US Pharm. 2021;46(2):43-44.

A new study comparing the incidence of sudden deaths occurring outside the hospital across New York City’s highly diverse neighborhoods with the percentage of positive SARS-CoV-19 tests found that increased sudden deaths during the pandemic correlate to the extent of virus infection in a neighborhood. The analysis appears in Heart Rhythm.

“Our research shows the highly diverse regional distribution of out-of-hospital sudden death during the COVID-19 pandemic surge and follows the geographic distribution of seroconversion to SARS-CoV-2 in New York City,” explained lead investigator Stavros E. Mountantonakis, MD, FHRS, Northwell Health-Lenox Hill Hospital, Department of Cardiac Electrophysiology, New York City. “This finding adds to the previously reported association between out-of-hospital sudden death and COVID-19 presumed deaths and further supports an association between out-of-hospital sudden death and SARS-COV-2 epidemiologic burden.”

The investigators collected results of all antibody tests reported to the New York City Department of Health between March 3 and August 20, 2020, for all New York City zip codes, excluding eight commercial districts. New York City requires mandatory reporting of all tests.

Data from March 20 to April 22, 2020, during the height of the pandemic, were obtained from the Fire Department of New York City on the number of patients pronounced dead at the scene from sudden cardiac arrest, the classification the department uses for out-of-hospital sudden death. For comparison, they collected data for the same period in 2019. Census data were used to examine the possible influence of factors including age, race, access to medical insurance, education, and immigration status.

The investigators noted that it is unclear whether this association is causative or if there are factors that affect the geographic distribution of sudden death and SARS-CoV-2 infection similarly.

Dr. Mountantonakis observed, “The epidemiological data is a direct surrogate of viral burden and indirectly associated with people dying suddenly at home. It remains to be seen whether this is due to cardiac complications related to the virus or poor access to healthcare in neighborhoods that suffered the most during the first wave of the COVID-19 pandemic.”

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