Variance of the COVID-19 occurrence in the community: influence on the emergency medical service and the survival of out-of-hospital cardiac arrest patients

Kim, Geun Chang; Kim, Sin Young; Kim, Jong Won; Hong, Dae Young; Lee, Kyeong Ryong; Baek, Kwang Je; Park, Sang O

J Korean Soc Emerg Med > Volume 34(2); 2023 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2023;34(2): 96-104.

지역 COVID-19 확진자 환자 발생수 변화가 응급의료체계 및 병원 밖 심정지 환자의 생존율에 미치는 영향에 관한 연구

김근창

건국대학교 의학전문대학원 응급의학교실

Variance of the COVID-19 occurrence in the community: influence on the emergency medical service and the survival of out-of-hospital cardiac arrest patients

Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea

Correspondence

Sang O Park ,Tel: 02-2030-5551, Fax: 02-2030-5780, Email: empso@kuh.ac.kr,

Received: June 29, 2022; Revised: October 11, 2022 Accepted: October 19, 2022. Published online: April 30, 2023.

ABSTRACT

Objective:
This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on emergency medical service (EMS) responses and out-of-hospital cardiac arrest (OHCA) outcomes.
Method:
This is a retrospective comparison study analyzing the OHCA data of a university medical center in Seoul during the COVID-19 pandemic period (January 2020-January 2021) and non-pandemic period (January 2019-January 2020). The EMS response time and OHCA outcomes were compared between both periods. Based on the weekly mean number of confirmed cases and their EMS response time, patients were classified into six groups and OHCA outcomes were compared.
Results:
This study evaluated 309 OHCA patients (non-pandemic period of 146, pandemic period of 163). Significant delays in the EMS response and transport time were observed during the pandemic period. However, no significant differences were obtained in the rate of return of spontaneous circulation (ROSC) and survival at discharge (12.4% in pandemic vs. 13.8% in non-pandemic; P=0.722). According to the weekly mean COVID-19 incidence when patients were over 100, there was a significant increase in the EMS response and transport time, whereas ROSC and survival rate were dramatically decreased.
Conclusion:
During the pandemic, the EMS service for OHCA patients was worse than before, with delayed and reduced survival for OHCA patients. We further determined that an increase in the number of COVID-19 cases (especially when weekly mean numbers were over 100) dramatically delayed the EMS response time. This resulted in a very low survival rate of OHCA patients.

Key words: Emergency medical services; Out-of-hospital cardiac arrest; COVID-19