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A total of 25,271 hospitalized OHCA patients were recruited from records spanning from January 1, 2020, to December 31, 2023. Study population divided into two groups, COVID-19 positive and COVID-19 negative groups. The mortality risk of the two groups was observed based on different follow-up periods. Subgroup analyses on sex, age, antivirals use, COVID-19 virus variant epidemic period were also conducted.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Our study included 2,776 patients in each group (COVID vs. non-COVID). The primary outcome was mortality at 14-day and 90-day follow-ups. COVID-19 patients had a lower 14-day mortality (HR 0.82, 95% CI: 0.76\u20130.88) but higher 90-day mortality (HR 1.16, 95% CI: 1.09\u20131.24) compared to non-COVID-19 patients. Secondary outcomes included higher mortality in COVID-19 patients under 65, and this trend persisted in those aged 65 and over. Male COVID-19 patients had elevated mortality risk. The Alpha and Delta variant period showed a higher mortality rate for COVID-19 patients than non-COVID-19 patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>COVID-19 was associated with a higher risk of mortality in OHCA patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13049-025-01395-2","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T09:55:15Z","timestamp":1746093315000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of COVID-19 on mortality in out-of-hospital cardiac arrest patients with return of spontaneous circulation: a retrospective cohort study"],"prefix":"10.1186","volume":"33","author":[{"given":"Nai-Chen","family":"Shih","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han-Wei","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun-Fa","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hsun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Hsien","family":"Chaou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Bin","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"issue":"10","key":"1395_CR1","doi-asserted-by":"publisher","first-page":"e2336992","DOI":"10.1001\/jamanetworkopen.2023.36992","volume":"6","author":"JZ Liu","year":"2023","unstructured":"Liu JZ, et al. 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