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Comparative Study
. 2020 Nov;13(11):e007303.
doi: 10.1161/CIRCOUTCOMES.120.007303. Epub 2020 Sep 25.

Characteristics and Outcomes of In-Hospital Cardiac Arrest Events During the COVID-19 Pandemic: A Single-Center Experience From a New York City Public Hospital

Jeremy A Miles  1   2 , Mateo Mejia  1 , Saul Rios  1 , Seth I Sokol  1 , Matthew Langston  1 , Steven Hahn  1 , Ephraim Leiderman  1 , Reka Salgunan  1 , Israa Soghier  1 , Perminder Gulani  1 , Keval Joshi  1 , Virginia Chung  1 , Joaquin Morante  1 , Diane Maggiore  1 , Dipan Uppal  1 , Ari Friedman  1 , Adarsh Katamreddy  1 , Nathaniel Abittan  1 , Gokul Ramani  1 , Wakil Irfan  1 , Wasla Liaqat  1 , Michael Grushko  1 , Mona Krouss  3   4 , Hyung J Cho  3   5 , Steven M Bradley  6 , Robert T Faillace  1
Affiliations
Comparative Study

Characteristics and Outcomes of In-Hospital Cardiac Arrest Events During the COVID-19 Pandemic: A Single-Center Experience From a New York City Public Hospital

Jeremy A Miles et al. Circ Cardiovasc Qual Outcomes. 2020 Nov.

Abstract

Background: Patients hospitalized for severe coronavirus disease 2019 (COVID-19) infection are at risk for in-hospital cardiac arrest (IHCA). It is unknown whether certain characteristics of cardiac arrest care and outcomes of IHCAs during the COVID-19 pandemic differed compared with a pre-COVID-19 period.

Methods: All patients who experienced an IHCA at our hospital from March 1, 2020 through May 15, 2020, during the peak of the COVID-19 pandemic, and those who had an IHCA from January 1, 2019 to December 31, 2019 were identified. All patient data were extracted from our hospital's Get With The Guidelines-Resuscitation registry, a prospective hospital-based archive of IHCA data. Baseline characteristics of patients, interventions, and overall outcomes of IHCAs during the COVID-19 pandemic were compared with IHCAs in 2019, before the COVID-19 pandemic.

Results: There were 125 IHCAs during a 2.5-month period at our hospital during the peak of the COVID-19 pandemic compared with 117 IHCAs in all of 2019. IHCAs during the COVID-19 pandemic occurred more often on general medicine wards than in intensive care units (46% versus 33%; 19% versus 60% in 2019; P<0.001), were overall shorter in duration (median time of 11 minutes [8.5-26.5] versus 15 minutes [7.0-20.0], P=0.001), led to fewer endotracheal intubations (52% versus 85%, P<0.001), and had overall worse survival rates (3% versus 13%; P=0.007) compared with IHCAs before the COVID-19 pandemic.

Conclusions: Patients who experienced an IHCA during the COVID-19 pandemic had overall worse survival compared with those who had an IHCA before the COVID-19 pandemic. Our findings highlight important differences between these 2 time periods. Further study is needed on cardiac arrest care in patients with COVID-19.

Keywords: COVID-19; heart arrest; hospitalization; pandemics; registries; survival rate.

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Figures

Figure 1.
Figure 1.
Location of in-hospital cardiac arrests during the coronavirus disease 2019 (COVID-19) pandemic vs before the COVID-19 pandemic. ED indicates emergency department; and ICU, intensive care unit.
Figure 2.
Figure 2.
Overall survival at discharge after in-hospital cardiac arrest before coronavirus disease 2019 (COVID-19) pandemic and during the COVID-19 pandemic.
See this image and copyright information in PMC

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