key: cord-0782556-lmbxm7lj
authors: Recher, Morgan; Baert, Valentine; Leteurtre, Stéphane; Hubert, Hervé
title: Consequences of coronavirus disease outbreak on paediatric out-of-hospital cardiac arrest in France
date: 2020-08-12
journal: Resuscitation
DOI: 10.1016/j.resuscitation.2020.08.002
sha: c7e94562d02282662a7244838e61a6fd905c8a15
doc_id: 782556
cord_uid: lmbxm7lj

nan

The coronavirus disease (COVID-19) pandemic has disturbed health organisations globally 1 and requires permanent and rapid adaptation of practices. In adults, the association between J o u r n a l P r e -p r o o f COVID-19 and changes in out-of-hospital cardiac arrest (OHCA) management has been established. 2 In France, the emergency medical system overload did not significantly affect pre-hospital management of adult patients with cardiac arrest. 3 However, it is unclear whether the pre-hospital management of children was different during the COVID-19 outbreak.

Using the French National OHCA Registry (RéAC), we compared OHCA occurrence in children (<18 years) in France during the initial days of the COVID-19 outbreak (1 February 2020-15 May 2020) with OHCA occurrence in children during the same period of 2019 (Supplementary file). We identified COVID-19 cases in compliance with the World Health Organization definition. 4 We compared the rate of patients with cardiopulmonary resuscitation initiated by witnesses, cause of OHCA, duration of no flow, time between cardiac arrest and the mobile medical team's (MMT) arrival, return of spontaneous circulation (ROSC) rate, and survival rate during hospital admission.

We included 53 OHCAs reported in 2019 and 32 in the 2020 pandemic period (men: 64.2% and 59.4%, respectively) with a median age of 9 years (range: 1-15 years) and 6 years (Table 1) .

The emergency medical management of paediatric patients with OHCA in France does not seem to have been affected by the overload of pre-hospital emergency medical services.

The recent worldwide COVID-19 pandemic has put health care systems to the test, most of which have been overburdened. To prevent and avoid malfunctioning of critical services, many countries have established a COVID-19 rapid response infrastructure to prevent reaching capacity. 5 Even if COVID-19 among paediatric patients seemed to be milder, with better prognosis than adults, the risk of COVID-19 contamination forced the teams to take the same precautions during adults and children OHCA. The fear of COVID-19

has not led to a reduction of witness-initiated CPR. Despite the low incidence of paediatric OHCA during the 2020 pandemic provides a lack of statistical power, we hypothesised that paediatric OHCA is always an event, which is fortunately rare, but shocking to everyone involved, thus prompting all the stages of management to address such cases effectively even in the midst of the COVID-19 pandemic.

Dr. Recher conceptualized the study, drafted the initial manuscript, reviewed, and revised the manuscript; Mme Baert conceptualized the study, conducted the initial analyses, reviewed, and revised the manuscript; Prof. Leteurtre conceptualized the study, reviewed and revised the manuscript; Prof. Hubert conceptualized the study, reviewed, and revised the manuscript. All authors have approved the final manuscript as submitted and agree to be accountable for all aspects of the work. 

None declared. 

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