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. 2022 Jan:170:134-140.
doi: 10.1016/j.resuscitation.2021.11.025. Epub 2021 Nov 24.

Impact of the three COVID-19 surges in 2020 on in-hospital cardiac arrest survival in the United States

Kashvi Gupta  1 , Saket Girotra  2 , Brahmajee K Nallamothu  3 , Kevin Kennedy  4 , Monique A Starks  5 , Paul S Chan  6 ; American Heart Association's Get With the Guidelines®-Resuscitation Investigators (listed in Supplementary Appendix)
Affiliations

Impact of the three COVID-19 surges in 2020 on in-hospital cardiac arrest survival in the United States

Kashvi Gupta et al. Resuscitation. 2022 Jan.

Abstract

Background: Studies have reported lower survival for in-hospital cardiac arrest (IHCA) during the initial COVID-19 surge. Whether the pandemic reduced IHCA survival during subsequent surges and in areas with lower COVID-19 rates is unknown.

Methods: Within Get-With-The-Guidelines®-Resuscitation, we identified 22,899 and 79,736 IHCAs during March to December in 2020 and 2015-2019, respectively. Using hierarchical regression, we compared risk-adjusted rates of survival to discharge in 2020 vs. 2015-19 during five COVID-19 periods: Surge 1 (March to mid-May), post-Surge 1 (mid-May to June), Surge 2 (July to mid-August), post-Surge 2 (mid-August to mid-October), and Surge 3 (mid-October to December). Monthly COVID-19 mortality rates for each hospital's county were categorized, per 1,000,000 residents, as very low (0-10), low (11-50), moderate (51-100), or high (>100).

Results: During each COVID-19 surge period in 2020, rates of survival to discharge for IHCA were lower, as compared with the same period in 2015-2019: Surge 1: adjusted OR: 0.81 (0.75-0.88); Surge 2: adjusted OR: 0.88 (0.79-0.97), Surge 3: adjusted OR: 0.79 (0.73-0.86). Lower survival was most pronounced at hospitals located in counties with moderate to high monthly COVID-19 mortality rates. In contrast, during the two post-surge periods, survival rates were similar in 2020 vs. 2015-2019: post-Surge 1: adjusted OR 0.93 (0.83-1.04) and post-Surge 2: adjusted OR 0.94 (0.86-1.03), even at hospitals with the highest county-level COVID-19 mortality rates.

Conclusions: During the three COVID-19 surges in the U.S. during 2020, rates of survival to discharge for IHCA dropped substantially, especially in communities with moderate to high COVID-19 mortality rates.

Keywords: COVID-19; Cardiac arrest; In-hospital arrest; Outcomes; Survival.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Survival Rates for IHCA in 2020 vs. 2015–2019. Unadjusted survival rates for IHCA for each half-month period between March to December are depicted for 2020 and the control period of 2015–2019.
See this image and copyright information in PMC

Comment in

References

    1. Shao F., Xu S., Ma X., et al. In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China. Resuscitation. 2020;151:18–23. - PMC - PubMed
    1. Thapa S.B., Kakar T.S., Mayer C., Khanal D. Clinical Outcomes of In-Hospital Cardiac Arrest in COVID-19. JAMA Intern Med. 2021;181:279–281. - PMC - PubMed
    1. Miles J.A., Mejia M., Rios S., et al. 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. Circ Cardiovasc Qual Outcomes. 2020;13 - PMC - PubMed
    1. Mitchell O.J.L., Yuriditsky E., Johnson N.J., et al. Coronavirus In-Hospital Cardiac Arrest Study G. In-hospital cardiac arrest in patients with coronavirus 2019. Resuscitation. 2021;160:72–78. - PMC - PubMed
    1. Hayek S.S., Brenner S.K., Azam T.U., et al. In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study. BMJ. 2020;371:m3513. - PMC - PubMed