Cardiac arrest survival rates fell in early years of pandemic
UTSW research shows rates for out-of-hospital episodes lagged, racial and ethnic outcome differences widened through 2022
DALLAS – May 27, 2025 – Survival rates for out-of-hospital cardiac arrest (OHCA) fell during the early years of the COVID-19 pandemic, with Black and Hispanic patients experiencing larger decreases in survival, according to a study led by UT Southwestern Medical Center researchers published in Resuscitation.
“Our results show that the pandemic largely eroded gains in cardiac arrest survival that had been achieved during the 10 years before the pandemic and exacerbated disparities,” said senior author Saket Girotra, M.D., Associate Professor of Internal Medicine in the Division of Cardiology at UT Southwestern.
Before the pandemic began in March 2020, OHCA survival rates had been steadily improving due to increased public awareness, faster emergency response times, and broader access to automated external defibrillators (AEDs). In 2019, the average overall survival rate stood at 9.9%, though it was lower in majority Black and Hispanic communities.
But overall survival dropped to 9% in 2020, with larger declines in majority Black and Hispanic communities. Through 2022, those racial/ethnic disparities persisted.
To assess OHCA trends after the pandemic began, Dr. Girotra and his colleagues analyzed data from the Cardiac Arrest Registry to Enhance Survival (CARES) — the largest national database tracking out-of-hospital cardiac arrest outcomes, with full data from 30 states and selected communities in 16 additional states. Researchers compared survival rates after cardiac arrest before the pandemic (2015-2019) to each of the years after the start of the pandemic (2020, 2021, and 2022).
“Our expectation was that survival after cardiac arrest had likely bounced back by 2022 to pre-pandemic levels,” said lead author Eric Hall, M.D., a clinical fellow in the Division of Cardiology at UT Southwestern. “What we found instead is that it remained 8%-10% lower, which suggests there were still some lingering effects of the pandemic on emergency cardiac care.”
The study cohort included 506,419 OHCA patients served by 1,313 emergency medical service (EMS) agencies. Not only were pre-pandemic survival rates lower in majority Black/Hispanic (7.9%) and integrated (10.7%) communities versus predominantly white communities (11.1%), they also fell more, with Black/Hispanic survival rates decreasing 16.5% in 2020, compared with the drop in white (8.1%) and integrated (6.5%) communities.
“These findings highlight the urgent need to address long-standing racial and ethnic differences in cardiac arrest outcomes,” Dr. Girotra said. “Our team is continuing to study how EMS agencies provide OHCA care in their communities to identify and share best practices.”
One factor in the rise of OHCA during the pandemic was an increase in cases related to drug overdoses. The study found that the number of drug-related OHCA cases continued to rise through the end of the study.
“The pandemic phase of COVID-19 may be over, but many of the health impacts remain,” Dr. Girotra said.
Other UTSW researchers who contributed to the study are James de Lemos, M.D., Professor of Internal Medicine and Chief of the Division of Cardiology; Anezi Uzendu, M.D., Assistant Professor of Internal Medicine in the Division of Cardiology; and Qiang Li, M.Sc., Biostatistical Consultant.
The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health (R01HL160734).
About UT Southwestern Medical Center  
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 23 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 140,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5.1 million outpatient visits a year.