• Abhishek Bhardwaj, Mahmoud Alwakeel, Jason Kirincich, Hassan Shaheen, David F Gaieski, Benjamin S Abella, Xiaofeng Wang, Mohammed J Al-Jaghbeer, Abhijit Duggal, Francois Abi Fadel, and Sudhir Krishnan.
• Department of Internal Medicine, University of California, Riverside, CA, Unites States.
• Resuscitation. 2023 Aug 1; 189: 109890109890.

AimTo assess whether there were differences in resuscitation efforts and outcomes for medical intensive care unit (MICU) in-hospital cardiac arrest (IHCA) during the COVID-19 pandemic when compared to pre-pandemic.MethodsComparing COVID-19 MICU-IHCA patients (03/2020 to 10/2020) to non-COVID-19 MICU IHCA (01/2014 to 12/2018) at Clevleand Clinic Health System (CCHS) of NE Ohio. Propensity score matching analysis (PSMA) was used to create comparable groups.ResultsThere were a total of 516 patients, 51 in COVID-19 MICU IHCA cohort and 465 in the non-COVID-19 MICU IHCA cohort. The mean (SD) age of the study population was 60.9 (16) years and 56% were males. In 92.1% (n = 475) patients, initial arrest rhythm was non-shockable. At the time of ICU admission, compared to the non-COVID-19 MICU-IHCA cohort, the COVID-19 MICU IHCA cohort had a lower mean APACHE III score (70 [32.9] vs 101.3 [39.6], P = <0.01). The COVID-19 cohort had a higher rate of survival to hospital discharge (12 [23.5%] vs 59 [12.7%], P = 0.03). Upon PSMA, the algorithm selected 40 COVID-19 patients and 200 non-COVID-19 patients. Imbalances in baseline characteristics, comorbidities, and APACHE III were well-balanced after matching. Survival rate after matching became non-significant; (10 [25%] vs 42 [21%], P = 0.67). Further, there were no significant differences in ICU or hospital length-of-stay or neurological outcomes at discharge for survivors in the two matched cohorts.ConclusionIt is imperative that COVID-19 patients receive unbiased and unrestricted resuscitation measures, without any discouragement.Copyright © 2023 Elsevier B.V. All rights reserved.

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