美国密歇根大学Salim S Hayek团队分析了covid-19重症患者发生院内心脏骤停的危险因素。2020年9月30日，该成果发表在《英国医学杂志》上。
Title: In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study
Author: Salim S Hayek, Samantha K Brenner, Tariq U Azam, Husam R Shadid, Elizabeth Anderson, Hanna Berlin, Michael Pan, Chelsea Meloche, Rafey Feroz, Patrick O’Hayer, Rayan Kaakati, Abbas Bitar, Kishan Padalia, Daniel Perry, Pennelope Blakely, Shruti Gupta, Shahzad Shaefi, Anand Srivastava, David M Charytan, Anip Bansal, Mary Mallappallil, Michal L Melamed, Alexandre M Shehata, Jag Sunderram, Kusum S Mathews, Anne K Sutherland, Brahmajee K Nallamothu, David E Leaf
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.