Use of out-of-hospital cardiac arrest registries to assess COVID-19 home mortality. Hubert, H., Baert, V., Beuscart, J., & Chazard, E. BMC medical research methodology, 20(1):305, December, 2020.
doi  abstract   bibtex   
BACKGROUND: In most countries, the official statistics for the coronavirus disease 2019 (COVID-19) take account of in-hospital deaths but not those that occur at home. The study's objective was to introduce a methodology to assess COVID-19 home deaths by analysing the French national out-of-hospital cardiac arrest (OHCA) registry (RéAC). METHODS: We performed a retrospective multicentre cohort study based on data recorded in the RéAC by 20 mobile medical teams (MMTs) between March 1st and April 15th, 2020. The participating MMTs covered 10.1% of the French population. OHCA patients were classified as probable or confirmed COVID-19 cases or as non-COVID-19 cases. To achieve our primary objective, we computed the incidence and survival at hospital admission of cases of COVID-19 OHCA occurring at home. Cardiac arrests that occurred in retirement homes or public places were excluded. Hence, we estimated the number of at-home COVID-19-related deaths that were not accounted for in the French national statistics. RESULTS: We included 670 patients with OHCA. The extrapolated annual incidence of OHCA per 100,000 inhabitants was 91.9 overall and 17.6 for COVID-19 OHCA occurring at home. In the latter group, the survival rate after being taken to the hospital after an OHCA was 10.9%. We estimated that 1322 deaths were not accounted in the French national statistics on April 15, 2020. CONCLUSIONS: The ratio of COVID-19 out-of-hospital deaths to in-hospital deaths was 12.4%, and so the national statistics underestimated the death rate.
@article{hubert_use_2020,
	title = {Use of out-of-hospital cardiac arrest registries to assess {COVID}-19 home mortality},
	volume = {20},
	issn = {1471-2288},
	doi = {10.1186/s12874-020-01189-3},
	abstract = {BACKGROUND: In most countries, the official statistics for the coronavirus disease 2019 (COVID-19) take account of in-hospital deaths but not those that occur at home. The study's objective was to introduce a methodology to assess COVID-19 home deaths by analysing the French national out-of-hospital cardiac arrest (OHCA) registry (RéAC).
METHODS: We performed a retrospective multicentre cohort study based on data recorded in the RéAC by 20 mobile medical teams (MMTs) between March 1st and April 15th, 2020. The participating MMTs covered 10.1\% of the French population. OHCA patients were classified as probable or confirmed COVID-19 cases or as non-COVID-19 cases. To achieve our primary objective, we computed the incidence and survival at hospital admission of cases of COVID-19 OHCA occurring at home. Cardiac arrests that occurred in retirement homes or public places were excluded. Hence, we estimated the number of at-home COVID-19-related deaths that were not accounted for in the French national statistics.
RESULTS: We included 670 patients with OHCA. The extrapolated annual incidence of OHCA per 100,000 inhabitants was 91.9 overall and 17.6 for COVID-19 OHCA occurring at home. In the latter group, the survival rate after being taken to the hospital after an OHCA was 10.9\%. We estimated that 1322 deaths were not accounted in the French national statistics on April 15, 2020.
CONCLUSIONS: The ratio of COVID-19 out-of-hospital deaths to in-hospital deaths was 12.4\%, and so the national statistics underestimated the death rate.},
	language = {eng},
	number = {1},
	journal = {BMC medical research methodology},
	author = {Hubert, Hervé and Baert, Valentine and Beuscart, Jean-Baptiste and Chazard, Emmanuel},
	month = dec,
	year = {2020},
	pmid = {33317467},
	pmcid = {PMC7734460},
	keywords = {COVID-19, COVID-19 home mortality, Epidemiology, Out-of-hospital cardiac arrest},
	pages = {305},
}

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