tetano
Editor, Senior Moderator
Resuscitation
. 2021 Jan 27;S0300-9572(21)00020-4.
doi: 10.1016/j.resuscitation.2021.01.012. Online ahead of print.
In-Hospital Cardiac Arrest in Patients with Coronavirus 2019
Oscar J L Mitchell[SUP] 1 [/SUP], Eugene Yuriditsky[SUP] 2 [/SUP], Nicholas J Johnson[SUP] 3 [/SUP], Olivia Doran[SUP] 4 [/SUP], David G Buckler[SUP] 5 [/SUP], Stacie Neefe[SUP] 6 [/SUP], Raghu R Seethala[SUP] 7 [/SUP], Sergey Motov[SUP] 8 [/SUP], Ari Moskowitz[SUP] 9 [/SUP], Jarone Lee[SUP] 10 [/SUP], Kelly M Griffin[SUP] 11 [/SUP], Michael G S Shashaty[SUP] 12 [/SUP], James M Horowitz[SUP] 2 [/SUP], Benjamin S Abella[SUP] 13 [/SUP], Coronavirus 2019 In-Hospital Cardiac Arrest (COVID IHCA) Study Group
Collaborators, Affiliations
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%), 32 (12.3%) survived to 30 days, and 31 (11.9%) survived to discharge. 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.
Keywords: COVID-19; cohort study; in-hospital cardiac arrest.
. 2021 Jan 27;S0300-9572(21)00020-4.
doi: 10.1016/j.resuscitation.2021.01.012. Online ahead of print.
In-Hospital Cardiac Arrest in Patients with Coronavirus 2019
Oscar J L Mitchell[SUP] 1 [/SUP], Eugene Yuriditsky[SUP] 2 [/SUP], Nicholas J Johnson[SUP] 3 [/SUP], Olivia Doran[SUP] 4 [/SUP], David G Buckler[SUP] 5 [/SUP], Stacie Neefe[SUP] 6 [/SUP], Raghu R Seethala[SUP] 7 [/SUP], Sergey Motov[SUP] 8 [/SUP], Ari Moskowitz[SUP] 9 [/SUP], Jarone Lee[SUP] 10 [/SUP], Kelly M Griffin[SUP] 11 [/SUP], Michael G S Shashaty[SUP] 12 [/SUP], James M Horowitz[SUP] 2 [/SUP], Benjamin S Abella[SUP] 13 [/SUP], Coronavirus 2019 In-Hospital Cardiac Arrest (COVID IHCA) Study Group
Collaborators, Affiliations
- PMID: 33515638
- DOI: 10.1016/j.resuscitation.2021.01.012
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%), 32 (12.3%) survived to 30 days, and 31 (11.9%) survived to discharge. 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.
Keywords: COVID-19; cohort study; in-hospital cardiac arrest.