19 June 2020 - - The COVID-19 pandemic in New York City caused a surge in out-of-hospital cardiac arrests and deaths, according to a study co-authored by researchers at Albert Einstein College of Medicine, Montefiore Health System, and the Fire Department of the city of New York (FDNY).

The study, published online in JAMA Cardiology, found a three-fold increase in out-of-hospital non-traumatic cardiac-arrest cases in March and April 2020 compared to the same period in 2019.

On the worst day, April 6, cardiac arrests peaked at 305 cases, an increase of nearly 10-fold compared with the same day one year earlier.

The mortality rate for cardiac-arrest cases also rose, from 75 % in 2019 to more than 90 % during the same period in 2020.

The study used data from the New York City emergency medical services system.

Run by the FDNY, it is the largest and busiest EMS system in the US, serving a population of more than 8.4m people and responding to more than 1.5m calls annually.

Data was analyzed for patients 18 years or older with out-of-hospital cardiac arrest who received EMS resuscitation from March 1, 2020 (when the first case of COVID-19 was diagnosed in New York City) through April 25, 2020 (when EMS call volume had receded to pre-COVID-19 levels).

For comparison, cardiac-arrest data was also analyzed for the same time period during 2019.

Between March 1 and April 25, 2020, 3,989 patients underwent EMS resuscitation attempts for out-of-hospital cardiac arrests, compared to 1,336 patients who were treated during that period in 2019.

Compared with cardiac arrests in 2019, cardiac arrests occurring during the pandemic were associated with several risk factors.

On average, the 2020 patients were older (average age of 72 vs. 68 for the 2019 cardiac-arrest patients); less likely to be white (20% white vs. 33%); more likely to have hypertension (54% vs. 46%); more likely to have diabetes (36% vs. 26%); more likely to have physical limitations (57% vs. 48%); more likely to have cardiac rhythms that don't respond to defibrillator shocks (92% vs. 81%); and more likely to die (90% vs 75%).

Why might a respiratory disease like COVID-19 trigger heart problems? In addition to overwhelming pneumonia and acute respiratory failure, COVID-19 damages the lining of blood vessels, leading to blood clots that can trigger heart attacks even in people with no previous cardiopulmonary diseases.

The study is titled "Characteristics Associated With Out-of-Hospital Cardiac Arrests and Resuscitations During the Novel Coronavirus Disease 2019 Pandemic in New York City." Other authors are: Pamela H. Lai, M.D., Ph.D., M.Sc., and Elizabeth A. Lancet, Dr.P.H. M.P.H., from FDNY; Michael D. Weiden, M.D. M.S., from FDNY and NYU Langone; and Mayris P. Webber, Dr.P.H. M.P.H.; Rachel Zeig-Owens, Dr.P.H., M.P.H.; and Charles B. Hall, Ph.D., all from Einstein-Montefiore and FDNY.

Albert Einstein College of Medicine is a center for research, medical education and clinical investigation. During the 2019-20 academic year, Einstein is home to 724 M.D. students, 158 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,800 full-time faculty members located on the main campus and at its clinical affiliates.