Impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest outcomes in Japan

Ayako Chida-Nagai; Hiroki Sato; Hirokuni Yamazawa; Atsuhito Takeda; Naohiro Yonemoto; Yoshio Tahara; Takanori lkeda

doi:10.1038/s41598-024-61650-x

Impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest outcomes in Japan

Sci Rep. 2024 May 16;14(1):11246. doi: 10.1038/s41598-024-61650-x.

Authors

Ayako Chida-Nagai¹, Hiroki Sato^{2

3}, Hirokuni Yamazawa⁴, Atsuhito Takeda⁴, Naohiro Yonemoto⁵, Yoshio Tahara⁵, Takanori lkeda⁵

Affiliations

¹ Department of Pediatrics, Hokkaido University Hospital, Kita 15, Nishi 7, Sapporo, Hokkaido, 060-8638, Japan. ayakonagai@med.hokudai.ac.jp.
² Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan.
³ Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, Japan.
⁴ Department of Pediatrics, Hokkaido University Hospital, Kita 15, Nishi 7, Sapporo, Hokkaido, 060-8638, Japan.
⁵ Japanese Circulation Society with Resuscitation Science Study (JCS-ReSS) Group, Tokyo, Japan.

Abstract

This study investigates the impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest (OHCA) outcomes in Japan, aiming to address a critical research gap. Analyzing data from the All-Japan Utstein registry covering pediatric OHCA cases from 2018 to 2021, the study observed no significant changes in one-month survival, neurological outcomes, or overall performance when comparing the pre-pandemic (2018-2019) and pandemic (2020-2021) periods among 6765 cases. However, a notable reduction in pre-hospital return of spontaneous circulation (ROSC) during the pandemic (15.1-13.1%, p = .020) was identified. Bystander-initiated chest compressions and rescue breaths declined (71.1-65.8%, 22.3-13.0%, respectively; both p < .001), while bystander-initiated automated external defibrillator (AED) use increased (3.7-4.9%, p = .029). Multivariate logistic regression analyses identified factors associated with reduced pre-hospital ROSC during the pandemic. Post-pandemic, there was no noticeable change in the one-month survival rate. The lack of significant change in survival may be attributed to the negative effects of reduced chest compressions and ventilation being offset by the positive impact of widespread AED availability in Japan. These findings underscore the importance of innovative tools and systems for safe bystander cardiopulmonary resuscitation during a pandemic, providing insights to optimize pediatric OHCA care.

Keywords: Bystander CPR; COVID-19; Child; OHCA.

MeSH terms

Adolescent
COVID-19* / epidemiology
Cardiopulmonary Resuscitation* / methods
Child
Child, Preschool
Defibrillators
Emergency Medical Services
Female
Humans
Infant
Infant, Newborn
Japan / epidemiology
Male
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / mortality
Out-of-Hospital Cardiac Arrest* / therapy
Pandemics
Registries*
Return of Spontaneous Circulation
SARS-CoV-2 / isolation & purification
Survival Rate