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Observational Study
. 2020 Jun:151:18-23.
doi: 10.1016/j.resuscitation.2020.04.005. Epub 2020 Apr 10.

In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China

Fei Shao  1 , Shuang Xu  2 , Xuedi Ma  3 , Zhouming Xu  3 , Jiayou Lyu  3 , Michael Ng  4 , Hao Cui  5 , Changxiao Yu  5 , Qing Zhang  6 , Peng Sun  7 , Ziren Tang  8
Affiliations
Observational Study

In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China

Fei Shao et al. Resuscitation. 2020 Jun.

Abstract

Objective: To describe the characteristics and outcomes of patients with severe COVID-19 and in-hospital cardiac arrest (IHCA) in Wuhan, China.

Methods: The outcomes of patients with severe COVID-19 pneumonia after IHCA over a 40-day period were retrospectively evaluated. Between January 15 and February 25, 2020, data for all cardiopulmonary resuscitation (CPR) attempts for IHCA that occurred in a tertiary teaching hospital in Wuhan, China were collected according to the Utstein style. The primary outcome was restoration of spontaneous circulation (ROSC), and the secondary outcomes were 30-day survival, and neurological outcome.

Results: Data from 136 patients showed 119 (87.5%) patients had a respiratory cause for their cardiac arrest, and 113 (83.1%) were resuscitated in a general ward. The initial rhythm was asystole in 89.7%, pulseless electrical activity (PEA) in 4.4%, and shockable in 5.9%. Most patients with IHCA were monitored (93.4%) and in most resuscitation (89%) was initiated <1 min. The average length of hospital stay was 7 days and the time from illness onset to hospital admission was 10 days. The most frequent comorbidity was hypertension (30.2%), and the most frequent symptom was shortness of breath (75%). Of the patients receiving CPR, ROSC was achieved in 18 (13.2%) patients, 4 (2.9%) patients survived for at least 30 days, and one patient achieved a favourable neurological outcome at 30 days. Cardiac arrest location and initial rhythm were associated with better outcomes.

Conclusion: Survival of patients with severe COVID-19 pneumonia who had an in-hospital cardiac arrest was poor in Wuhan.

Keywords: COVID-19; Cardiopulmonary resuscitation; In-hospital cardiac arrest; ROSC; Survival.

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Figures

Fig. 1
Fig. 1
Flow diagram illustrating the number of patients during the study with respect to the location of cardiac arrests. ROSC, return of spontaneous circulation; ICU, intensive care unit; DNAR, do-not-attempt-resuscitation.
See this image and copyright information in PMC

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References

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