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In-hospital cardiac arrest in patients with coronavirus 2019

Authors
  • Mitchell, Oscar J.L.1, 2
  • Yuriditsky, Eugene3
  • Johnson, Nicholas J.4
  • Doran, Olivia2
  • Buckler, David G.5
  • Neefe, Stacie1
  • Seethala, Raghu R.6
  • Motov, Sergey7
  • Moskowitz, Ari8
  • Lee, Jarone9
  • Griffin, Kelly M.10
  • Shashaty, Michael G.S.1, 11, 12
  • Horowitz, James M.3
  • Abella, Benjamin S.2, 12
  • Anderson, Jordan
  • Berg, Katherine M.
  • Butt, Mahlaqa
  • Covin, Donna S.
  • Damani, Aashka
  • Donnelly, Patrick J.
  • And 9 more
Type
Published Article
Journal
Resuscitation
Publisher
Elsevier B.V.
Publication Date
Jan 27, 2021
Volume
160
Pages
72–78
Identifiers
DOI: 10.1016/j.resuscitation.2021.01.012
PMID: 33515638
PMCID: PMC7839632
Source
PubMed Central
Keywords
License
Unknown

Abstract

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.

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