• MitchellOscar J LOJLPulmonary, Allergy, and Critical Care Division, University of Pennsylvania, United States; Center for Resuscitation Science, University of Pennsylvania, United States. Electronic address: oscar.mitchell@pennmedicine.upenn.edu., Eugene Yuriditsky, Nicholas J Johnson, Olivia Doran, David G Buckler, Stacie Neefe, Raghu R Seethala, Sergey Motov, Ari Moskowitz, Jarone Lee, Kelly M Griffin, ShashatyMichael G SMGSPulmonary, Allergy, and Critical Care Division, University of Pennsylvania, United States; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, United States; Department of Emergency Medicine, University of, James M Horowitz, Benjamin S Abella, and Coronavirus 2019 In-Hospital Cardiac Arrest (COVID IHCA) Study Group.
• Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania, United States; Center for Resuscitation Science, University of Pennsylvania, United States. Electronic address: oscar.mitchell@pennmedicine.upenn.edu.
• Resuscitation. 2021 Mar 1; 160: 727872-78.

BackgroundCoronavirus 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).AimWe aimed to characterize outcomes from IHCA in patients with COVID-19 and to identify patient- and hospital-level variables associated with 30-day survival.MethodsWe 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.ResultsThere 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%), 31 (11.9%) survived to hospital discharge, and 32 (12.3%) survived to 30 days. 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).ConclusionsWe 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.Copyright © 2021 Elsevier B.V. All rights reserved.

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