Background
Higher COVID-19 incidence has been associated with higher out-of-hospital sudden cardiac arrest (SCA) burden. Incidence of COVID-19 has been disproportionately higher in non-white populations.
Objective
To compare SCA incidence overall and by ethnicity during 14 months of the COVID-19 pandemic (Mar 1, 2020 - Apr 30, 2021) to the 14 months prior to the pandemic (Jan 1, 2019 - Feb 29, 2020) in a large community.
Methods
All out of hospital SCA cases with likely cardiac etiology with resuscitation attempted by emergency medical services (EMS) were prospectively identified from Jan 1, 2019 through Apr 30, 2021 in Ventura County, CA (pop. 848,112). We compared SCA incidence overall and in Hispanic and non-Hispanic county residents. COVID monthly incidence was obtained from US Centers for Disease Control data. Incidence rates used US Census 2018 data for Ventura County and were estimated with Poisson regression.
Results
In the pre-pandemic period (Jan 1, 2019 - Feb 29, 2020) there were 430 SCA cases in Ventura County, of whom 95 (22%) were Hispanic. During the pandemic period (Mar 1, 2020 - Apr 30, 2021) there were 526 SCA cases, of whom 164 (31%) were Hispanic. Comparing the pre-pandemic and pandemic 14-month periods, the overall crude incidence increased by 11 cases per 100,000 from 50.7 to 62.0 per 100,000 (p<0.001). Among Hispanics, the crude incidence increased by 19 cases per 100,000 from 26.4 to 45.6 per 100,000 (p<0.001) while among non-Hispanics, the increase was not statistically significant (from 68.6 to 74.2 per 100,000). During the pandemic, the monthly COVID incidence was <5000 until Nov 2020 when it rose sharply, peaking in Jan 2021 (Figure). Among total cumulative COVID cases in Ventura County through Dec. 8, 2021 with race/ethnicity data available, Hispanic individuals comprised 58.5%, while the overall county population is 44.6% Hispanic.
Conclusion
SCA incidence was significantly higher during the COVID-19 pandemic period, with a larger increase Hispanic than non-Hispanic residents. These findings have implications for community public health and EMS response planning during the pandemic and subsequent outbreaks.
