This population-based, observational study assessed the incidence and outcomes of out-of-hospital cardiac arrest (OHCA) in an urban region (Paris, France) during the COVID-19 pandemic, compared with non-pandemic periods.

The authors examined data for non-traumatic OHCA (N=30,768) and evaluated OHCA incidence and outcomes over a 6-week period during the pandemic in adult inhabitants of the study area.

They identified 521 OHCAs during the pandemic period (March 16-April 26, 2020) and 3052 total OCHAs occurring in the same weeks during the non-pandemic period (years 2012-2019). When comparing these periods, they found that the maximum weekly OHCA incidence increased from 13.42 (95% CI 12.77–14.07) to 26.64 (25.72–27.53) per million inhabitants (p<0.0001), before returning to normal in the final weeks of the pandemic period.

Patient demographics did not change substantially during the pandemic compared with the non-pandemic period. On the other hand, there was a higher rate of OHCA at home (460 [90.2%] vs 2336 [76.8%]; p<0·0001), less bystander cardiopulmonary resuscitation (239 [47.8%] vs 1165 [63.9%]; p<0·0001) and shockable rhythm (46 [9.2%] vs 472 [19.1%]; p<0·0001), and longer delays to intervention (median 10.4 min [IQR 8.4–13.8] vs 9.4 min [7.9–12.6]; p<0.0001) during the pandemic period. In addition, the proportion of patients who had an OHCA and were admitted alive decreased from 22.8% to 12.8% (p<0·0001).

After adjustment for potential confounders, the pandemic period remained significantly associated with lower survival rate at hospital admission (odds ratio 0.36, 95% CI 0.24–0.52; p<0.0001). COVID-19 infection, confirmed or suspected, accounted for approximately a third of the increase in OHCA incidence during the pandemic.