Purpose of the study
We aimed to assess the characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in Iasi County during the second, third and fourth waves and to seek a relation between the OHCAs and COVID-19.
Materials and methods:
All OHCA with cardiopulmonary resuscitation (CPR) was included, registered by the Iasi County medical crews during pandemic period: second wave (October 1st-December 31st), third wave (March1st – April 30th) and fourth wave (September 1st – October 31st). The group was defined as having ongoing infection included cases with confirmed PCR test for Covid-19.
Results
A total of 1154 OHCAs occurred during three waves period, mean [SD] age 68.83[15.73] years, 678 men [58.7%], from urban area. Prevalence of Covid-19 in OHCA was 15.07% (432/42, 272/11, 450/121). Incidence of OHCA was higher (26.88%) in the last period compared with previous waves. Previous pathology of cardio-pulmonary arrest are was: cardiovascular disease (35.05%), neoplasia (21.26%), neurologic (12.06%) and respiratory (11.49%). Ventricular fibrillation was the initial rhythm of cardiac arrest in 11.90%/ 18.18%/0.82% cases and pulseless ventricular tachycardia in 1.65% of OHCA cases. Time to EMS (emergency medical services) arrival median was 6 minutes for urban area and 21 minutes for rural area with a significant increasing during third wave. ROSC (return of spontaneous circulation) was obtained in 38 cases (50%/27.27%/9.09%). A significant statistical correlation was found between the first documented rhythm and ROSC (p= 0.04) only during the second wave. Bystanders CPR were more common during the fourth wave 10%.
Conclusions
Cardiopulmonary resuscitation outcomes depend on a wide range of factors such as cause of cardiac arrest and type (witnessed or unwitnessed), underlying disease, the first documented rhythm, age, CPR duration, call-to-arrival time. The lower CPR success rate among patients with COVID-19 has been attributed to factors such as the first documented rhythm.

Out-of-hospital cardiac arrest during the COVID-19 pandemic in North-East region of Romania

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