Use of out-of-hospital cardiac arrest registries to assess COVID-19 home mortality
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(2020) 20:305
RESEARCH ARTICLE
Open Access
Use of out-of-hospital cardiac arrest registries to assess COVID-19 home mortality Hervé Hubert1,2,3* , Valentine Baert1,2, Jean-Baptiste Beuscart1 and Emmanuel Chazard1
Abstract Background: In most countries, the official statistics for the coronavirus disease 2019 (COVID-19) take account of inhospital deaths but not those that occur at home. The study’s objective was to introduce a methodology to assess COVID-19 home deaths by analysing the French national out-of-hospital cardiac arrest (OHCA) registry (RéAC). Methods: We performed a retrospective multicentre cohort study based on data recorded in the RéAC by 20 mobile medical teams (MMTs) between March 1st and April 15th, 2020. The participating MMTs covered 10.1% of the French population. OHCA patients were classified as probable or confirmed COVID-19 cases or as non-COVID-19 cases. To achieve our primary objective, we computed the incidence and survival at hospital admission of cases of COVID-19 OHCA occurring at home. Cardiac arrests that occurred in retirement homes or public places were excluded. Hence, we estimated the number of at-home COVID-19-related deaths that were not accounted for in the French national statistics. Results: We included 670 patients with OHCA. The extrapolated annual incidence of OHCA per 100,000 inhabitants was 91.9 overall and 17.6 for COVID-19 OHCA occurring at home. In the latter group, the survival rate after being taken to the hospital after an OHCA was 10.9%. We estimated that 1322 deaths were not accounted in the French national statistics on April 15, 2020. Conclusions: The ratio of COVID-19 out-of-hospital deaths to in-hospital deaths was 12.4%, and so the national statistics underestimated the death rate. Keywords: COVID-19, Out-of-hospital cardiac arrest, COVID-19 home mortality, Epidemiology
Background The severity of the coronavirus disease 2019 (COVID19) is directly related to resulting health complications like severe acute respiratory syndrome, septic shock, sepsis, and cardiac, thrombotic or thromboembolic disorders [1–7]. These complications can lead to out-ofhospital cardiac arrest (OHCA) when patients are not * Correspondence: [email protected] 1 University of Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, F-59000 Lille, France 2 French National Out-of-Hospital Cardiac Arrest Registry, Lille, France Full list of author information is available at the end of the article
rapidly admitted to hospital [8, 9]. The World Health Organization (WHO) and most national governments provided daily death COVID-19 counts. The COVID-19 mortality rates are difficult to estimate because the total number of infected patients in a given country will depend on the national or regional testing strategy. Moreoadditional ver, most COVID-19 death counts are limited to inhospital deaths, which is unlikely to account for all COVID-19 mortalities. At the beginning of April, the French Ministry of Health star
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