In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China

Resuscitation. 2020 Jun:151:18-23. doi: 10.1016/j.resuscitation.2020.04.005. Epub 2020 Apr 10.


Objective: To describe the characteristics and outcomes of patients with severe COVID-19 and in-hospital cardiac arrest (IHCA) in Wuhan, China.

Methods: The outcomes of patients with severe COVID-19 pneumonia after IHCA over a 40-day period were retrospectively evaluated. Between January 15 and February 25, 2020, data for all cardiopulmonary resuscitation (CPR) attempts for IHCA that occurred in a tertiary teaching hospital in Wuhan, China were collected according to the Utstein style. The primary outcome was restoration of spontaneous circulation (ROSC), and the secondary outcomes were 30-day survival, and neurological outcome.

Results: Data from 136 patients showed 119 (87.5%) patients had a respiratory cause for their cardiac arrest, and 113 (83.1%) were resuscitated in a general ward. The initial rhythm was asystole in 89.7%, pulseless electrical activity (PEA) in 4.4%, and shockable in 5.9%. Most patients with IHCA were monitored (93.4%) and in most resuscitation (89%) was initiated <1 min. The average length of hospital stay was 7 days and the time from illness onset to hospital admission was 10 days. The most frequent comorbidity was hypertension (30.2%), and the most frequent symptom was shortness of breath (75%). Of the patients receiving CPR, ROSC was achieved in 18 (13.2%) patients, 4 (2.9%) patients survived for at least 30 days, and one patient achieved a favourable neurological outcome at 30 days. Cardiac arrest location and initial rhythm were associated with better outcomes.

Conclusion: Survival of patients with severe COVID-19 pneumonia who had an in-hospital cardiac arrest was poor in Wuhan.

Keywords: COVID-19; Cardiopulmonary resuscitation; In-hospital cardiac arrest; ROSC; Survival.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • COVID-19
  • Cardiopulmonary Resuscitation / methods*
  • China
  • Cohort Studies
  • Coronavirus Infections / complications*
  • Female
  • Heart Arrest / etiology
  • Heart Arrest / mortality*
  • Heart Arrest / therapy
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / therapy*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • SARS-CoV-2
  • Survival Analysis
  • Treatment Outcome