- Among patients with severe COVID-19 pneumonia experiencing in-hospital cardiac arrest (IHCA), rates of restoration of spontaneous circulation (ROSC) and overall outcomes are poor.
Why this matters
- In situations with personal protective equipment (PPE) constraints, clinicians can consider alternating persons conducting chest compressions every minute.
- A mechanical chest compression device can be used if prolonged compressions are required.
- The American Heart Association interim guidance offers additional recommendations.
- Overall mortality among 761 patients with severe COVID-19 pneumonia was 19.3% at 40 days.
- Data for 136 of 151 patients who experienced IHCA were analyzed.
- 80.9% (110) were age >60 years; 33.8% (46) were women.
- Median hospital length of stay: 7 days (interquartile range: 4-11 days).
- Comorbidity rates:
- Hypertension: 30.2%.
- Diabetes: 19.9%.
- Coronary heart disease: 11.0%.
- IHCA etiology:
- Respiratory: 87.5% (119).
- Cardiac: 7.4% (10).
- Other: 5.1% (7).
- Initial rhythm:
- Ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT): 5.9% (8).
- Pulseless electrical activity: 4.4% (6).
- Asystole: 89.7% (122).
- Time to resuscitation initiation:
- ROSC achieved in 75.0% (6) with initial VF/VT and 9% (11) in asystole.
- ROSC by age:
- >60 years: 10.5% (11/105).
- ≤60 years: 22.6% (7/31; P=.08).
- Of these, 2 patients in each age group, all men, were alive at 30 days (P=.19).
- Retrospective, single-center cohort analysis of characteristics, outcomes (ROSC, 30-day survival) among patients with severe COVID-19 and IHCA, January 15-February 25, in Wuhan, China.
- Funding: None disclosed.
- Residual confounders likely.
- Limited generalizability.
- CPR quality data lacking.