A population-based, cross-sectional study was conducted including 5,325 patients 18 years or older who experienced out-of-hospital cardiac arrest and received emergency medical service (EMS) resuscitation during either the COVID-19 period (March 1 – April 25, 2020) or the comparison period (March 1 – April 25, 2019). The 2020 COVID-19 period was found to have 2,635 more patients with out-of-hospital cardiac arrest who received EMS resuscitation and an incidence rate triple that of the comparison period in 2019 (47.5/100,000 vs. 15.9/100,000). Over 90% of the excess cases resulted in out-of-hospital deaths with Black, Hispanic, and Asian patients at an increased risk for COVID-19-associated out-of-hospital cardiac arrests and death. These results--in addition to similar bystander CPR rates, EMS response times, and duration of resuscitation efforts during both periods--highlight the importance of intervening early in the course of COVID-19 infection and ensuring health care access to vulnerable populations during a pandemic.