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Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest
OBJECTIVE: We studied characteristics, survival, causes of cardiac arrest, conditions preceding cardiac arrest, predictors of survival and trends in the prevalence of COVID-19 among in-hospital cardiac arrest (IHCA) cases. DESIGN AND SETTING: Registry-based observational study. PARTICIPANTS: We stud...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635887/ https://www.ncbi.nlm.nih.gov/pubmed/34848525 http://dx.doi.org/10.1136/bmjopen-2021-054943 |
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author | Holm, Astrid Jerkeman, Matilda Sultanian, Pedram Lundgren, Peter Ravn-Fischer, Annica Israelsson, Johan Giesecke, Jasna Herlitz, Johan Rawshani, Araz |
author_facet | Holm, Astrid Jerkeman, Matilda Sultanian, Pedram Lundgren, Peter Ravn-Fischer, Annica Israelsson, Johan Giesecke, Jasna Herlitz, Johan Rawshani, Araz |
author_sort | Holm, Astrid |
collection | PubMed |
description | OBJECTIVE: We studied characteristics, survival, causes of cardiac arrest, conditions preceding cardiac arrest, predictors of survival and trends in the prevalence of COVID-19 among in-hospital cardiac arrest (IHCA) cases. DESIGN AND SETTING: Registry-based observational study. PARTICIPANTS: We studied all cases (≥18 years of age) of IHCA receiving cardiopulmonary resuscitation in the Swedish Registry for Cardiopulmonary Resuscitation during 15 March 2020 to 31 December 2020. A total of 1613 patients were included and divided into the following groups: ongoing infection (COVID-19+; n=182), no infection (COVID-19–; n=1062) and unknown/not assessed (n=369). MAIN OUTCOMES AND MEASURES: We studied monthly trends in proportions of COVID-19 associated IHCAs, causes of IHCA in relation to COVID-19 status, clinical conditions preceding the cardiac arrest and predictors of survival. RESULTS: The rate of COVID-19+ patients suffering an IHCA increased to 23% during the first pandemic wave (April), then abated to 3% in July, and then increased to 19% during the second wave (December). Among COVID-19+ cases, 43% had respiratory insufficiency or infection as the underlying cause of the cardiac arrest, compared with 18% among COVID-19– cases. The most common clinical sign preceding cardiac arrest was hypoxia (57%) among COVID-19+ cases. OR for 30-day survival for COVID-19+ cases was 0.50 (95% CI 0.33 to 0.76), compared with COVID-19– cases. CONCLUSION: During pandemic peaks, up to one-fourth of all IHCAs are complicated by COVID-19, and these patients have halved chance of survival, with women displaying the worst outcomes. |
format | Online Article Text |
id | pubmed-8635887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-86358872021-12-02 Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest Holm, Astrid Jerkeman, Matilda Sultanian, Pedram Lundgren, Peter Ravn-Fischer, Annica Israelsson, Johan Giesecke, Jasna Herlitz, Johan Rawshani, Araz BMJ Open Cardiovascular Medicine OBJECTIVE: We studied characteristics, survival, causes of cardiac arrest, conditions preceding cardiac arrest, predictors of survival and trends in the prevalence of COVID-19 among in-hospital cardiac arrest (IHCA) cases. DESIGN AND SETTING: Registry-based observational study. PARTICIPANTS: We studied all cases (≥18 years of age) of IHCA receiving cardiopulmonary resuscitation in the Swedish Registry for Cardiopulmonary Resuscitation during 15 March 2020 to 31 December 2020. A total of 1613 patients were included and divided into the following groups: ongoing infection (COVID-19+; n=182), no infection (COVID-19–; n=1062) and unknown/not assessed (n=369). MAIN OUTCOMES AND MEASURES: We studied monthly trends in proportions of COVID-19 associated IHCAs, causes of IHCA in relation to COVID-19 status, clinical conditions preceding the cardiac arrest and predictors of survival. RESULTS: The rate of COVID-19+ patients suffering an IHCA increased to 23% during the first pandemic wave (April), then abated to 3% in July, and then increased to 19% during the second wave (December). Among COVID-19+ cases, 43% had respiratory insufficiency or infection as the underlying cause of the cardiac arrest, compared with 18% among COVID-19– cases. The most common clinical sign preceding cardiac arrest was hypoxia (57%) among COVID-19+ cases. OR for 30-day survival for COVID-19+ cases was 0.50 (95% CI 0.33 to 0.76), compared with COVID-19– cases. CONCLUSION: During pandemic peaks, up to one-fourth of all IHCAs are complicated by COVID-19, and these patients have halved chance of survival, with women displaying the worst outcomes. BMJ Publishing Group 2021-11-29 /pmc/articles/PMC8635887/ /pubmed/34848525 http://dx.doi.org/10.1136/bmjopen-2021-054943 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Cardiovascular Medicine Holm, Astrid Jerkeman, Matilda Sultanian, Pedram Lundgren, Peter Ravn-Fischer, Annica Israelsson, Johan Giesecke, Jasna Herlitz, Johan Rawshani, Araz Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title | Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title_full | Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title_fullStr | Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title_full_unstemmed | Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title_short | Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest |
title_sort | cohort study of the characteristics and outcomes in patients with covid-19 and in-hospital cardiac arrest |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635887/ https://www.ncbi.nlm.nih.gov/pubmed/34848525 http://dx.doi.org/10.1136/bmjopen-2021-054943 |
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