni, Rosa Fracchia, Antonio Cuzzoli, Andrea Pagliosa, Guido Matiz, Alessandra Russo, Andrea Vecchi, Cecilia Fantoni, Cristian Fava, Cinzia Franzosi, C Vimercati, D Franchi, Enrico Storti, Erika Taravelli, Fulvio L F Giovenzana, Giovanni Buetto, Guido Garzena, Giorgio Antonio Iotti, Guido Villa, Marco Botteri, Salvatore Ivan Caico, Irene Raimondi Cominesi, Livio Carnevale, Matteo Caresani, Mario Luppi, Maurizio Migliori, Paola Centineo, Paola Genoni, Roberta Bertona, Roberto De Ponti, Riccardo Osti, Stefano Buratti, Gian Battista Danzi, Arianna Marioni, Antonella De Pirro, Simone Molinari, Vito Sgromo, Valeria Musella, Martina Paglino, Francesco Mojoli, Bruno Lusona, Michele Pagani, Moreno Curti,

Respiratory Support and Mechanisms

Abstract Aims 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). Conclusion 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.