Impact of the coronavirus pandemic on bystander CPR, dispatcher-assisted CPR, EMS response time, and survival outcomes in China.

AIM: This study aimed to evaluate whether the COVID-19 pandemic affected out-of-hospital cardiac arrest (OHCA) care and outcomes across multiple regions in China, despite the country's strict containment measures.

METHODS

Data from the BASeline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) Utstein Registry between 2019 and 2020 were analyzed. OHCA cases from 18 Emergency Medical Services (EMS) agencies were included. The primary outcome was survival to hospital discharge or 30 days, while secondary outcomes included return of spontaneous circulation (ROSC), and favorable neurologic outcome (Cerebral Performance Category [CPC] score 1-2). Three periods were compared: pre-COVID-19, outbreak, and regular prevention and control. Multilevel logistic regression adjusted for Utstein variables and center-level clustering was used.

RESULTS

A total of 16,595 patients received CPR (pre-COVID-19 n = 3890; outbreak n = 5939; regular prevention and control n = 6766). Survival to hospital discharge or 30 days did not differ significantly across periods. ROSC was lower during the outbreak (5.3% vs. 3.6%, AOR 0.80, P = 0.045) and regular prevention and control periods (5.3% vs. 3.5%, AOR 0.80, P = 0.045). Bystander CPR and dispatcher-assisted CPR were significantly less frequent during the regular prevention and control period. EMS response time was longer in the regular prevention and control period (median 12 min vs. 11 min; AOR 1.25, P = 0.006).

CONCLUSION

The COVID-19 pandemic impacted the EMS system in China, reducing bystander CPR, dispatcher-assisted CPR, and ROSC, and increasing EMS response times. However, survival and neurological outcomes did not deteriorate significantly.