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Multicenter Study
. 2020 Dec 14;20(1):305.
doi: 10.1186/s12874-020-01189-3.

Use of out-of-hospital cardiac arrest registries to assess COVID-19 home mortality

Hervé Hubert  1   2   3 , Valentine Baert  4   5 , Jean-Baptiste Beuscart  4 , Emmanuel Chazard  4
Affiliations
Multicenter Study

Use of out-of-hospital cardiac arrest registries to assess COVID-19 home mortality

Hervé Hubert et al. BMC Med Res Methodol. .

Abstract

Background: In most countries, the official statistics for the coronavirus disease 2019 (COVID-19) take account of in-hospital deaths but not those that occur at home. The study's objective was to introduce a methodology to assess COVID-19 home deaths by analysing the French national out-of-hospital cardiac arrest (OHCA) registry (RéAC).

Methods: We performed a retrospective multicentre cohort study based on data recorded in the RéAC by 20 mobile medical teams (MMTs) between March 1st and April 15th, 2020. The participating MMTs covered 10.1% of the French population. OHCA patients were classified as probable or confirmed COVID-19 cases or as non-COVID-19 cases. To achieve our primary objective, we computed the incidence and survival at hospital admission of cases of COVID-19 OHCA occurring at home. Cardiac arrests that occurred in retirement homes or public places were excluded. Hence, we estimated the number of at-home COVID-19-related deaths that were not accounted for in the French national statistics.

Results: We included 670 patients with OHCA. The extrapolated annual incidence of OHCA per 100,000 inhabitants was 91.9 overall and 17.6 for COVID-19 OHCA occurring at home. In the latter group, the survival rate after being taken to the hospital after an OHCA was 10.9%. We estimated that 1322 deaths were not accounted in the French national statistics on April 15, 2020.

Conclusions: The ratio of COVID-19 out-of-hospital deaths to in-hospital deaths was 12.4%, and so the national statistics underestimated the death rate.

Keywords: COVID-19; COVID-19 home mortality; Epidemiology; Out-of-hospital cardiac arrest.

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Conflict of interest statement

The authors declare that there are no competing and conflicts of interest.

Figures

Fig. 1
Fig. 1
Participating centers, populations covered, and the rate of COVID-19 contamination on April 15th, 2020, by French administrative region. Bobigny comprises four MERSs (in Aulnay-sous-Bois, Bobigny, Montfermeil, and Saint-Denis). Original figures created by the authors
See this image and copyright information in PMC

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