Impact of COVID-19 on Out-of-Hospital Cardiac Arrest in Korea

Young Su Kim; Seung Hyo Lee; Hyouk Jae Lim; Won Pyo Hong

doi:10.3346/jkms.2023.38.e92

Impact of COVID-19 on Out-of-Hospital Cardiac Arrest in Korea

J Korean Med Sci. 2023 Mar 27;38(12):e92. doi: 10.3346/jkms.2023.38.e92.

Authors

Young Su Kim¹, Seung Hyo Lee¹, Hyouk Jae Lim^{1

2

3}, Won Pyo Hong^{1

2

4}

Affiliations

¹ 119 EMS Division, National Fire Agency 119, Sejong, Korea.
² Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
³ Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
⁴ Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea. pyotang@gmail.com.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a global public health crisis that has had a significant impact on emergency medical services (EMS). Several studies have reported an increase in the incidence of out-of-hospital cardiac arrest (OHCA) and a decreased survival due to COVID-19, which has been limited to a short period or has been reported in some regions. This study aimed to investigate the effect of COVID-19 on OHCA patients using a nationwide database.

Methods: We included adult OHCA patients treated by EMS providers from January 19, 2019 to January 20, 2021. The years before and after the first confirmed case in Korea were set as the non-COVID-19 and COVID-19 periods, respectively. The main exposure of interest was the COVID-19 period, and the primary outcome was prehospital return of spontaneous circulation (ROSC). Other OHCA variables were compared before and after the COVID-19 pandemic and analyzed. We performed a multivariable logistic regression analysis to understand the independent effect of the COVID-19 period on prehospital ROSC.

Results: The final analysis included 51,921 eligible patients, including 25,355 (48.8%) during the non-COVID-19 period and 26,566 (51.2%) during the COVID-19 period. Prehospital ROSC deteriorated during the COVID-19 period (10.2% vs. 11.1%, P = 0.001). In the main analysis, the adjusted odds ratios (AORs) for prehospital ROSC showed no significant differences between the COVID-19 and non-COVID-19 periods (AOR [95% confidence interval], 1.02 [0.96-1.09]).

Conclusion: This study found that the proportion of prehospital ROSC was lower during the COVID-19 period than during the non-COVID-19 period; however, there was no statistical significance when adjusting for potential confounders. Continuous efforts are needed to restore the broken chain of survival in the prehospital phase and increase the survival rate of OHCA patients.

Keywords: COVID-19; Cardiopulmonary Resuscitation; Emergency Medical Services; Out-of-Hospital Cardiac Arrest; Return of Spontaneous Circulation.

MeSH terms

Adult
COVID-19* / epidemiology
Cardiopulmonary Resuscitation*
Emergency Medical Services*
Humans
Out-of-Hospital Cardiac Arrest*
Pandemics
Republic of Korea / epidemiology

Grants and funding

National Fire Agency of Korea/Korea