Arpana Paruchuri, MD,
Rush University Medical Center
Chicago, Illinois
Disclosure information not submitted.
Akshar Chauhan
MD
Rush University Medical Center
Chicago, Illinois, United States
Disclosure information not submitted.
Shasha Chen
MD
Rush University Medical Center
Chicago, Illinois, United States
Disclosure information not submitted.
Abhaya Trivedi, MD
MD
Rush University Medical Center
Chicago, Illinois, United States
Disclosure information not submitted.
Title: Analysis of In-Hospital Cardiac Arrest in COVID-19 Patients: A Single-Center Retrospective Analysis
Introduction:
Survival for patients infected with coronavirus disease 2019 (COVID-19) following in-hospital cardiac arrest is low with a 30-day survival rate at 0-3%4,5,6,7,8. When compared to subgroup analyses of similar cohorts of patients without COVID-19 from the same registry, these rates are lower than expected9. Therefore, our study aims to contribute to the emerging body of knowledge describing the efficacy of resuscitation following in-hospital cardiac arrest in COVID-19 patients by examining the incidence, characteristics, and outcomes of these patients in a tertiary care center in Chicago, Illinois. We define cardiac arrest as cessation of cardiac activity characterized by pulselessness and requiring CPR or defibrillation.
Methods:
A retrospective analysis of medical charts for adult patients without COVID-19 who have undergone an inpatient cardiac arrest from March 1, 2019 to December 1, 2019 are compared to cardiac arrest patients with and without COVID-19 from March 1, 2020 through December 1, 2020 at Rush University Medical Center. Endpoints include 30-day mortality and survival to discharge.
Results:
Thus far, 112 patients have been identified as experiencing cardiac arrest during the periods studied and 33 of these patients were found to have COVID-19 at the time of admission. Of the 112 total patients, 69% of patients achieved return of spontaneous circulation (ROSC) after resuscitation, with 36% surviving to discharge and a 30-day mortality of 35%. For patients with COVID-19 at admission, 79% achieved ROSC and 42% survived to discharge and were alive at 30 days. In comparison, 66% achieved ROSC in the non-COVID group, with 33% surviving to discharge and 32% remaining alive at 30 days.
Conclusions:
In contrast to previously published literature, at our institution rates of ROSC and survival to discharge were not lower in the COVID-19 group and 30-day mortality was not higher in patients with COVID-19 who experienced cardiac arrest when compared to those without a diagnosis of COVID. Our overall 30-day mortality rates for both groups of patients appear similar to those identified in the American Heart Association Get With The Guidelines®-Resuscitation registry. Further studies are needed to determine whether additional factors contribute to the significant heterogeneity in results nationwide.