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. 2021 Mar 2:6:100105.
doi: 10.1016/j.resplu.2021.100105. eCollection 2021 Jun.

Out-of-hospital cardiac arrests and mortality in Swiss Cantons with high and low COVID-19 incidence: A nationwide analysis

Enrico Baldi  1   2   3   4 , Angelo Auricchio  1   4 , Catherine Klersy  5 , Roman Burkart  6 , Claudio Benvenuti  1 , Chiara Vanetta  1 , Jürg Bärtschi  6 ; SWISSRECA researchers
Affiliations

Out-of-hospital cardiac arrests and mortality in Swiss Cantons with high and low COVID-19 incidence: A nationwide analysis

Enrico Baldi et al. Resusc Plus. .

Abstract

Aims: Many countries reported an increase of out-of-hospital cardiac arrests (OHCAs) and mortality during the COVID-19 pandemic. However, all these data refer to regional settings and national data are still missing. We aimed to assess the OHCA incidence and population mortality during COVID-19 pandemic in whole Switzerland and in the different regions (Cantons) according to the infection rate.

Methods: We considered OHCAs and deaths which occurred in Switzerland after the first diagnosed case of COVID-19 (February 25th) and for the subsequent 65 days and in the same period in 2019. We also compared Cantons with high versus low COVID-19 incidence.

Results: A 2.4% reduction in OHCA cases was observed in Switzerland. The reduction was particularly high (-21.4%) in high-incidence COVID-19 cantons, whilst OHCAs increased by 7.7% in low-incidence COVID-19 cantons. Mortality increased by 8.6% in the entire nation: a 27.8% increase in high-incidence cantons and a slight decrease (-0.7%) in low-incidence cantons was observed. The OHCA occurred more frequently at home, CPR and AED use by bystander were less frequent during the pandemic. Conversely, the OHCAs percentage in which a first responder was present, initiated the CPR and used an AED, increased. The outcome of patients in COVID-19 high-incidence cantons was worse compared to low-incidence cantons.

Conclusions: During the COVID-19 pandemic in Switzerland mortality increased in Cantons with high-incidence of infection, whilst not in the low-incidence ones. OHCA occurrence followed an opposite trend showing how variables related to the health-system and EMS organization deeply influence OHCA occurrence during a pandemic.

Keywords: COVID-19; Mortality; Out-of-hospital cardiac arrest; Switzerland.

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Figures

Fig. 1
Fig. 1
OHCA cumulative incidence per 100,000 inhabitants in high-incidence and low-incidence of COVID-19 Cantons in the first 65 days of the pandemic in 2020 and in the same period of 2019 (upper panel). Difference 2020–2019 in OHCA cumulative incidence per 100,000 inhabitants in high-incidence and low-incidence of COVID-19 Cantons in the first 65 days of the pandemic in 2020 and in the same period of 2019 (lower panel).
Fig. 2
Fig. 2
Association between the difference in OHCA cumulative incidence per 100,000 inhabitants between 2020 and 2019 periods and COVID-19 cumulative incidence per 100,000 inhabitants in high-incidence and low-incidence of COVID-19 Cantons.
See this image and copyright information in PMC

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