Impact of Coronavirus Disease 2019 Pandemic on Pediatric Out-of-Hospital Cardiac Arrest in the Emergency Department

Chun-Yu Chen; En-Pei Lee; Yu-Jun Chang; Wen-Chieh Yang; Mao-Jen Lin; Han-Ping Wu

doi:10.3389/fped.2022.846410

Impact of Coronavirus Disease 2019 Pandemic on Pediatric Out-of-Hospital Cardiac Arrest in the Emergency Department

Front Pediatr. 2022 Apr 25:10:846410. doi: 10.3389/fped.2022.846410. eCollection 2022.

Authors

Chun-Yu Chen^{1

2}, En-Pei Lee^{3

4}, Yu-Jun Chang⁵, Wen-Chieh Yang^{1

2}, Mao-Jen Lin^{6

7}, Han-Ping Wu^{1

2

8}

Affiliations

¹ Department of Pediatric Emergency, China Medical University Children's Hospital, China Medical University, Taichung City, Taiwan.
² Department of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan.
³ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, Taiwan.
⁴ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Laboratory of Epidemiology and Biostastics, Changhua Christian Hospital, Changhua City, Taiwan.
⁶ Department of Medicine, College of Medicine, Tzu Chi University, Hualien City, Taiwan.
⁷ Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung City, Taiwan.
⁸ Department of Medical Research, China Medical University Children's Hospital, China Medical University, Taichung City, Taiwan.

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) in children is a critical condition with a poor prognosis. After the coronavirus disease 2019 (COVID-19) pandemic developed, the epidemiology and clinical characteristics of the pediatric emergency department (PED) visits have changed. This study aimed to analyze the impact of the COVID-19 pandemic on pediatric OHCA in the PED.

Methods: From January 2018 to September 2021, we retrospectively collected data of children (18 years or younger) with a definite diagnosis of OHCA admitted to the PED. Patient data studied included demographics, pre-/in-hospital information, treatment modalities; and outcomes of interest included sustained return of spontaneous circulation (SROSC) and survival to hospital-discharge (STHD). These were analyzed and compared between the periods before and after the COVID-19 pandemic.

Results: A total of 97 patients with OHCA (68 boys and 29 girls) sent to the PED were enrolled in our study. Sixty cases (61.9%) occurred in the pre-pandemic period and 37 during the pandemic. The most common age group was infants (40.2%) (p = 0.018). Asystole was the most predominant cardiac rhythm (72.2%, P = 0.048). Eighty patients (82.5%) were transferred by the emergency medical services, 62 (63.9%) gained SROSC, and 25 (25.8%) were STHD. During the COVID-19 pandemic, children with non-trauma OHCA had significantly shorter survival duration and prolonged EMS scene intervals (both p < 0.05).

Conclusion: During the COVID-19 pandemic, children with OHCA had a significantly lower rate of SROSC and STHD than that in the pre-pandemic period. The COVID-19 pandemic has changed the nature of PED visits and has affected factors related to ROSC and STHD in pediatric OHCA.

Keywords: COVID-19; OHCA; children; emergency department; out-of-hospital cardiac arrest.