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 - 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
SN - 0300-9572
VL - 160
SP - 72
EP - 78
JO - Resuscitation
JF - Resuscitation
ER -