Table 1.
Summary of studies.
| Lai 2020 | Baldi 2020 | Ball 2020 | Elmer 2020 | Marijon 2020 | Ortiz 2020 | Paoli 2020 | Sayre 2020 | Semeraro 2020 | Uy-Evanado 2020 | Total | p-value | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Location of study |
New York, USA | Lombardy, Italy | Victoria, Australia | Pennsylvania, USA | Paris, France | Spain | Pauda, Italy | Washington, USA | Bologna, Italy | Oregon and California, USA | ||||
| NOS Score | Good | Fair | Good | Fair | Fair | Good | Fair | Fair | Fair | Good | ||||
| Time period | Before pandemic | March 1 to April 25, 2019 | February 21 to April 21, 2019 | March 16 to May 12, 2017−2019 | January 2016 to February 2020 | March 18 to April 28, 2019 | April 1−30 2017, and February 1 to March 31 2018 | March 1 to April 30, 2019 | January 1 to February 25, 2019 | January 1 to June 30, 2019 | March 1 to May 31, 2019 | |||
| During pandemic | March 1 to April 25, 2019 | February 21 to April 20, 2020 | March 16 to May 12, 2020 | March 1 to May 25, 2020 | March 16 to April 26, 2020 | March 11 to April 30, 2020 | March 1 to April 30, 2020 | February 26 to April 15, 2020 | January 1 to June 30, 2020 | March 1 to May 31, 2020 | ||||
| Sample Size | Before pandemic | 2302 | 321 | 2599 | 12252 | 3052^ | 1723# | 206 | 540 | 563 | 231 | 23789 | NA | |
| During pandemic | 6709 | 490 | 935 | 683 | 521 | 683# | 200 | 527 | 624 | 278 | 11590 | NA | ||
| Difference in OHCA incidence | 2019 | 2302 | 321 | NR* | NR* | 395 | NR* | 206 | NR* | 563 | 231 | 4018 | NA | |
| 2020 | 6709 | 490 | NR* | NR* | 521 | NR* | 200 | NR* | 624 | 278 | 8822 | |||
| Percentage change | 191.4% | 52.6% | NR* | NR* | 31.9% | NR* | −3% | NR* | 10.8% | 20.3% | 119.6% | |||
| Age (Years), Mean (SD) | Before pandemic | 68 (19) | 77 (14) | 66 (19) | 63 (19) | 69 (18) | 66 (17) | 77 (14) | NR | 83 (13) | 69 (17) | 65.6 | NA | |
| During pandemic | 72 (18) | 76 (13) | 68 (19) | 64 (19) | 70 (17) | 64 (16) | 79 (17) | NR | 83 (13) | 65 (18) | 70.8 | NA | ||
| Male patients, N (%) | Before pandemic | 752/1336 (56.3%) | 188/321 (58.6%) | 845/1218# (69.4%) | 7700/12252 (62.8%) | 1826/3047 (59.9%) | 1210/1723# (70.2%) | 98/179 (54.7%) | NR | 284/563 (50.4%) | 137/231 (59.3%) | 13040/20870 (62.5%) | <0.001 | |
| During pandemic | 2183/3989 (54.7%) | 321/490 (65.5%) | 250/380# (65.8%) | 430/683 (63.0%) | 334/519 (64.4%) | 433/623# (69.5%) | 89/175 (50.9%) | NR | 318/624 (51.0%) | 174/278 (62.6%) | 4532/7761 (58.4%) | |||
| Mortality, N (%) | Before pandemic | 1922/2302 (83.5%) | 156/321 (48.6%) | 827/1218# (67.9%) | 6302/12252 (51.4%) | 2357/3052 (77.2%) | 1109/1634# (67.9%) | 200/206 (97.1%) | 292/540 (54.1%) | 509/563 (90.4%) | 157/231 (68.0%) | 13831/22319 (62.0%) | <0.001 | |
| During pandemic | 6244/6709 (93.1%) | 253/490 (51.6%) | 285/380# (75.0%) | 329/683 (48.2%) | 454/521 (87.1%) | 473/580# (81.6%) | 194/200 (97.0%) | 297/527 (56.4%) | 586/624 (93.9%) | 213/278 (76.6%) | 9328/10992 (84.9%) | |||
| Bystander CPR, N (%) | Before pandemic | 441/1336 (33.0%) | 87/192 (45.3%) | 889/1218# (73.0%) | 4125/12,252 (33.7%) | 1165/1822 (63.9%) | 788/1723# (45.7%) | 15/60 (25.0%) | 227/540 (42.0%) | 29/110# (26.4%) | 142/231 (61.5%) | 7908/19484 (40.6%) | 0.003 | |
| During pandemic | 1359/3989 (34.1%) | 89/257 (34.6%) | 299/380# (78.7%) | 246/683 (36.0%) | 239/500 (47.8%) | 230/623# (36.9%) | 10/55 (18.2%) | 207/527 (39.3%) | 30/95# (31.6%) | 141/278 (50.7%) | 2850/7387 (38.6%) | |||
| Unwitnessed OHCA, N (%) | Before pandemic | 982/1336 (73.5%) | 147/321 (45.8%) | 329/1218# (27.0%) | 8772/12252 (71.6%) | 1021/2908 (35.1%) | 392/1723# (22.8%) | 42/59 (71.1%) | NR | NR | 109/231 (47.2%) | 11794/20048 (58.8%) | <0.001 | |
| During pandemic | 2909/3989 (72.9%) | 261/490 (53.3%) | 179/380# (47.1%) | 466/683 (68.2%) | 206/500 (41.2%) | 130/623# (20.9%) | 39/52 (75.0%) | NR | NR | 138/278 (49.6%) | 4328/6995 (61.9%) | |||
| EMS Resuscitation attempted, N (%) | Before pandemic | 1336/2302 (58.0%) | 222/321 (69.2%) | 1218/2599 (46.9%) | NR | NR | NR | 48/90 (53.3%) | 248/540 (45.9%) | 110/563 (19.5%) | NR | 3182/6415 (49.6%) | <0.001 | |
| During pandemic | 3989/6709 (59.5%) | 324/490 (64.1%) | 380/935 (40.6%) | NR | NR | NR | 45/114 (39.5%) | 230/527 (43.6%) | 95/624 (15.2%) | NR | 5053/9399 (53.8%) | |||
| ROSC, N (%) | Before pandemic | 463/1336 (34.7%) | 44/222 (19.8%) | 416/1218 (34.2%) | 1529/12252 (12.5%) | NR | 525/1723# (30.5%) | 4/206 (1.9%) | NR | 54/563 (9.6%) | 95/231 (41.1%) | 3130/17751 (17.6%) | 0.22 | |
| During pandemic | 727/3989 (18.2%) | 27/314 (8.6%) | 112/380 (29.5%) | 95/683 (13.9%) | NR | 107/623# (17.2%) | 2/200 (1.0%) | NR | 38/624 (6.1%) | 95/278 (34.2%) | 1203/7091 (17.0%) | |||
| Shockable cardiac rhythm/shocked events, N (%) | Before pandemic | 38/345 (11.0%) | 37/222 (16.7%) | 318/1218# (26.1%) | NR | 472/2471 (19.1%) | 386/1723# (22.4%) | NR | NR | 34/563 (6.0%) | 64/231 (27.7%) | 1349/6773 (19.9%) | <0.001 | |
| During pandemic | 45/1254 (3.6%) | 36/314 (11.5%) | 90/380# (23.7%) | NR | 46/500 (9.2%) | 118/623# (18.9%) | NR | NR | 33/624 (5.3%) | 64/278 (23.0%) | 432/3973 (10.9%) | |||
| OHCA at home, N (%) | Before pandemic | NR | 267/321 (83.2%) | 965/1218# (79.2%) | NR | 2336/3042 (76.8%) | 1042/1723# (60.5%) | NR | NR | 82/110# (74.5%) | 145/231 (62.8%) | 4837/6645 (72.8%) | <0.001 | |
| During pandemic | NR | 442/490 (90.2%) | 342/380# (90.0%) | NR | 460/510 (90.2%) | 478/623# (76.7%) | NR | NR | 65/95# (68.4%) | 210/278 (75.5%) | 1997/2376 (84.0%) | |||
| Intubation | Before pandemic | NR | NR | 594/1218# (48.8%) | 2760/6571 (42.0%) | NR | 1224/1723# (71.0%) | NR | NR | NR | NR | 5589/10848 (51.5%) | <0.001 | |
| During pandemic | NR | NR | 171/380# (45.0%) | 127/353 (36.0%) | NR | 320/630# (50.8%) | NR | NR | NR | NR | 2533/5352 (47.3%) | |||
| Supraglottic airway | Before pandemic | NR | NR | NR | 904/6571 (13.8%) | NR | 103/1723# (6.0%) | NR | NR | NR | NR | 1200/9630 (12.5%) | <0.001 | |
| During pandemic | NR | NR | NR | 89/353 (25.2%) | NR | 110/630# (17.5%) | NR | NR | NR | NR | 1584/4972 (31.9%) | |||
| Mechanical CPR | Before pandemic | NR | 23/138 (16.7%) | 177/1218# (14.5%) | NR | NR | NR | NR | NR | NR | NR | 200/1356 (14.7%) | 0.24 | |
| During pandemic | NR | 9/138 (6.5%) | 56/380# (14.7%) | NR | NR | NR | NR | NR | NR | NR | 65/518 (12.5%) | |||
| AED use | Before pandemic | NR | NR | 84/1218# (6.9%) | 1744/12252 (14.2%) | 33/1092 (3.0%) | 173/1723# (10.0%) | NR | NR | NR | 12/231 (5.2%) | 2046/16516 (12.4%) | <0.001 | |
| During pandemic | NR | NR | 15/380# (3.9%) | 104/683 (15.2%) | 2/500 (0.4%) | 43/630# (6.8%) | NR | NR | NR | 4/278 (1.4%) | 168/2471 (6.8%) | |||
| Survival to hospital admission | Before pandemic | NR | 44/222 (19.8%) | 359/1218# (29.5%) | NR | 695/3052 (22.8%) | 525/1634# (32.1%) | NR | NR | 42/110# (38.2%) | 74/231 (32.0%) | 1739/6467 (26.9%) | <0.001 | |
| During pandemic | NR | 27/314 (8.6%) | 92/380# (24.2%) | NR | 67/521 (12.9%) | 107/580# (18.4%) | NR | NR | 31/95# (32.6%) | 65/278 (23.4%) | 389/2168 (17.9%) | |||
| Survival to hospital discharge | Before pandemic | NR | 21/222 (9.5%) | 142/1218# (11.7%) | NR | 164/3052 (5.4%) | 168/1723# (9.8%) | NR | NR | 22/110# (20.0%) | 34/231 (14.7%) | 551/6556 (8.4%) | 0.002 | |
| During pandemic | NR | 16/314 (5.1%) | 22/380# (5.8%) | NR | 16/517 (3.1%) | 42/623# (6.7%) | NR | NR | 23/95# (24.2%) | 22/278 (7.9%) | 141/2207 (6.4%) | |||
| Call to arrival in minutes, Median (IQR) | Before pandemic | 5.1 (2.3−7.2) | 12 (9−15) | 8.5 (6.6−11.4) | NR | 9.4 (7.9−12.6) | 12 (8−19) | 15 (11−19) | NR | 9 (7−13) | 6.4 (1.6−13.7) | NA | 0.036 | |
| During pandemic | 5.9 (2.3−9.6) | 15 (11−20) | 9.8 (8.0−12.8) | NR | 10.4 (8.4−13.8) | 15 (9−23) | 16 (12−22) | NR | 9 (7−12) | 7 (0.7−22.8) | NA | |||
| Etiology of OHCA, N (%) | Medical | Before pandemic | NR | 175/204 (58.8%) | 979/1218# (80.4%) | 11,153/12252 (91.0%) | NR | NR | 287/321 (89.4%) | NR | 99/110# (90.0%) | NR | 12693/14105 (90.0%) | 0.56 |
| During pandemic | NR | 179/197 (90.9%) | 293/380# (77.1%) | 643/683 (94.1%) | NR | NR | 465/490 (94.9%) | NR | 89/95# (93.7%) | NR | 1669/1845 (90.5%) | |||
| Trauma | Before pandemic | 43/2302 (1.9%) | 17/204 (8.3%) | 60/1218# (4.9%) | 1099/12252 (9.0%) | NR | NR | 28/321 (8.7%) | NR | 6/110# (5.5%) | NR | 1253/14105 (8.9%) | 0.031 | |
| During pandemic | 42/6709 (0.6%) | 15/197 (7.6%) | 22/380# (5.8%) | 40/683 (5.9%) | NR | NR | 13/490 (2.7%) | NR | 4/95# (4.2%) | NR | 136/1845 (7.4%) | |||
| Drowning | Before pandemic | NR | 0/204 (0.0%) | NR | NR | NR | NR | 0/321 (0.0%) | NR | 1/110# (0.9%) | NR | 1/635 (0.2%) | 1.00 | |
| During pandemic | NR | 1/197 (0.5%) | NR | NR | NR | NR | 0/490 (0.0%) | NR | 0/95# (0.0%) | NR | 1/782 (0.1%) | |||
| Overdose | Before pandemic | NR | 1/204 (0.5%) | 58/1218# (4.8%) | NR | NR | NR | 1/321 (0.3%) | NR | 4/110# (3.6%) | NR | 64/1853 (3.5%) | 0.58 | |
| During pandemic | NR | 0/197 (0.0%) | 18/380# (4.7%) | NR | NR | NR | 1/490 (0.2%) | NR | 2/95# (2.1%) | NR | 21/1162 (1.8%) | |||
| Asphyxia | Before pandemic | NR | 7/204 (3.4%) | 44/1218# (3.6%) | NR | NR | NR | 5/321 (1.6%) | NR | NR | NR | 56/1743 (3.2%) | 1.00 | |
| During pandemic | NR | 6/197 (3.0%) | 15/380# (3.9%) | NR | NR | NR | 11/490 (2.2%) | NR | NR | NR | 32/1067 (3.0%) | |||
NOS: Newcastle Ottawa Scale; USA: United States of America; SD: Standard deviation; N: Number; CPR: NR: Not reported; Cardiopulmonary resuscitation; OHCA: Out of hospital cardiac arrest; EMS: Emergency medical services; ROSC: Return of spontaneous circulation; AED: Automatic external defibrillator.
* The study did not compare the incidence of OHCA between 2019 and 2020 and was thus excluded from this analysis.
# Out of resuscitations attempted by emergency medical services.
^ Marijon et al looked at two different timeframes and compared the incidence and outcomes of OHCA against data from the pandemic period in 2020.