Sudden death in the prehospital setting in times of COVID-19

Mario Fitz Maurice, Fernando Di Tommasso, Nadia D. Formica Mazraani, Pablo Agüero, Paula C. Sastre, Alfredo Hirschson Prado


One in five adult deaths in developed countries is due to cardiovascular causes; half of these deaths occur suddenly and alarge percentage in the out-of-hospital setting. Multiple studies demonstrated that the access of the general population tolearning simple and pragmatic cardiopulmonary resuscitation maneuvers and the presence of automatic external defibrillatortranslates into a large increase in survival without sequelae in victims of sudden out-of-hospital sudden cardiac death.Today there is a situation represented by the pandemic by COVID-19, which questions what we have learned to date andmakes us face two extremely complex situations. On the one hand, the cardiovascular involvement and the consequent increasein malignant ventricular arrhythmias generated by this infection, both in patients with previous pathologies or not,has shown an increase in the incidence of episodes of sudden out-of-hospital death. On the other hand, it forces us to rethinkall the actions put into place at the moment that a patient presents with an episode of sudden out-of-hospital sudden cardiacdeath since now the possibility of transmission of this highly contagious disease is added during resuscitation maneuvers.Re-finding a risk-benefit balance that allows increasing the patient’s


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020