Increase in out-of-hospital cardiac arrests in Italy linked to COVID-19
A study published in The New England Journal of Medicine showed a correlation between out-of-hospital cardiac arrests and COVID-19 in Lombardy, Italy.
Using the Lombardia Cardiac Arrest Registry, Enrico Baldi, MD, University of Pavia, Pavia, Italy, and colleagues compared out-of-hospital cardiac arrests that occurred in the provinces of Lodi, Cremona, Pavia, and Mantua during the first 40 days of the COVID-19 outbreak (February 21-March 31, 2020) with those that occurred during the same period in 2019 (February 21-April 1, 2019 to account for the leap year).
During the 2020 study period, a total of 9,806 cases of COVID-19 were reported. During this period, 362 cases of out-of-hospital cardiac arrest were identified, compared with 229 cases during the same period in 2019 -- a 58% increase. Increases of various magnitudes in the numbers of cases of out-of-hospital cardiac arrest were seen in all 4 provinces.
Of the 362 cases of out-of-hospital cardiac arrest in 2020, 103 were suspected to have or had received a diagnosis of COVID-19 (87 and 16 patients, respectively). These numbers account for 77.4% of the increase in cases of out-of-hospital cardiac arrest observed in these provinces in 2020.
“The cumulative incidence of out-of-hospital cardiac arrest in 2020 was strongly associated with the cumulative incidence of COVID-19 (Spearman rank correlation coefficient, 0.87; 95% confidence interval, 0.83-0.91; P< 0.001), and the increase in the number of cases of out-of-hospital cardiac arrest over the number in 2019 followed the time course of the COVID-19 outbreak,” the authors wrote.