Evaluation of the impact of the COVID-19 Pandemic on Nonhospital Cardiac Arrest Rates
Article Sidebar
Main Article Content
Abstract
Objective: This study aimed to investigate whether the coronavirus disease 2019 (COVID-19) pandemic resulted in delayed access to acute medical conditions and an increase in nonhospital cardiac arrests.
Material and Methods: In this retrospective cross-sectional study, emergency department admissions of nonhospital cardiac arrest patients during the pre-pandemic period (11/03/2019-31/01/2020) and the pandemic period (11/03/2020-31/01/2021) were examined. Demographic data, comorbidities, pre-arrest complaints and onset of complaints, return of spontaneous circulation, and duration of stay in the emergency department were compared.
Results: Although there was a 49% decrease in general hospital admissions and a 28% decrease in emergency department admissions between the two defined periods, there was a 38% increase in out-of-hospital cardiac arrests during the pandemic period. There was no statistically significant difference between the patients who underwent cardiopulmonary resuscitation in both periods in terms of gender (p=0.06), age (p=0.15), and comorbidity (p=0.14). Pre-arrest chest pain and dyspnea were more common in the pandemic period than in the pre-pandemic period (p=0.02). Patients who achieved spontaneous return during the pandemic period had longer intensive care unit waiting times (p<0.001).
Conclusions: Limitations such as the risk of transmission of the COVID-19 disease, the desire to protect social distance, and curfews caused people with chronic diseases to delay their follow-up and avoid the need to seek emergency health care in case of acute exacerbations.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2022-08-13
Published 2022-08-17
References
Rosenbaum L. The Untold Toll - The Pandemic’s Effects on Patients without Covid-19. N Engl J Med. 2020;382(24):2368-71. DOI: https://doi.org/10.1056/NEJMms2009984
Kruizinga MD, Peeters D, van Veen M, van Houten M, Wieringa J, Noordzij JG, et al. The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature. Eur J Pediatr. 2021;180(7):2271-79. DOI: https://doi.org/10.1007/s00431-021-04015-0
Oseran AS, Nash D, Kim C, Moisuk S, Lai P-Y, Pyhtila J, et al. Changes in hospital admissions for urgent conditions during COVID-19 pandemic. Am J Manag Care. 2020;26(8):327-28. DOI: https://doi.org/10.37765/ajmc.2020.43837
Ojetti V, Covino M, Brigida M, Petruzziello C, Saviano A, Migneco A, et al. Non-covid diseases during the pandemic: Where have all other emergencies gone? Medicina (Kaunas). 2020;56(10):512. DOI: https://doi.org/10.3390/medicina56100512
Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health. 2020;4(5):e10-e11. DOI: https://doi.org/10.1016/S2352-4642(20)30108-5
Johnston KJ, Allen L, Melanson TA, Pitts SR. A “Patch” to the NYU Emergency Department Visit Algorithm. Health Serv Res. 2017;52(4):1264-76. DOI: https://doi.org/10.1111/1475-6773.12638
Lim ZJ, Ponnapa Reddy M, Afroz A, Billah B, Shekar K, Subramaniam A. Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis. Resuscitation. 2020;157:248-258. DOI: https://doi.org/10.1016/j.resuscitation.2020.10.025
Chowdhury SD, Oommen AM. Epidemiology of COVID-19. Journal of digestive endoscopy. 2020;11(1):3-7. https://doi.org/10.1055/s-0040-1712187
Glober NK, Supples M, Faris G, et al. Out-of-hospital cardiac arrest volumes and characteristics during the COVID-19 pandemic. Am J Emerg Med. 2021;48:191-197. DOI: https://doi.org/10.1016/j.ajem.2021.04.072
Chan PS, Girotra S, Tang Y, Al-Araji R, Nallamothu BK, McNally B. Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic. JAMA Cardiol. 2021;6(3):296-303. DOI: https://doi.org/10.1001/jamacardio.2020.6210
Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242. DOI: https://doi.org/10.1001/jama.2020.2648
Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TM, Soares WE, Hoppe JA, et al. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA Intern Med. 2020;180(10):1328-33. DOI: https://doi.org/10.1001/jamainternmed.2020.3288
Kapsner LA, Kampf MO, Seuchter SA, Gruendner J, Gulden C, Mate S, et al. Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown. Front Public Health. 2020;8:594117. DOI: https://doi.org/10.3389/fpubh.2020.594117
Ünal R, Güven R, Atik D, Erdur A, Ak E, Cander B. Effect of covid-19 pandemic on in-hospital mortality. Medical Science and Discovery. 2021;8(6):389–393. DOI: https://doi.org/10.36472/msd.v8i6.561
Lange SJ, Ritchey MD, Goodman AB, Dias T, Twentyman E, Fuld J, et al. Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions - United States, January-May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):795-800. DOI: https://doi.org/10.15585/mmwr.mm6925e2
Shekhar AC, Mercer C, Blumen I, Narula J. Suboptimal rates of return of spontaneous circulation with prehospital CPR in the COVID-19 era. Resuscitation. 2020;154:50-51. https://doi.org/10.1016/j.resuscitation.2020.06.032
Hollander JE, Carr BG. Virtually Perfect? Telemedicine for Covid-19. N Engl J Med. 2020;382(18):1679-81. DOI:https://doi.org/10.1056/NEJMp2003539