TY - JOUR
T1 - In-hospital cardiac arrest in patients with coronavirus 2019
AU - Mitchell, Oscar J.L.
AU - Yuriditsky, Eugene
AU - Johnson, Nicholas J.
AU - Doran, Olivia
AU - Buckler, David G.
AU - Neefe, Stacie
AU - Seethala, Raghu R.
AU - Motov, Sergey
AU - Moskowitz, Ari
AU - Lee, Jarone
AU - Griffin, Kelly M.
AU - Shashaty, Michael G.S.
AU - Horowitz, James M.
AU - Abella, Benjamin S.
AU - Anderson, Jordan
AU - Berg, Katherine M.
AU - Butt, Mahlaqa
AU - Covin, Donna S.
AU - Damani, Aashka
AU - Donnelly, Patrick J.
AU - Kaafarani, Haytham M.A.
AU - Kabariti, Sarah
AU - Kingsley, Thomas C.
AU - Kohn, Rachel
AU - Ma, Kevin C.
AU - Mullen-Fortino, Margaret
AU - Naar, Leon
AU - West, Frances Mae
AU - Zeniecki, Patrick
N1 - Funding Information:
BA has received philanthropic funding for a randomized trial of COVID-19 therapeutics, and a City of Philadelphia grant for COVID-19 community testing. JH receives fees for consulting at Inari Medical, Penumbra Inc. and Abiomed. JL receives consultancy fees from Butterfly Inc. and grant support from the National Institute of Health (NIH), Department of Defense (DOD), Nihon-Kohden Corp, and Beckman Coulter Inc. OJLM is supported by an NIH T32 grant, 5T32HL007891-22. OJLM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Information:
A manuscript containing 55 patients from one hospital in the study cohort (as well as 55 controls from 2018/2019) is currently under consideration at Resuscitation Plus as a retrospective case-control study - RESPLU-D-20-00074R1. Oscar Mitchell is supported by a T32 grant from the National Institute of Health ( 5T32HL007891-22 ).
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/3
Y1 - 2021/3
N2 - Background: 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). Aim: 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. Methods: 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. Results: 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). Conclusions: 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.
AB - Background: 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). Aim: 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. Methods: 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. Results: 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). Conclusions: 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.
KW - COVID-19
KW - Cohort study
KW - In-hospital cardiac arrest
UR - http://www.scopus.com/inward/record.url?scp=85100702552&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100702552&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2021.01.012
DO - 10.1016/j.resuscitation.2021.01.012
M3 - Article
C2 - 33515638
AN - SCOPUS:85100702552
VL - 160
SP - 72
EP - 78
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -