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. 2021 Feb;18(2):215-218.
doi: 10.1016/j.hrthm.2020.11.022.

Association between regional distributions of SARS-CoV-2 seroconversion and out-of-hospital sudden death during the first epidemic outbreak in New York

Kristie M Coleman  1 , Moussa Saleh  2 , Stavros E Mountantonakis  2
Affiliations

Association between regional distributions of SARS-CoV-2 seroconversion and out-of-hospital sudden death during the first epidemic outbreak in New York

Kristie M Coleman et al. Heart Rhythm. 2021 Feb.

Abstract

Background: Increased incidence of out-of-hospital sudden death (OHSD) has been reported during the coronavirus 2019 (COVID-19) pandemic. New York City (NYC) represents a unique opportunity to examine the epidemiologic association between the two given the variable regional distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its highly diverse neighborhoods.

Objective: The purpose of this study was to examine the association between OHSD and SARS-CoV-2 epidemiologic burden during the first COVID-19 pandemic across the highly diverse neighborhoods of NYC.

Methods: The incidences of OHSD between March 20 and April 22, 2019, and between March 20 and April 22, 2020, as reported by the Fire Department of New York were obtained. As a surrogate for viral epidemiologic burden, we used percentage of positive SARS-CoV-2 antibody tests performed between March 3 and August 20, 2020. Data were reported separately for the 176 zip codes of NYC. Correlation analysis and regression analysis were performed between the 2 measures to examine association.

Results: Incidence of OHSD per 10,000 inhabitants and percentage of SARS-CoV-2 seroconversion were highly variable across NYC neighborhoods, varying from 0.0 to 22.9 and 12.4% to 50.9%, respectively. Correlation analysis showed a moderate positive correlation between neighborhood data on OHSD and percentage of positive antibody tests to SARS-CoV-2 (Spearman ρ 0.506; P <.001). Regression analysis showed that seroconversion to SARS-CoV-2 and OHSD in 2019 were independent predictors for OHSD during the first epidemic surge in NYC (R2 = 0.645).

Conclusion: The association in geographic distribution between OHSD and SARS-CoV-2 epidemiologic burden suggests either a causality between the 2 syndromes or the presence of local determinants affecting both measures in a similar fashion.

Keywords: Arrhythmias; COVID-19 pandemic; Epidemiologic burden; Out-of-hospital sudden death; SARS-CoV-2 antibodies.

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Figures

Figure 1
Figure 1
A: Geographic distribution of incidence of out-of-hospital sudden death (OHSD) per 10,000 inhabitants (historical control) (March 22 to April 22, 2019) in New York City. B: Geographic distribution of incidence of OHSD per 10,000 inhabitants during coronavirus 2019 (COVID-19) outbreak (March 22 to April 22, 2020) in New York City. C: Scatterplot depicting neighborhood-level association between OHSD during the COVID-19 outbreak and percentage of positive tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies.
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