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