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In this retrospective study of 54 patients with COVID-19 who had in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (CPR), return of spontaneous circulation was achieved in 53.7% of patients, but none survived to hospital discharge. Most patients developed a nonshockable rhythm, with the most common being pulseless electrical activity (81.5%). Notably, at the time of arrest many patients were receiving various forms of life support, including mechanical ventilation (79%), renal replacement therapy (33%), and/or vasopressor support (46.3%). Prior to the pandemic, the study institution had a survival rate of 25% following in-hospital cardiac arrest, with 11% in patients with nonshockable rhythms.
The findings in this small retrospective study suggest poor outcomes following CPR for in-hospital cardiac arrest in patients with COVID-19. This may be in part related to the fact that most of these patients had high-risk clinical features including various forms of life support and nonshockable rhythms, which have previously been associated with poor outcomes. Further research is warranted to best inform future clinical practice, as performing CPR on patients with COVID-19 generates aerosols and thus increases risk of infection transmission.
– Amy S. Korwin, MD
This abstract is available on the publisher's site.
Before the outbreak of coronavirus disease 2019 (COVID-19), 25% of patients who underwent in-hospital cardiac arrest (IHCA) survived to discharge, with the initial rhythm being nonshockable in 81% of cases. Despite the outbreak causing many deaths, to our knowledge, information on IHCA among this subset of patients in the US is lacking.