Valentine Baert1,2, Deborah Jaeger3, Hervé Hubert1,2, Jean-Baptiste Lascarrou4,5, Guillaume Debaty6, Tahar Chouihed3, François Javaudin7,8. 1. Univ. Lille, CHU Lille, ULR 2694 - METRICS, Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France. 2. French national out-of-hospital cardiac arrest registry, Registre électronique des Arrêts Cardiaques, Lille, France. 3. Université de Lorraine, Inserm U1116; F-CRIN INI-CRCT, Emergency Department, University Hospital of Nancy, Nancy, France. 4. Medical ICU, University Hospital Center, Nantes, France. 5. the Paris Cardiovascular Research Center, INSERM Unité 970 & the AfterROSC Network, Paris, France. 6. Grenoble University Hospital, Grenoble, France. 7. Department of Emergency Medicine, University Hospital of Nantes, Nantes, France. francois.javaudin@chu-nantes.fr. 8. University of Nantes, Microbiotas Hosts Antibiotics and bacterial Resistances (MiHAR), University of Nantes, Nantes, France. francois.javaudin@chu-nantes.fr.
Abstract
BACKGROUND: The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA). METHODS: OHCA of medical origins identified from the French National Cardiac Arrest Registry between March 1st and April 31st 2020 (COVID-19 period), were analysed. Different resuscitation characteristics were compared with the same period from the previous year (non-COVID-19 period). RESULTS: Overall, 1005 OHCA during the COVID-19 period and 1620 during the non-COVID-19 period were compared. During the COVID-19 period, bystanders and first aid providers initiated CPR less frequently (49.8% versus 54.9%; difference, - 5.1 percentage points [95% CI, - 9.1 to - 1.2]; and 84.3% vs. 88.7%; difference, - 4.4 percentage points [95% CI, - 7.1 to - 1.6]; respectively) as did mobile medical teams (67.3% vs. 75.0%; difference, - 7.7 percentage points [95% CI, - 11.3 to - 4.1]). First aid providers used defibrillators less often (66.0% vs. 74.1%; difference, - 8.2 percentage points [95% CI, - 11.8 to - 4.6]). Return of spontaneous circulation (ROSC) and D30 survival were lower during the COVID-19 period (19.5% vs. 25.3%; difference, - 5.8 percentage points [95% CI, - 9.0 to - 2.5]; and 2.8% vs. 6.4%; difference, - 3.6 percentage points [95% CI, - 5.2 to - 1.9]; respectively). CONCLUSIONS: During the COVID-19 period, we observed a decrease in CPR initiation regardless of whether patients were suspected of SARS-CoV-2 infection or not. In the current atmosphere, it is important to communicate good resuscitation practices to avoid drastic and lasting reductions in survival rates after an OHCA.
BACKGROUND: The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA). METHODS: OHCA of medical origins identified from the French National Cardiac Arrest Registry between March 1st and April 31st 2020 (COVID-19 period), were analysed. Different resuscitation characteristics were compared with the same period from the previous year (non-COVID-19 period). RESULTS: Overall, 1005 OHCA during the COVID-19 period and 1620 during the non-COVID-19 period were compared. During the COVID-19 period, bystanders and first aid providers initiated CPR less frequently (49.8% versus 54.9%; difference, - 5.1 percentage points [95% CI, - 9.1 to - 1.2]; and 84.3% vs. 88.7%; difference, - 4.4 percentage points [95% CI, - 7.1 to - 1.6]; respectively) as did mobile medical teams (67.3% vs. 75.0%; difference, - 7.7 percentage points [95% CI, - 11.3 to - 4.1]). First aid providers used defibrillators less often (66.0% vs. 74.1%; difference, - 8.2 percentage points [95% CI, - 11.8 to - 4.6]). Return of spontaneous circulation (ROSC) and D30 survival were lower during the COVID-19 period (19.5% vs. 25.3%; difference, - 5.8 percentage points [95% CI, - 9.0 to - 2.5]; and 2.8% vs. 6.4%; difference, - 3.6 percentage points [95% CI, - 5.2 to - 1.9]; respectively). CONCLUSIONS: During the COVID-19 period, we observed a decrease in CPR initiation regardless of whether patients were suspected of SARS-CoV-2 infection or not. In the current atmosphere, it is important to communicate good resuscitation practices to avoid drastic and lasting reductions in survival rates after an OHCA.
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