The Impact of the COVID-19 Pandemic on Resuscitation Attempts, Bystander CPR and Survival Outcomes in Australia and New Zealand: A Binational Population-Based, Epistry Study

Abstract

Aim This study aims to assess the impact of the COVID-19 pandemic on out-of-hospital cardiac arrest (OHCA) incidence, bystander cardiopulmonary resuscitation (CPR), EMS resuscitation attempts and survival across Australia and New Zealand. Method Data were extracted for all OHCAs patients attended by emergency medical services (EMS) between 2017 and 2021 from the Aus-ROC OHCA Epistry (Epidemiological registry). Logistic regression was used to explore differences between the pre-COVID-19 (January 1, 2017 to March 15, 2020) and COVID-19 (March 16, 2020 to December 31, 2021) periods for bystander CPR, EMS-attempted resuscitation, survival to hospital arrival (event survival) and survival to hospital discharge/30 days. Results The incidence of OHCA increased during COVID-19 in Australia and New Zealand, although this varied regionally. When compared to the pre-COVID-19 period, COVID-19 was associated with a significant increase in the odds of an EMS-attempted resuscitation in Queensland (adjusted odds ratio (aOR) = 1.19; 95%CI: 1.01–1.40, p = 0.03) and Western Australia (aOR = 1.26; 95%CI: 1.03–1.54, p = 0.02). The COVID-19 period was associated with a decrease in survival to hospital arrival in Australia overall (aOR = 0.91; 95% CI:0.83–0.99, p = 0.04), and by region in Victoria (aOR = 0.74; 95% CI:0.63–0.87, p < 0.01) and Tasmania (aOR = 0.48; 95% CI:0.25–0.91, p = 0.02), and with a decrease in survival to hospital discharge/30 days in Australia (aOR = 0.82; 95% CI:0.70–0.96, p = 0.01), and by region in Victoria (aOR = 0.70; 95% CI:0.54–0.91, p < 0.01) and South Australia (aOR = 0.61; 95% CI:0.37–0.99, p = 0.04). There were no significant changes in survival during COVID-19 in New Zealand. Conclusion Regional variations were observed with respect to the associations of COVID-19 with resuscitation attempts and OHCA survival.