Abstract 119: Resuscitation Outcomes In Covid-19-associated Out-of-hospital Cardiac Arrest

Abstract

BACKGROUND: Since the beginning of the pandemic, there have been numerous reports of increased mortality in the setting of both in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) in patients with novel coronavirus-19 (COVID-19) infection. Due to these alarming mortality rates, it has been proposed that resuscitation may represent futility when COVID-19 is suspected or confirmed in patients with cardiac arrest. However, it continues to remain unclear whether the currently available data is sufficient to be broadly applied to all patients and hospitals. HYPOTHESIS: In COVID-positive patients presenting after OHCA, resuscitation should be pursued and is not futile as has previously been suggested. METHODS: 264 consecutive patients presenting to the University of Minnesota Medical Center were obtained from the Cardiac Arrest Registry to Enhance Survival (CARES) database from March 2020 through April 2022. Patient data was obtained retrospectively for COVID19 infection status, initial documented arrest rhythm, and survival to hospital discharge. RESULTS: 264 patients were collected for analysis with 2 being excluded due to incomplete data. Of the remaining 262, 16 were found to be COVID-positive. Of these patients, 2 (12.5%) survived to hospital discharge compared to 72 (29.2%) in the group without COVID. In COVID-positive patients presenting with initially shockable rhythm (11 patients), survival was 18.2% compared with no survival noted in those with initially non-shockable rhythm. 9 patients with COVID were cannulated for ECMO, with 1 (11.1%) surviving to hospital discharge. CONCLUSIONS: This study provides insight into resuscitation in the setting of OHCA when COVID is suspected or confirmed. Though small in overall number of patients, our study indicates that resuscitation efforts in COVID-positive patients are not futile, as has previously been suggested.