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

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.