JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has led to changes in healthcare systems and behaviors. However, the impact of COVID-19 on the incidence and outcomes of out-of-hospital cardiac arrest (OHCA) throughout the entire pandemic period remains unclear.

Objective:

This study aims to address these gaps by examining the incidence and outcomes of OHCA in Hong Kong (HK) before and during the pandemic.

Methods:

This is a retrospective regional registry study. The researchers matched OHCA data from the Hong Kong Fire Service Department with COVID-19 confirmed case records from the Hong Kong Centre for Health Protection between December 2017 and May 2023. The data included information on response times, location of OHCA, witness presence, initial rhythm, bystander CPR, use of public-access defibrillation, resuscitation in the accident and emergency department, and survival to admission. Descriptive analyses were conducted, and statistical tests such as ANOVA and chi-square were used to examine differences between variables. The incidence of OHCA and survival rates were calculated, and logistic regression analysis was performed to assess associations. The prevalence of OHCA and COVID-19 during the peak of the pandemic was also described.

Results:

A total of 43,882 cases of OHCA were reported in HK and included in our analysis. During the pandemic period, there was a significant increase in OHCA incidence, with a corresponding decrease in survival rates compared to the pre-pandemic period. The location of OHCA shifted, with a decrease in incidents in public places and a potential increase in incidents at home. Bystander cardiopulmonary resuscitation (CPR) rates increased, but survival rates to admission dropped significantly during the pandemic. There was a correlation between the development of OHCA and the prevalence of COVID-19 in HK.

Conclusions:

The COVID-19 pandemic has had a significant impact on OHCA in HK, resulting in increased incidence and decreased survival rates. The findings highlight the importance of addressing the indirect effects of the pandemic, such as increased stress levels and strain on healthcare systems, on OHCA outcomes. Strategies should be developed to improve OHCA prevention, emergency response systems, and healthcare services during public health emergencies to mitigate the impact on population health.