• Salim S Hayek, Samantha K Brenner, Tariq U Azam, Husam R Shadid, Elizabeth Anderson, Hanna Berlin, Michael Pan, Chelsea Meloche, Rafey Feroz, Patrick O'Hayer, Rayan Kaakati, Abbas Bitar, Kishan Padalia, Daniel Perry, Pennelope Blakely, Shruti Gupta, Shahzad Shaefi, Anand Srivastava, David M Charytan, Anip Bansal, Mary Mallappallil, Michal L Melamed, Alexandre M Shehata, Jag Sunderram, Kusum S Mathews, Anne K Sutherland, Brahmajee K Nallamothu, David E Leaf, and STOP-COVID Investigators.
• Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA shayek@med.umich.edu.
• BMJ. 2020 Sep 30; 371: m3513.

ObjectivesTo estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19).DesignMulticenter cohort study.SettingIntensive care units at 68 geographically diverse hospitals across the United States.ParticipantsCritically ill adults (age ≥18 years) with laboratory confirmed covid-19.Main Outcome MeasuresIn-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality.ResultsAmong 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older.ConclusionsCardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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