tetano
Editor, Senior Moderator
Resusc Plus
. 2020 Dec;4:100054.
doi: 10.1016/j.resplu.2020.100054. Epub 2020 Nov 21.
Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19
Eugene Yuriditsky[SUP] 1 [/SUP], Oscar J L Mitchell[SUP] 2 [/SUP], Shari B Brosnahan[SUP] 3 [/SUP], Nathaniel R Smilowitz[SUP] 1 [/SUP], Karsten W Drus[SUP] 3 [/SUP], Anelly M Gonzales[SUP] 3 [/SUP], Yuhe Xia[SUP] 4 [/SUP], Sam Parnia[SUP] 3 [/SUP], James M Horowitz[SUP] 1 [/SUP]
Affiliations
Abstract
Aims: To define outcomes of patients with COVID-19 compared to patients without COVID-19 suffering in-hospital cardiac arrest (IHCA).
Materials and methods: We performed a single-center retrospective study of IHCA cases. Patients with COVID-19 were compared to consecutive patients without COVID-19 from the prior year. Return of spontaneous circulation (ROSC), 30-day survival, and cerebral performance category (CPC) at 30-days were assessed.
Results: Fifty-five patients with COVID-19 suffering IHCA were identified and compared to 55 consecutive IHCA patients in 2019. The COVID-19 cohort was more likely to require vasoactive agents (67.3% v 32.7%, p = 0.001), invasive mechanical ventilation (76.4% v 23.6%, p < 0.001), renal replacement therapy (18.2% v 3.6%, p = 0.029) and intensive care unit care (83.6% v 50.9%, p = 0.001) prior to IHCA. Patients with COVID-19 had shorter CPR duration (10 min v 22 min, p = 0.002). ROSC (38.2% v 49.1%, p = 0.336) and 30-day survival (20% v 32.7%, p = 0.194) did not differ. A 30-day cerebral performance category of 1 or 2 was more common among non-COVID patients (27.3% v 9.1%, p = 0.048).
Conclusions: Return of spontaneous circulation and 30-day survival were similar between IHCA patients with and without COVID-19. Compared to previously published data, we report greater ROSC and 30-day survival after IHCA in COVID-19.
Keywords: AHA, American Heart Association; CAD, Coronary artery disease; CKD, Chronic kidney disease; COVID-19; COVID-19, Coronavirus disease 2019; CPC, Cerebral performance category; Cardiac arrest; Cardiopulmonary resuscitation; DNR, Do not resuscitate; HLD, Hyperlipidemia; HTN, Hypertension; IHCA, In-hospital cardiac arrest; OHCA, Out-of-hospital cardiac arrest; PEA, Pulseless electrical activity; ROSC; ROSC, Return of spontaneous circulation; VF, Ventricular fibrillation; VT, Ventricular tachycardia.
. 2020 Dec;4:100054.
doi: 10.1016/j.resplu.2020.100054. Epub 2020 Nov 21.
Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19
Eugene Yuriditsky[SUP] 1 [/SUP], Oscar J L Mitchell[SUP] 2 [/SUP], Shari B Brosnahan[SUP] 3 [/SUP], Nathaniel R Smilowitz[SUP] 1 [/SUP], Karsten W Drus[SUP] 3 [/SUP], Anelly M Gonzales[SUP] 3 [/SUP], Yuhe Xia[SUP] 4 [/SUP], Sam Parnia[SUP] 3 [/SUP], James M Horowitz[SUP] 1 [/SUP]
Affiliations
- PMID: 33403368
- PMCID: PMC7680084
- DOI: 10.1016/j.resplu.2020.100054
Abstract
Aims: To define outcomes of patients with COVID-19 compared to patients without COVID-19 suffering in-hospital cardiac arrest (IHCA).
Materials and methods: We performed a single-center retrospective study of IHCA cases. Patients with COVID-19 were compared to consecutive patients without COVID-19 from the prior year. Return of spontaneous circulation (ROSC), 30-day survival, and cerebral performance category (CPC) at 30-days were assessed.
Results: Fifty-five patients with COVID-19 suffering IHCA were identified and compared to 55 consecutive IHCA patients in 2019. The COVID-19 cohort was more likely to require vasoactive agents (67.3% v 32.7%, p = 0.001), invasive mechanical ventilation (76.4% v 23.6%, p < 0.001), renal replacement therapy (18.2% v 3.6%, p = 0.029) and intensive care unit care (83.6% v 50.9%, p = 0.001) prior to IHCA. Patients with COVID-19 had shorter CPR duration (10 min v 22 min, p = 0.002). ROSC (38.2% v 49.1%, p = 0.336) and 30-day survival (20% v 32.7%, p = 0.194) did not differ. A 30-day cerebral performance category of 1 or 2 was more common among non-COVID patients (27.3% v 9.1%, p = 0.048).
Conclusions: Return of spontaneous circulation and 30-day survival were similar between IHCA patients with and without COVID-19. Compared to previously published data, we report greater ROSC and 30-day survival after IHCA in COVID-19.
Keywords: AHA, American Heart Association; CAD, Coronary artery disease; CKD, Chronic kidney disease; COVID-19; COVID-19, Coronavirus disease 2019; CPC, Cerebral performance category; Cardiac arrest; Cardiopulmonary resuscitation; DNR, Do not resuscitate; HLD, Hyperlipidemia; HTN, Hypertension; IHCA, In-hospital cardiac arrest; OHCA, Out-of-hospital cardiac arrest; PEA, Pulseless electrical activity; ROSC; ROSC, Return of spontaneous circulation; VF, Ventricular fibrillation; VT, Ventricular tachycardia.