In-hospital cardiac arrest in patients with coronavirus 2019

Mitchell, Oscar; Yuriditsky, Eugene; Johnson, Nicholas J.; Doran, Olivia; Buckler, David G; Neefe, Stacie; Seethala, Raghu R.; Motov, Sergey; Moskowitz, Ari; Lee, Jarone; Griffin, Kenneth W.; Shashaty, Michael G. S.; Horowitz, James; Abella, Benjamin S.; Anderson, Jordan; Berg, Katherine M.; Butt, Mahlaqa; Covin, Donna; Damani, Aashka; Donnelly, Patrick J.; Kaafarani, Haytham M.A.; Kabariti, Sarah; Kingsley, Thomas C.; Kohn, Rachel; Kevin, C.; Mullen-Fortino, Margaret; Naar, Leon; West, Frances Mae; Zeniecki, Patrick

doi:10.1016/j.resuscitation.2021.01.012

Cited by 29 publications

(38 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In most studies, a devastating mortality ranging from 88-100% has been reported [8,[10][11][12]. A recent multicenter study from the US showed large variations in outcome after IHCA between centers [13]. A large number of IHCA in the recent literature occurred within the intensive care unit (ICU) [8,12,13].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

Roedl

Söffker

Wichmann

et al. 2021

JCM

View full text Add to dashboard Cite

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) led to an ongoing pandemic with a surge of critically ill patients. Very little is known about the occurrence and characteristic of cardiac arrest in critically ill patients with COVID-19 treated at the intensive care unit (ICU). The aim was to investigate the incidence and outcome of intensive care unit cardiac arrest (ICU-CA) in critically ill patients with COVID-19. This was a retrospective analysis of prospectively recorded data of all consecutive adult patients with COVID-19 admitted (27 February 2020–14 January 2021) at the University Medical Centre Hamburg-Eppendorf (Germany). Of 183 critically ill patients with COVID-19, 18% (n = 33) had ICU-CA. The median age of the study population was 63 (55–73) years and 66% (n = 120) were male. Demographic characteristics and comorbidities did not differ significantly between patients with and without ICU-CA. Simplified Acute Physiological Score II (SAPS II) (ICU-CA: median 44 points vs. no ICU-CA: 39 points) and Sequential Organ Failure Assessment (SOFA) score (median 12 points vs. 7 points) on admission were significantly higher in patients with ICU-CA. Acute respiratory distress syndrome (ARDS) was present in 91% (n = 30) with and in 63% (n = 94) without ICU-CA (p = 0.002). Mechanical ventilation was more common in patients with ICU-CA (97% vs. 67%). The median stay in ICU before CA was 6 (1–17) days. A total of 33% (n = 11) of ICU-CAs occurred during the first 24 h of ICU stay. The initial rhythm was non-shockable (pulseless electrical activity (PEA)/asystole) in 91% (n = 30); 94% (n = 31) had sustained return of spontaneous circulation (ROSC). The median time to ROSC was 3 (1–5) minutes. Patients with ICU-CA had significantly higher ICU mortality (61% vs. 37%). Multivariable logistic regression showed that the presence of ARDS (odds ratio (OR) 4.268, 95% confidence interval (CI) 1.211–15.036; p = 0.024) and high SAPS II (OR 1.031, 95% CI 0.997–1.065; p = 0.077) were independently associated with the occurrence of ICU-CA. A total of 18% of critically ill patients with COVID-19 suffered from a cardiac arrest within the intensive care unit. The occurrence of ICU-CA was associated with presence of ARDS and severity of illness.

show abstract

Section: Introductionmentioning

confidence: 99%

Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

Roedl

Söffker

Wichmann

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…The initial studies from China and the United States reported markedly low IHCA survival ranging from 0% to 2.9 % ( 1 – 3 ), and many healthcare systems considered a universal do-not-resuscitate (DNR) order for IHCA in COVID-19 patients ( 4 , 5 ). Two studies from United States reported a 12% survival to hospital discharge after COVID-19–related IHCA ( 6 , 7 ). The most recent study from the United States again reported zero survival after IHCA ( 8 ).…”

mentioning

confidence: 99%

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

Bhardwaj

Alwakeel

Saleem

et al. 2021

Critical Care Explorations

Self Cite

View full text Add to dashboard Cite

IMPORTANCE: In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12%. These numbers are significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20–25% in the United States for non–coronavirus disease 2019 patients. OBJECTIVE: To assess the incidence of in-hospital cardiac arrest survival of coronavirus disease 2019 patients. DESIGN: A retrospective cohort study of adult patients with coronavirus disease 2019 subsequently found to have in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (cardiopulmonary resuscitation). SETTING: Multiple hospitals of the Cleveland Clinic Health System. PATIENTS: All adult patients (age ≥ 18 yr) admitted to Cleveland Clinic Health System with a diagnosis of coronavirus disease 2019 who experienced in-hospital cardiac arrest requiring cardiopulmonary resuscitation. MEASUREMENTS AND MAIN RESULTS: From March 01, 2020 to October 15, 2020, 3,555 patients with coronavirus disease 2019 were hospitalized; 1,372 were admitted to the ICU; 58 patients had in-hospital cardiac arrest. Median age of this cohort was 66.5 years (interquartile range, 55.0–76.0 yr). Patients were predominantly male (62.5%), White (53.4%), with a median body mass index of 29.7 (interquartile range, 25.8–34.6). Most in-hospital cardiac arrests were in critical care environments (ICU), 51 of 58 (87.9%); seven of 58 (12.1%) were on ward locations. Thirty-four of 58 patients (58.6%) were on mechanical ventilation prior to in-hospital cardiac arrest with a median duration of mechanical ventilation of 9 days (interquartile range, 2–18 d). Twenty-four of 58 patients (44%) were on vasopressors prior to arrest. Initial arrest rhythm was pulseless electrical activity at (63.8%), asystole (29.3%), and pulseless ventricular tachycardia/fibrillation (6.9%). Of the 58 patients, 35 (60.3%) attained return of spontaneous circulation, and 13 of 58 (22.4%) were discharged alive. CONCLUSIONS: We report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar to before the coronavirus disease 2019 pandemic.

show abstract

“…Mortality in patients with COVID-19 infection has varied across the world and is higher in men, older patients, and those with comorbid illnesses [ 2 , 10 , 11 ]. Additional studies have shown improvement in achieving ROSC after IHCA in COVID-19 [ 12 - 14 ]. Mitchell et al reported a 22% rate of ROSC after CPR in COVID-19 patients in a study of 260 IHCA including 11 medical centers [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additional studies have shown improvement in achieving ROSC after IHCA in COVID-19 [ 12 - 14 ]. Mitchell et al reported a 22% rate of ROSC after CPR in COVID-19 patients in a study of 260 IHCA including 11 medical centers [ 12 ]. They noted large variability of ROSC rate between medical centers, suggesting that single-center studies may not be representative.…”

Section: Discussionmentioning

confidence: 99%

“…et al reported a 22% rate of ROSC after CPR in COVID-19 patients in a study of 260 IHCA including 11 medical centers[12]. They noted large variability of ROSC rate between medical centers, suggesting that singlecenter studies may not be representative.Yuriditsky et al compared IHCA in 55 COVID-19 patients to 55 patients in 2019 and found the rate of ROSC after IHCA was not significantly different; 38.2% in COVID patients compared to 49.1% (P=0.336) [13].…”

mentioning

confidence: 99%

See 1 more Smart Citation

In-Hospital Cardiac Arrest (IHCA) and Outcomes in Patients Admitted With COVID-19 Infection

Khosla¹,

Delio²,

Glass³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

In-hospital cardiac arrest in patients with coronavirus 2019

Cited by 29 publications

References 33 publications

Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

In-Hospital Cardiac Arrest (IHCA) and Outcomes in Patients Admitted With COVID-19 Infection

Contact Info

Product

Resources

About