OBJECTIVES: 

To describe and compare survival among patients with out-of-hospital cardiac arrest as a function of their status for coronavirus disease 2019.

DESIGN: 

We performed an observational study of out-of-hospital cardiac arrest patients between March 2020 and December 2020. Coronavirus disease 2019 status (confirmed, suspected, or negative) was defined according to the World Health Organization’s criteria.

SETTING: 

Information on the patients and their care was extracted from the French national out-of-hospital cardiac arrest registry. The French prehospital emergency medical system has two tiers: the fire department intervenes rapidly to provide basic life support, and mobile ICUs provide advanced life support. The study data (including each patient’s coronavirus disease 2019 status) were collected by 95 mobile ICUs throughout France.

PATIENTS: 

We included 6,624 out-of-hospital cardiac arrest patients: 127 cases with confirmed coronavirus disease 2019, 473 with suspected coronavirus disease 2019, and 6,024 negative for coronavirus disease 2019.

INTERVENTIONS: 

None.

MEASUREMENTS AND MAIN RESULTS: 

The “confirmed” and “suspected” groups of coronavirus disease 2019 patients had similar characteristics and were more likely to have suffered an out-of-hospital cardiac arrest with a respiratory cause (confirmed: 53.7%, suspected coronavirus disease 2019: 56.5%; p = 0.472) than noncoronavirus disease 2019 patients (14.0%; p < 0.001 vs confirmed coronavirus disease 2019 patients). Advanced life support was initiated for 57.5% of the confirmed coronavirus disease 2019 patients, compared with 64.5% of the suspected coronavirus disease 2019 patients (p = 0.149) and 70.6% of the noncoronavirus disease 2019 ones (p = 0.002). The survival rate at 30-day postout-of-hospital cardiac arrest was 0% in the confirmed coronavirus disease 2019 group, 0.9% in the suspected coronavirus disease 2019 group (p = 0.583 vs confirmed), and 3.5% (p = 0.023) in the noncoronavirus disease 2019 group.

CONCLUSIONS: 

Our results highlighted a zero survival rate in out-of-hospital cardiac arrest patients with confirmed coronavirus disease 2019. This finding raises important questions with regard to the futility of resuscitation for coronavirus disease 2019 patients and the management of the associated risks.

中文翻译：

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2019 年冠状病毒病和院外心脏骤停：无人生还*

目标： 

描述和比较院外心脏骤停患者的生存率与其 2019 年冠状病毒病状况的关系。

设计： 

我们对 2020 年 3 月至 2020 年 12 月期间院外心脏骤停患者进行了一项观察性研究。2019 年冠状病毒病状态（确诊、疑似或阴性）是根据世界卫生组织的标准定义的。

环境： 

有关患者及其护理的信息来自法国国家院外心脏骤停登记处。法国院前急救医疗系统分为两级：消防部门迅速介入提供基本生命支持，移动ICU提供高级生命支持。研究数据（包括每位患者的 2019 年冠状病毒病状态）由法国各地 95 个移动 ICU 收集。

患者： 

我们纳入了 6,624 名院外心脏骤停患者：127 例确诊为 2019 年冠状病毒病，473 例疑似为 2019 年冠状病毒病，6,024 例为 2019 年冠状病毒病阴性。

干预措施： 

没有任何。

测量和主要结果： 

2019冠状病毒病的“确诊”和“疑似”群体具有相似的特征，并且更有可能因呼吸道原因发生院外心脏骤停（确诊：53.7％，疑似2019冠状病毒病：56.5％；p = 0.472）高于非冠状病毒疾病 2019 患者（14.0%；p < 0.001 与确诊的冠状病毒疾病 2019 患者相比）。57.5% 的确诊 2019 冠状病毒病患者启动了高级生命支持，而疑似 2019 冠状病毒病患者的这一比例为 64.5% ( p = 0.149)，非 2019 冠状病毒病患者的这一比例为 70.6% ( p = 0.002)。确诊的 2019 年冠状病毒病组中，院外心脏骤停 30 天的存活率为 0%，疑似 2019 年冠状病毒病组中的存活率为 0.9%（p = 0.583 与确诊组），以及 3.5%（p = 0.023）在 2019 年非冠状病毒疾病组中。

结论： 

我们的结果强调，确诊 2019 年冠状病毒病的院外心脏骤停患者的存活率为零。这一发现提出了关于对 2019 年冠状病毒病患者进行复苏无效以及相关风险管理的重要问题。