Impact of the COVID-19 pandemic on favourable neurological outcome after EMS-witnessed out-of-hospital cardiac arrest: a prospective nationwide observational study.

Impact of the COVID-19 pandemic on favourable neurological outcome after EMS-witnessed out-of-hospital cardiac arrest: a prospective nationwide observational study.

Publication date: Oct 01, 2025

To evaluate the impact of the COVID-19 pandemic on favourable neurological outcome after out-of-cardiac arrest (OHCA) witnessed by emergency medical services (EMS) personnels in Japan. We conducted an interrupted time series analysis (ITSA) using a prospective, nationwide, population-based registry in Japan to assess 30-day favourable neurological outcome (Cerebral Performance Category 1 or 2), prehospital return of spontaneous circulation (ROSC), and 30-day survival among adult patients with EMS-witnessed OHCA during the pre-pandemic (January 2016-March 2020) and pandemic (April 2020-December 2021) periods. Subgroup analyses were performed by stratifying regions based on state of emergency declaration status. A controlled ITSA was conducted to compare outcome trends between areas with and without significant COVID-19 spread. In total, 58,315 adult patients with EMS-witnessed OHCA were identified. Favourable neurological outcome significantly declined during the pandemic (relative risk [RR], 0. 80; 95 % CI, 0. 71-0. 91; p

Concepts Keywords
Cardiac Adult
December Aged
Japan Aged, 80 and over
Pandemic All-Japan Utstein Registry
Cardiopulmonary Resuscitation
COVID-19
COVID-19 pandemic
Emergency Medical Services
Female
Good neurological outcome
Humans
Japan
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Prospective Studies
Registries
SARS-CoV-2
Segmented regression model

Semantics

Type Source Name
disease MESH COVID-19 pandemic
disease MESH out-of-hospital cardiac arrest
disease MESH cardiac arrest
disease MESH emergency
disease MESH Long Covid

Original Article

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