In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study

Hayek, Salim S; Brenner, Samantha K; Azam, Tariq U; Shadid, Husam R; Anderson, Elizabeth; Berlin, Hanna; Pan, Michael; Meloche, Chelsea; Feroz, Rafey; O’Hayer, Patrick; Kaakati, Rayan; Bitar, Abbas; Padalia, Kishan; Perry, Daniel; Blakely, Pennelope; Gupta, Shruti; Shaefi, Shahzad; Srivastava, Anand; Charytan, David M; Bansal, Anip; Mallappallil, Mary; Melamed, Michal L; Shehata, Alexandre M; Sunderram, Jag; Mathews, Kusum S; Sutherland, Anne K; Nallamothu, Brahmajee K; Leaf, David E; Malik, A Bilal; Bitar, Abbas; Abu-Saif, Abeer; Green, Adam; Ahoubim, Afshin; Oyintayo, Ajiboye; Jose, Aju; Athreya, Akshay; Jacobs, Alanna L; Fornoni, Alessia; Hodakowski, Alexander J; Leidner, Alexander S; Shehata, Alexandre M; Iardino, Alfredo; Friedman, Allon N; Renaghan, Amanda D; Leonberg-Yoo, Amanda K; Bansal, Amar D; Athavale, Ambarish M; Podoll, Amber S; Azhar, Ambreen; Patrawalla, Amee; Pannu, Ameeka; Zhou, Amy M; Srivastava, Anand; Admon, Andrew J; Vissing, Andrew; Bansal, Anip; Vijayan, Anitha; Hasty, Anna E; Sutherland, Anne K; Faugno, Anthony J; Saha, Aparna; Williams, Aquino; Rashidi, Arash; Mueller, Ariel L; Kapoor, Aromma; Tolwani, Ashita; Macina, Ashley; Tariq, Asma; Ahmed, Ayesha; Danek, Barbara A; Wu, Benjamin; Shukla, Bhavarth; Mehta, Bijal; Brown, Brent R; Garibaldi, Brian T; Schulze, Carl E; Walther, Carl P; Martinez, Carlos; Hsu, Caroline M; Corona-Villalobos, Celia P; Vasquez, Charles R; Meloche, Chelsea; Shah, Chintan V; Parikh, Chirag R; Rowan, Chris; Schorr, Christa A; Joy, Christina Mariyam; Mosher, Christopher L; Meshberger, Christopher; Kovesdy, Csaba P; Weiner, Daniel E; Edmonston, Daniel L; Perry, Danny; Hall, Danyell; Charytan, David; De La Zerda, David; Leaf, David E; Zonies, David; Altman, Deena R; Lazarous, Deepa G; Zhu, Denzel; Sirganagari, Dheeraj Reddy; Pan, Di; Finkel, Diana G; Willett, Duwayne L; Price-Haywood, Eboni G; Schenck, Edward J; Cervantes, Carmen Elena; Anderson, Elizabeth; Au, Elizabeth H; Burnham, Ellen L; Leven, Emily A; Chang, Emily H; Gallagher, Emily J; Judd, Eric; Newman, Erik T; Yap, Ernie; Kapania, Esha M; Kim, Ethan C; Macedo, Etienne; Madhani-Lovely, Farah; Modersitzki, Frank; Contreras, Gabriel; Naimy, Gabriel; Bambrick-Santoyo, Gabriela; Nadkarni, Girish N; Mosoyan, Gohar; Katz-Greenberg, Goni; Schumaker, Greg L; Milligan, Gregory P; Nguyen, H Bryant; Berlin, Hanna; Rhee, Harin; Singh, Harkarandeep; Gershengorn, Hayley B; Yang, Heather; Soh, Howard; Wen, Huei Hsun; Chen, Huiwen; Shadid, Husam; Strohbehn, Ian A; Mohamed, Ibrahim; Berim, Ilya; Puri, Isha; Vohra, Ishaan; Kruser, Jacqueline M; Sunderram, Jag; Lash, James P; Krishnan, Jamuna; Radbel, Jared; Adams, Jason Y; Shah, Jatan A; Neyra, Javier A; Koyner, Jay L; Vatson, Jayanth S; Rachoin, Jean-Sebastien; Boateng, Jeffery O; Paer, Jeffrey M; Flythe, Jennifer E; Griffiths, Jennifer; Rodriguez, Jesus; Li, Jiahua; Ouyang, Jie; Sharma, Jill H; Wang, Jing G; Zhang, Jingjing; Reiser, Jochen; Guirguis, John; Byun, John J; Donnelly, John P; Wagner, John; Levitt, Joseph E; Hermes, Joy-Marie; Velez, Juan Carlos Q; Valencia, Juan D; Arunthamakun, Justin; Thakkar, Jyotsana; Bhattacharya, Jyotsna; Sedaliu, Kaltrina; Prudhvi, Kalyan; Pokharel, Kapil K; Senter, Katharine; Kelly, Katherine J; Liu, Kathleen D; Kopecky, Kathleen F; Rose, Keith M; Kashani, Kianoush; Padalia, Kishan J; Hess, Kristen M; Mathews, Kusum S; Enfield, Kyle B; Golestaneh, Ladan; Bickley, Laura; Latta, Laura; Meyer, Leah; Boudourakis, Leon; Thomas, Leslie F; Chan, Lili; Shea, Lisa; Matute-Trochez, Luis A; Gomez-Escobar, Luis G; Elias, Madona; Plataki, Maria; Thaxton, Mariah; Sosa, Marie Anne; Liotta, Mark; Christov, Marta; Mallappallil, Mary C; Tugman, Matthew J; Scharf, Matthew T; Semler, Matthew W; Brogan, Maureen; Roche, Meaghan S; Krajewski, Megan L; Sise, Meghan E; Lee, Meghan; Chang, Michael; Pan, Michael; Melamed, Michal L; Chonchol, Michel; Hernán, Miguel A; Molnar, Miklos Z; Yunes, Milagros; Joo, Min J; Sharshir, Moh’d A; Farag, Mohamed; Fisher, Molly; Nadamuni, Mridula V; Gupta, Mrigank S; Ali, Muhammad Imran; Mohamed, Muner MB; Ernecoff, Natalie C; Kumar, Neelja; Cairl, Nicholas S; Patel, Nilam P; Goyal, Nitender; ul aain Bhatti, Noor; Chaaban, Nourhan; Kamal, Omer; Garcia, Pablo; Kao, Patricia F; Walters, Patricia; O’ Hayer, Patrick; Pattharanitima, Pattharawin; Bergl, Paul A; Bhatraju, Pavan K; Blakely, Pennelope; Wilson, Perry; McCullough, Peter A; Cangialosi, Peter; Hart, Peter; Guru, Pramod K; Kumar, Princy N; Feroze, Rafey; Kapoor, Rajat; Hejal, Rana; Kshirsagar, Ravi K; Kaakati, Rayan; Lisk, Rebecca; Beutler, Rebecca M; Levy, Rebecca V; Wunderink, Richard G; Raichoudhury, Ritesh; Redfern, Roberta E; Go, Ronaldo C; Malik, Rubab F; Song, Rui; Avasare, Rupali S; Mocerino, Ryan; Spiardi, Ryan C; Hedayati, S Susan; Taldone, Sabrina; John, Sabu; Hayek, Salim S; Abu Omar, Samah; Brenner, Samantha K; Anumudu, Samaya J; Gautam, Samir C; Short, Samuel AP; Woo, Sang Hoon; Kapoor, Sanjana; Gupta, Sanjeev; Kassaye, Seble G; Alvarez-Mulett, Sergio L; Goldberg, Seth; Tehranian, Shahrzad; Shaefi, Shahzad; Shastri, Shani; Sharma, Shreyak; Upadhyay, Shristi; Gupta, Shruti; Anand, Shuchi; Bajracharya, Siddhartha; Verma, Siddharth; Shankar, Sidharth; Correa, Simon; Chaudhry, Sobaata; Bose, Sonali; Puri, Sonika; Cho, Soo Jung; Arikapudi, Sowminya; Lee, Stefi; Toth-Manikowski, Stephanie M; Coca, Steven G; Menez, Steven; Chang, Steven Y; Sharma, Sunita; Waikar, Sushrut S; Boyle, Suzanne M; Arora, Tanima; Ferreira, Tanira; Shaukat, Tanveer; Johns, Tanya S; Azam, Tariq U; Nguyen, Thuy-Duyen; Albertson, Timothy E; Li, Tingting; Miano, Todd A; Ugwuowo, Ugochukwu; Rusnak, Vadym V; Allusson, Valerie; Jotwani, Vasantha K; Peev, Vasil; Jaikaransingh, Vishal; Cruz, Vivian S; Wang, Wei; Whalen, William; Deng, Xiaoying; Ahmad, Yahya; Zhou, Yan; Melaku, Yohannes; Azzi, Yorg; Wen, Yumeng; Cohen, Zaza; Kibbelaar, Zoe A; Post, Zoe

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.