• European heart journal · Mar 2021

    Observational Study

    Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation.

    • Pedram Sultanian, Peter Lundgren, Anneli Strömsöe, Solveig Aune, Göran Bergström, Eva Hagberg, Jacob Hollenberg, Jonny Lindqvist, Therese Djärv, Albert Castelheim, Anna Thorén, Fredrik Hessulf, Leif Svensson, Andreas Claesson, Hans Friberg, Per Nordberg, Elmir Omerovic, Annika Rosengren, Johan Herlitz, and Araz Rawshani.
    • University of Gothenburg, Institute of Medicine, Department of Molecular and Clinical Medicine, Gothenburg, Sweden.
    • Eur. Heart J. 2021 Mar 14; 42 (11): 1094-1106.

    AimTo study the characteristics and outcome among cardiac arrest cases with COVID-19 and differences between the pre-pandemic and the pandemic period in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA).Method And ResultsWe included all patients reported to the Swedish Registry for Cardiopulmonary Resuscitation from 1 January to 20 July 2020. We defined 16 March 2020 as the start of the pandemic. We assessed overall and 30-day mortality using Cox regression and logistic regression, respectively. We studied 1946 cases of OHCA and 1080 cases of IHCA during the entire period. During the pandemic, 88 (10.0%) of OHCAs and 72 (16.1%) of IHCAs had ongoing COVID-19. With regards to OHCA during the pandemic, the odds ratio for 30-day mortality in COVID-19-positive cases, compared with COVID-19-negative cases, was 3.40 [95% confidence interval (CI) 1.31-11.64]; the corresponding hazard ratio was 1.45 (95% CI 1.13-1.85). Adjusted 30-day survival was 4.7% for patients with COVID-19, 9.8% for patients without COVID-19, and 7.6% in the pre-pandemic period. With regards to IHCA during the pandemic, the odds ratio for COVID-19-positive cases, compared with COVID-19-negative cases, was 2.27 (95% CI 1.27-4.24); the corresponding hazard ratio was 1.48 (95% CI 1.09-2.01). Adjusted 30-day survival was 23.1% in COVID-19-positive cases, 39.5% in patients without COVID-19, and 36.4% in the pre-pandemic period.ConclusionDuring the pandemic phase, COVID-19 was involved in at least 10% of all OHCAs and 16% of IHCAs, and, among COVID-19 cases, 30-day mortality was increased 3.4-fold in OHCA and 2.3-fold in IHCA.© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

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