Abstract
Objectives
To 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).
Design
Multicenter cohort study.
Setting
Intensive care units at 68 geographically
diverse hospitals across the United States.
Participants
Critically ill adults (age ≥18 years) with
laboratory confirmed covid-19.
Main outcome measures
In-hospital cardiac arrest within 14 days of
admission to an intensive care unit and
in-hospital mortality.
Results
Among 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.
Conclusions
Cardiac arrest is common in critically ill
patients with covid-19 and is associated with poor
survival, particularly among older patients.