Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?

OBJECTIVES: There is limited data regarding outcomes after in-hospital cardiac arrest among coronavirus disease 2019 patients None of the studies have reported the outcomes of in-hospital cardiac arrest in coronavirus disease 2019 patients in the United States We describe the characteristics and outcomes of in-hospital cardiac arrest in coronavirus disease 2019 patients in rural Southwest Georgia DESIGN: Retrospective cohort study SETTING: Single-center, multihospital PATIENTS: Consecutive coronavirus disease 2019 patients who experienced in-hospital cardiac arrest with attempted resuscitation INTERVENTIONS: Attempted resuscitation with advanced cardiac life support MEASUREMENT AND MAIN RESULTS: Out of 1,094 patients hospitalized for coronavirus disease 2019 during the study period, 63 patients suffered from in-hospital cardiac arrest with attempted resuscitation and were included in this study The median age was 66 years, and 49 2% were males The majority of patients were African Americans (90 5%) The most common comorbidities were hypertension (88 9%), obesity (69 8%), diabetes (60 3%), and chronic kidney disease (33 3%) Eighteen patients (28 9%) had a Charlson Comorbidity Index of 0-2 The most common presenting symptoms were shortness of breath (63 5%), fever (52 4%), and cough (46%) The median duration of symptoms prior to admission was 14 days During hospital course, 66 7% patients developed septic shock, and 84 1% had acute respiratory distress syndrome Prior to in-hospital cardiac arrest, 81% were on ventilator, 60 3% were on vasopressors, and 39 7% were on dialysis The majority of in-hospital cardiac arrest (84 1%) occurred in the ICU Time to initiation of advanced cardiac life support protocol was less than 1 minute for all in-hospital cardiac arrest in the ICU and less than 2 minutes for the remaining patients The most common initial rhythms were pulseless electrical activity (58 7%) and asystole (33 3%) Although return of spontaneous circulation was achieved in 29% patients, it was brief in all of them The in-hospital mortality was 100% CONCLUSIONS: In our study, coronavirus disease 2019 patients suffering from in-hospital cardiac arrest had 100% in-hospital mortality regardless of the baseline comorbidities, presenting illness severity, and location of arrest