The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19.
The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19.
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DOI：
10.1016/j.eclinm.2021.100815
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发表时间：
2021-04
影响因子：
15.1
通讯作者：
Writing group on behalf of the Metropolitan EMS Medical Directors Global Alliance
中科院分区：
文献类型：
--
作者：
McVaney KE;Pepe PE;Maloney LM;Bronsky ES;Crowe RP;Augustine JJ;Gilliam SO;Asaeda GH;Eckstein M;Mattu A;Fumagalli R;Aufderheide TP;Osterholm MT;Writing group on behalf of the Metropolitan EMS Medical Directors Global Alliance
尽管情况各不相同，但许多主要大都市报告 2020 年初院外心脏骤停 (OHCA) 发生了前所未有的大幅增加。这项研究探讨了这些增加的相对幅度及其与 COVID-19 患病率的关系。美国 50 个最大城市的 EMS（9-1-1 系统）医疗主任同意提供各自管辖范围内 2020 年 1 月至 6 月期间成人（年龄 >18 岁）发生的 OHCA 每月汇总、去识别化、预先存在的统计数据。还提供了 2018 年和 2019 年相应时间段的相同比较数据。等效数据来自意大利、英国和法国的最大城市，以及澳大利亚珀斯和新西兰奥克兰。 OHCA 的显着升级通常与当地 COVID-19 的流行情况平行。 4 月份，大多数美国城市 (34/50) 的 OHCA 与 2018-2019 年相比增加了 20% 以上，这反映了当地 COVID-19 的高流行率。观察到 13 个 OHCA 增加了 1·5 倍，三个 COVID-19 震中增加了 >100%（纽约市为 2·5 倍）。相反，受 COVID-19 影响较小的城市的 OHCA 数量没有变化（甚至减少）。总共 (n = 50)，4 月份每个城市的 OHCA 病例平均增加了 59% (p = 0·03)。然而，到了 6 月，在缓解了 COVID-19 的传播后，OHCA 升级最高的城市恢复到（或接近）了 COVID-19 之前的 OHCA 数字，而 4 月份受 COVID-19 影响最小的城市（并且没有经历 OHCA 增加），然后当 COVID-19 开始在当地激增时，OHCA 显着升级。欧洲、澳大利亚和新西兰的城市效仿了美国的经验。大多数大都市都经历了 OHCA 的深度升级，通常与当地 COVID-19 的流行同步。 这些患者中的大多数在没有进行 COVID-19 检测的情况下就被宣布死亡。不涉及资金。城市提供了为标准质量保证功能定期收集的去识别化汇总数据。
Though variable, many major metropolitan cities reported profound and unprecedented increases in out-of-hospital cardiac arrest (OHCA) in early 2020. This study examined the relative magnitude of those increases and their relationship to COVID-19 prevalence. EMS (9-1-1 system) medical directors for 50 of the largest U.S. cities agreed to provide the aggregate, de-identified, pre-existing monthly tallies of OHCA among adults (age >18 years) occurring between January and June 2020 within their respective jurisdictions. Identical comparison data were also provided for corresponding time periods in 2018 and 2019. Equivalent data were obtained from the largest cities in Italy, United Kingdom and France, as well as Perth, Australia and Auckland, New Zealand. Significant OHCA escalations generally paralleled local prevalence of COVID-19. During April, most U.S. cities (34/50) had >20% increases in OHCA versus 2018–2019 which reflected high local COVID-19 prevalence. Thirteen observed 1·5-fold increases in OHCA and three COVID-19 epicenters had >100% increases (2·5-fold in New York City). Conversely, cities with lesser COVID-19 impact observed unchanged (or even diminished) OHCA numbers. Altogether (n = 50), on average, OHCA cases/city rose 59% during April (p = 0·03). By June, however, after mitigating COVID-19 spread, cities with the highest OHCA escalations returned to (or approached) pre-COVID OHCA numbers while cities minimally affected by COVID-19 during April (and not experiencing OHCA increases), then had marked OHCA escalations when COVID-19 began to surge locally. European, Australian, and New Zealand cities mirrored the U.S. experience. Most metropolitan cities experienced profound escalations of OHCA generally paralleling local prevalence of COVID-19. Most of these patients were pronounced dead without COVID-19 testing. No funding was involved. Cities provided de-identified aggregate data collected routinely for standard quality assurance functions.
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