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

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.