ESCAPE-NET H2020
Published June 30, 2020 | Version v1
Journal article Open

COVID-19 Kills at Home: The Close Relationship Between the Epidemic and the Increase of Out-Of-Hospital Cardiac Arrests

Authors/Creators

  • 1. 1 Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy. 2 Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • 2. Azienda Regionale Emergenza Urgenza, Milan, Italy.
  • 3. SOREU della Pianura, Azienda Regionale Emergenza Urgenza (AREU), Pavia, Italy.
  • 4. Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • 5. Service of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • 6. AAT Pavia - Azienda Regionale Emergenza Urgenza (AREU), c/o Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • 7. AAT Pavia - Azienda Regionale Emergenza Urgenza (AREU), c/o Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.; ASST di Pavia, Pavia, Italy
  • 8. AAT Lodi - Azienda Regionale Emergenza Urgenza (AREU), c/o ASST di Lodi, Lodi, Italy.
  • 9. AAT Mantova - Azienda Regionale Emergenza Urgenza (AREU), c/o ASST di Mantua, Mantua, Italy.
  • 10. Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy.
  • 11. AAT Cremona - Azienda Regionale Emergenza Urgenza (AREU), c/o ASST di Cremona, Cremona, Italy.
  • 12. Lombardia CARe

Description

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 (ρ 0.87, P < 0.001) and for each province separately (Lodi: ρ 0.98, P < 0.001; Cremona: ρ 0.98, P < 0.001; Pavia: ρ 0.87, P < 0.001; Mantova: ρ 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.

Notes

The Lombardia CARe Registry is partially supported by Fondazione Banca del Monte di Lombardia.

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Additional details

Funding

European Commission
ESCAPE-NET - European Sudden Cardiac Arrest network: towards Prevention, Education and NEw Treatment 733381