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Survival after in-hospital cardiac arrest 35% lower in COVID-19 patients

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ADULT COVID-19 patients who had an in-hospital cardiac arrest (IHCA) are 35 per cent less likely to receive potentially life-saving defibrillation without delay and survive to hospital release.

  A study published today in JAMA Network Open by University of Iowa researchers indicates that of 24,915 patients with IHCA from 286 US hospitals, of whom 5,916 (23.7 per cent) had COVID-19 from March to December 2020. per cent were women while 24.8 per cent were Black and 61.1 per cent were Whit as 3.8 per cent were of other races and 10.3 per cent of unknown race.

  According to the study, the 5,916 COVID-19 patients were younger and more often men and of Black race; more likely to have an initial nonshockable rhythm, pneumonia, respiratory insufficiency, or sepsis; and be receiving mechanical ventilation and vasopressors to treat low blood pressure at the time of IHCA.

  Relative to uninfected patients, those with COVID-19 had lower rates of survival to hospital release after IHCA (11.9 per cent Vs 23.5 per cent; adjusted relative risk [RR], 0.65) and return of spontaneous circulation (53.7 per cent Vs 63.6 per cent; adjusted RR, 0.86). They were also more likely to experience delays in defibrillation (27.7 per cent Vs 36.6 per cent; RR, 1.30) but not epinephrine administration.

  The link between COVID-19 and worse survival after IHCA held true for patients with nonsurgical diagnoses, those in an intensive care unit, and those who received timely defibrillation or epinephrine administration while the authors noted that earlier studies in the pandemic reported survival rates of less than 3 per cent among COVID-19 patients who had an IHCA.

  “However, these results were from single-center studies that comprised only 295 patients with COVID-19 in hospitals that were overwhelmed early during the pandemic. This observation underscores the sizable effect of the pandemic on in-hospital resuscitation. Because IHCA survival among patients with COVID-19 in this study was not as poor as reported previously, we believe that COVID-19 infection alone should not be used as a criterion for withholding resuscitation care from hospitalised patients,” they wrote. “As new variants emerge, future studies will be needed to assess the ongoing impact of COVID-19 infection on IHCA survival, the authors wrote.

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