COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests
COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests
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DOI：
10.1093/eurheartj/ehaa508
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发表时间：
2020-08-21
影响因子：
39.3
通讯作者：
Savastano, Simone
中科院分区：
文献类型：
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作者：
Baldi, Enrico;Sechi, Giuseppe Maria;Savastano, Simone
在COVID-19流行的早期阶段，已经报告了院外心脏骤停（OHCA）发生率的增加，但到目前为止，OHCA发生率增加与COVID-19之间的相关性尚未得到明确证明。我们的目的是验证与2019年相比的OHCA差异与COVID-19流行曲线之间是否存在关联。方法和结果我们纳入了在洛迪省，克雷莫纳省，帕维亚省，在首例记录在案的COVID病例后的两个月内，于隆巴迪亚地区发生19起事件，并与二零一九年同期发生的事件进行比较。研究地区于2020年2月21日至4月20日的COVID-19累计发病率为每100 000名居民956例，OHCA累计发病率为每100 000名居民21例，较2019年增加52%（2020年为490例OHCA，2019年为321例）。2020年至2019年每10万居民的OHCA累积发病率差异与全港每10万居民的COVID-19累积发病率之间存在强有力的统计学显著相关性（rho0.87，P < 0.001），各省分别（洛迪：rho 0.98，P < 0.001;克雷莫纳：rho 0.98，P < 0.001;帕维亚：rho 0.87，P < 0.001;曼托瓦：结论2020年OHCA的增加与COVID-19疫情显著相关，并伴随着短期结果的减少。政府和地方卫生当局在规划应对疫情的医疗战略时，应认真考虑我们的研究结果，特别是考虑到预期的反复爆发。
Aims An increase in out-of-hospital cardiac arrest (OHCA) incidence has been reported in the very early phase of the COVID-19 epidemic, but a clear demonstration of a correlation between the increased incidence of OHCA and COVID-19 is missing so far. We aimed to verify whether there is an association between the OHCA difference compared with 2019 and the COVID-19 epidemic curve.Methods and results We included all the consecutive OHCAs which occurred in the Provinces of Lodi, Cremona, Pavia, and Mantova in the 2 months following the first documented case of COVID-19 in the Lombardia Region and compared them with those which occurred in the same time frame in 2019. The cumulative incidence of COVID-19 from 21 February to 20 April 2020 in the study territory was 956 COVID-19/100 000 inhabitants and the cumulative incidence of OHCA was 21 cases/100 000 inhabitants, with a 52% increase as compared with 2019 (490 OHCAs in 2020 vs. 321 in 2019). A strong and statistically significant correlation was found between the difference in cumulative incidence of OHCA between 2020 and 2019 per 100 000 inhabitants and the COVID-19 cumulative incidence per 100 000 inhabitants both for the overall territory (rho 0.87, P < 0.001) and for each province separately (Lodi: rho 0.98, P < 0.001; Cremona: rho 0.98, P < 0.001; Pavia: rho 0.87, P < 0.001; Mantova: rho 0.81, P < 0.001).Conclusion The increase in OHCAs in 2020 is significantly correlated to the COVID-19 pandemic and is coupled with a reduction in short-term outcome. Government and local health authorities should seriously consider our results when planning healthcare strategies to face the epidemic, especially considering the expected recurrent outbreaks.