In-hospital cardiac arrest in patients with coronavirus 2019

• Published in: Resuscitation Vol. 160; pp. 72 - 78
• Main Authors: Mitchell, Oscar J.L., Yuriditsky, Eugene, Johnson, Nicholas J., Doran, Olivia, Buckler, David G., Neefe, Stacie, Seethala, Raghu R., Motov, Sergey, Moskowitz, Ari, Lee, Jarone, Griffin, Kelly M., Shashaty, Michael G.S., Horowitz, James M., Abella, Benjamin S., Anderson, Jordan, Berg, Katherine M., Butt, Mahlaqa, Covin, Donna S., Damani, Aashka, Donnelly, Patrick J., Kaafarani, Haytham M.A., Kabariti, Sarah, Kingsley, Thomas C., Kohn, Rachel, Ma, Kevin C., Mullen-Fortino, Margaret, Naar, Leon, West, Frances Mae, Zeniecki, Patrick
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2021
• Subjects: Aged; Clinical Paper; Cohort study; COVID-19; COVID-19 - complications; COVID-19 - mortality; Female; Heart Arrest - mortality; Heart Arrest - virology; Hospitalization; Humans; In-hospital cardiac arrest; Male; Middle Aged; Retrospective Studies; Survival Rate; United States; United States; COVID-19; In-hospital cardiac arrest; Cohort study
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2021.01.012

Coronavirus Disease 2019 (COVID-19) has caused over 1 200 000 deaths worldwide as of November 2020. However, little is known about the clinical outcomes among hospitalized patients with active COVID-19 after in-hospital cardiac arrest (IHCA). We aimed to characterize outcomes from IHCA in patients with COVID-19 and to identify patient- and hospital-level variables associated with 30-day survival. We conducted a multicentre retrospective cohort study across 11 academic medical centres in the U.S. Adult patients who received cardiopulmonary resuscitation and/or defibrillation for IHCA between March 1, 2020 and May 31, 2020 who had a documented positive test for Severe Acute Respiratory Syndrome Coronavirus 2 were included. The primary outcome was 30-day survival after IHCA. There were 260 IHCAs among COVID-19 patients during the study period. The median age was 69 years (interquartile range 60–77), 71.5% were male, 49.6% were White, 16.9% were Black, and 16.2% were Hispanic. The most common presenting rhythms were pulseless electrical activity (45.0%) and asystole (44.6%). ROSC occurred in 58 patients (22.3%), 31 (11.9%) survived to hospital discharge, and 32 (12.3%) survived to 30 days. Rates of ROSC and 30-day survival in the two hospitals with the highest volume of IHCA over the study period compared to the remaining hospitals were considerably lower (10.8% vs. 64.3% and 5.9% vs. 35.7% respectively, p < 0.001 for both). We found rates of ROSC and 30-day survival of 22.3% and 12.3% respectively. There were large variations in centre-level outcomes, which may explain the poor survival in prior studies.