Epidemic of the SARS-CoV-2 Omicron variant in Shanghai, China in 2022: Transient and persistent effects on Out-of-hospital cardiac arrests

Abstract

Objective: To investigate transient and persistent effects of the Shanghai Omicron epidemic in 2022 on the incidence, characteristics, and outcomes of out-of-hospital cardiac arrest (OHCA).

Methods: This retrospective study examined electronic records of patients admitted to the Shanghai Emergency Medical Center during five periods: pre-epidemic, 1 January 2018 to 31 December 2019; low COVID-19 incidence, 1 January 2020 to 27 March 2022; Omicron epidemic, 28 March to 31 May 2022; early post-epidemic, 1 June to 31 July 2022; and late post-epidemic, 1 August to 30 September 2022. Clinicodemographic characteristics and outcomes of OHCA cases were compared between the pre-epidemic and other periods.

Results: A total of 55,104 OHCAs were included. The monthly number of OHCAs in the Omicron epidemic was 2.1 times the number in the pre-epidemic (1702 vs 793), while the number in the early post-epidemic was 1.9 times the number in the pre-epidemic (1515 vs 793). Compared to the pre-epidemic, OHCA during or after the epidemic was more likely to involve individuals with hypertension, coronary artery disease, heart failure or stroke. The probability that circulation would spontaneously resume after OHCA was significantly lower during the epidemic than before it (aOR 0.61, 95% CI 0.41-0.90; P = 0.012). However, this difference disappeared by the early post-epidemic.

Conclusion: The monthly number of OHCAs doubled during the Omicron epidemic in Shanghai, and it remained elevated for another two months. OHCA affected individuals with cardiovascular and cerebrovascular diseases more during and after the epidemic than before it.

Keywords: COVID-19; Epidemic; Omicron variant; Out-of-hospital cardiac arrest.

Fig. 1

Study Flowchart.

Fig. 2

Correspondence Between Monthly OHCA Cases in Downtown Shanghai and Monthly SARS-CoV-2 Infections in Shanghai or in China or Worldwide From January 2018 to September 2022. Data on SARS-CoV-2 infections in Shanghai, in China, and Worldwide were collected and plotted based on public information from Shanghai Municipal Health Commission (acquired from: http://wsjkw.sh.gov.cn/yqtb/index.html), National Health Commission of the People’s Republic of China (acquired from: http://www.nhc.gov.cn/xcs/yqtb/list_gzbd.shtml), and WHO Coronavirus (COVID-19) Dashboard (acquired from: https://covid19.who.int/), respectively.