Outcomes are grim when COVID-19 patients receive CPR for in-hospital cardiac arrest

In-hospital cardiac arrest (IHCA) outcomes are significantly worse when the patient has COVID-19, according to new findings published in JAMA Internal Medicine. In fact, none of the patients in the study who underwent CPR for cardiac arrest survived to discharge.

The study’s authors explored data on more than 1,300 COVID-19 patients who were treated in a single health system from March 15 to April 3. While 60 (4.6%) of those patients underwent CPR for cardiac arrest, six had to be excluded due to a lack of proper documentation. Of those final 54 patients, a return of spontaneous circulation was achieved in 53.7%—but the mortality rate was still ultimately 100%.

Before the pandemic, the authors noted, 25% of patients undergoing CPR for IHCA survived to discharge.

“Given that most of the patients in this study developed a nonshockable rhythm, the outcome was likely to be poor,” wrote lead author Shrinjaya B. Thapa, MD, William Beaumont Hospital in Royal Oak, Michigan, and colleagues. “Additionally, at the time of cardiac arrest, many patients were either receiving mechanical ventilation, kidney replacement therapy, or vasopressor support, all factors previously shown to be associated with a poor outcome following IHCA.”

These findings, Thapa et al. concluded, “warrant further investigation into the risks and benefits of performing prolonged CPR in this subset of patients, especially because the resuscitation process generates aerosols that may place healthcare personnel at a higher risk of contracting the virus.”

Read the full research letter here.