It is not a death sentence if a COVID-19 patient suffers a cardiac arrest while undergoing hospital treatment for the virus, according to new research that contradicts reports early in the pandemic. The new insight from a researcher at the Perelman School of Medicine at the University of Pennsylvania still shows that such events remain deadly, but can be survived at a rate likely to be close to that among patients other hospitals before the pandemic began. This analysis was presented during the American Heart Association annual scientific meeting this month.
“Early studies showed very low rates of COVID-19 patients who were successfully resuscitated and went on to survive after suffering a cardiac arrest. The first Wuhan study showed a 30-day survival rate of 2.9 percent and a second cohort from New York. City showed no survival at all, “said Oscar Mitchell, MD, a fellow in Pulmonary and Critical Care Medicine at the University of Pennsylvania Hospital and the Resuscitation Science Center. “These results, of course, raised concerns that offering CPR to these patients did nothing and may have been exposing hospital staff to the virus. But our results showed that it is possible to survive with status neurologically good if CPR is attempted. “
Examining data between March and late May 2020 at 11 different hospitals throughout the United States, Mitchell and his co-researchers identified 260 patients with COVID-19 who suffered cardiac arrest – complete loss of heart rhythm – while in hospital for treatment. During that time, the data showed that 22 percent of those patients could be resuscitated. After their cardiac arrests, 12 percent of patients survived the events for at least a month, a standard marker for death when investigating adverse health events.
Overall, successful resuscitation rates were still about a third of what they were before COVID-19, and the 30-day survival numbers were half. However, those rates may have been skewed by the variation in hospital outcomes.
New York City hospitals included in the study treated the lion’s share of the patients (204). However, the rate of successful resuscitation for New York patients was 11 percent compared to 64 percent at the other hospitals. Furthermore, the 30-day survival rate was 6 percent in New York compared to 36 percent elsewhere. As such, the numbers of hospitals other than New York were, in fact, in line with what might be expected for other hospital patients experiencing cardiac arrest before COVID.
“What this shows is that these patients have a similar survival rate to the pre-pandemic,” said one of the study’s senior researchers, Benjamin Abella, MD, professor of Emergency Medicine. “It shows that our routine approach to hospital cardiac arrest may still be effective in COVID-19 patients and we should regard it as clearly survivable.”
The difference in numbers by location may have been due to differences in circumstances at each site, the researchers hypothesized.
“The stress of the COVID-19 pandemic on hospital resources may have amplified variations in things like detecting cardiac arrest, how patients were treated during cardiac arrest, and post-incident care,” Mitchell said.
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Materials provided by University of Pennsylvania School of Medicine. Note: Content can be edited for style and length.