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Association of the COVID-19 Pandemic With Prehospital Characteristics and Outcomes of Pediatric Patients With Out-of-Hospital Cardiac Arrest in Japan, 2005-2020

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Sudden cardiac arrest is a major public health concern and a leading cause of death. Several pre–COVID-19 and post–COVID-19 comparisons have found an association between the COVID-19 pandemic and worse adult out-of-hospital cardiac arrest (OHCA) outcomes15; however, to our knowledge, studies on pediatric OHCA outcomes during the COVID-19 pandemic are limited. This study investigated the association of the COVID-19 pandemic with prehospital characteristics and outcomes of pediatric patients with OHCA in Japan.

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Article Information

Accepted for Publication: August 22, 2022.

Published: October 6, 2022. doi:10.1001/jamanetworkopen.2022.35401

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Zha L et al. JAMA Network Open.

Corresponding Author: Ling Zha, PhD, MPH, Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita 565-0871, Japan (sarin@envi.med.osaka-u.ac.jp).

Author Contributions: Drs Zha and Kitamura had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Zha, Hosomi, Kitamura.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Zha, Hosomi, Kitamura.

Critical revision of the manuscript for important intellectual content: Zha, Kiyohara, Sobue, Kitamura.

Statistical analysis: Zha, Hosomi, Kiyohara.

Obtained funding: Kitamura.

Supervision: Sobue, Kitamura.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by a Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (22K09139) (Dr Kitamura).

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: The authors thank all emergency medical service personnel and physicians in Japan and the Fire and Disaster Management Agency and Institute for Fire Safety and Disaster Preparedness of Japan for their generous cooperation in establishing and maintaining the Utstein database. We thank our colleagues from the Osaka University Center of Medical Data Science and Advanced Clinical Epidemiology Investigator’s Research Project for providing insights and expertise regarding our study.

Additional Information: The data that support the findings of this study are available from the All-Japan Utstein Registry; however, restrictions apply to the availability of these data, which were used under license for the present study and are therefore not publicly available. However, the data are available from the authors on reasonable request and with permission from the All-Japan Utstein Registry.

Hara  M , Hayashi  K , Kitamura  T .  Outcomes differ by first documented rhythm after witnessed out-of-hospital cardiac arrest in children: an observational study with prospective nationwide population-based cohort database in Japan.   Eur Heart J Qual Care Clin Outcomes. 2017;3(1):83-92. doi:10.1093/ehjqcco/qcw040 PubMedGoogle ScholarCrossref
Bielski  K , Szarpak  A , Jaguszewski  MJ ,  et al.  The influence of COVID-19 on out-hospital cardiac arrest survival outcomes: an updated systematic review and meta-analysis.   J Clin Med. 2021;10(23):5573. doi:10.3390/jcm10235573 PubMedGoogle ScholarCrossref
Marijon  E , Karam  N , Jost  D ,  et al.  Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study.   Lancet Public Health. 2020;5(8):e437-e443. doi:10.1016/S2468-2667(20)30117-1 PubMedGoogle ScholarCrossref
Wyckoff  MH , Singletary  EM , Soar  J ,  et al; COVID-19 Working Group.  2021 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: summary from the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group.   Resuscitation. 2021;169:229-311. doi:10.1016/j.resuscitation.2021.10.040 PubMedGoogle ScholarCrossref
Yamaji  K , Kohsaka  S , Inohara  T ,  et al; J-PCI Registry Investigators.  Percutaneous coronary intervention during the COVID-19 pandemic in Japan: insights from the nationwide registration data.   Lancet Reg Health West Pac. 2022;22:100434. doi:10.1016/j.lanwpc.2022.100434 PubMedGoogle ScholarCrossref
Matsuyama  T , Kitamura  T , Kiyohara  K ,  et al.  Assessment of the 11-year nationwide trend of out-of-hospital cardiac arrest cases among elderly patients in Japan (2005-2015).   Resuscitation. 2018;131:83-90. doi:10.1016/j.resuscitation.2018.08.011 PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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