Outcomes of Cardiopulmonary Resuscitation in Patients With COVID-19

Cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest (IHCA) in patients with coronavirus disease 2019 (COVID-19) presents unique challenges. Cardiopulmonary resuscitation may be delayed because of isolation procedures, and advanced life support resources may be limited. Additionally, CPR for patients with COVID-19 exposes health care workers to increased risk of viral transmission. Improving our understanding of the likelihood of successful outcomes after CPR is crucial to informing goals-of-care discussions, determining the appropriateness of resuscitative efforts, and guiding policy. To date, to our knowledge, there is limited evidence on outcomes for IHCA among patients with COVID-19. A single-center study of 136 patients with IHCA in Wuhan, China, reported poor outcomes but was limited by cardiac arrests occurring during shortages of advanced life support resources. Nonetheless, this study found only 18 patients (13%) achieved return of spontaneous circulation, 4 (3%) survived to 30 days, and only 1 (<1%) achieved a favorable neurological outcome by 30 days. In this issue of JAMA Internal Medicine, Thapa et al report what to our knowledge are the first US data on outcomes for IHCA among patients with COVID-19. In their case series of 54 patients, 52 (96%) had a nonshockable initial rhythm, 29 (54%) achieved return of spontaneous circulation, and 0 survived to hospital discharge (95% CI, 0%-6.6%). This very low hospital survival is likely driven by several...
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research