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Out-of-Hospital Cardiac Arrests Increased in Italy in 2020

TUESDAY, May 5, 2020 -- The incidence of out-of-hospital cardiac arrest was strongly associated with the cumulative incidence of COVID-19 in 2020 in Lombardy, Italy, according to a research letter published online April 29 in the New England Journal of Medicine.

Enrico Baldi, M.D., from the University of Pavia in Italy, and colleagues compared out-of-hospital cardiac arrests that occurred during the first 40 days of the COVID-19 outbreak in the Lombardy region of Italy to those that occurred during the same period in 2019. A total of 9,806 cases of COVID-19 were reported during the 2020 study period.

The researchers identified 362 cases of out-of-hospital cardiac arrest during them 2020 study period compared with 229 cases during the same period in 2019 (58 percent increase). Compared with 2019, the median arrival of the emergency medical service was three minutes longer in 2020; the proportion of patients who received cardiopulmonary resuscitation from bystanders was 15.6 percent lower. In 2020, the incidence of out-of-hospital death among patients in whom resuscitation was attempted by the emergency medical service was 14.9 percentage points higher than in 2019. There was a strong correlation between cumulative incidence of out-of-hospital cardiac arrest in 2020 and the cumulative incidence of COVID-19; the increase in the number of cases versus 2019 followed the time course of the COVID-19 outbreak.

"A total of 103 patients who had out-of-hospital cardiac arrest were suspected to have or had received a diagnosis of COVID-19," the authors write. "These numbers account for 77.4 percent of the increase in cases of out-of-hospital cardiac arrest observed in these provinces in 2020."

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Posted: May 2020