A Retrospective Analysis of CPR effectiveness in confirmed or suspected COVID-19 patients

Author(s): Kevin Stepanek, Mohamad A. Hatahet

Background: The idea for this study is to investigate if patients with COVID-19 had worse cardiac arrest outcomes as compared to patients without COVID-19.

Objectives: Our goal is to compare cardiac arrest outcomes in the context of individual patient variables such as COVID-19 results, age, and comorbid condition. We hypothesize worse prognosis for COVID-19 patients, and this may be beneficial in discussions about prognosis and to help providers establish goals of care.

Methods: A retrospective review was conducted of 9,522 patients admitted between March 2020 and November 2021. Data collected included age, sex, COVID-19 PCR result, length of stay, CODE BLUE (cardiac arrest), result of code and hospitalization, and specific cardiac indices such as ejection fraction and cardiac biomarkers.

Results: This study found 3,392 patients (35.6%) were COVID-19 positive/suspected. There was a higher incidence of CODE BLUE (p = 0.01) in the COVID-19 positive / suspected group. There was a higher incidence of patient expiration in the COVID-19 positive / suspected group (p = 0.01). There was a significant association with expiration after CODE BLUE in COVID-19 positive/suspected patients. Patients with an elevated troponin or BNP had more cardiac arrests and worse post-arrest outcomes, regardless of COVID-19 result. There was no difference in Ejection Fraction and outcomes, regardless of COVID-19 result.

Conclusions: This study found a significantly higher incidence of cardiac arrest in patients with confirmed/suspected COVID-19. The post-arrest outcomes were also worse for COVID-19 positive/suspected patients. Elevated cardiac biomarkers correlate with more cardiac arrest and worse outcomes overall.