Impact of the three COVID-19 surges in 2020 on in-hospital cardiac arrest survival in the United States.

Journal Article (Journal Article)

BACKGROUND: Studies have reported lower survival for in-hospital cardiac arrest (IHCA) during the initial COVID-19 surge. Whether the pandemic reduced IHCA survival during subsequent surges and in areas with lower COVID-19 rates is unknown. METHODS: Within Get-With-The-Guidelines®-Resuscitation, we identified 22,899 and 79,736 IHCAs during March to December in 2020 and 2015-2019, respectively. Using hierarchical regression, we compared risk-adjusted rates of survival to discharge in 2020 vs. 2015-19 during five COVID-19 periods: Surge 1 (March to mid-May), post-Surge 1 (mid-May to June), Surge 2 (July to mid-August), post-Surge 2 (mid-August to mid-October), and Surge 3 (mid-October to December). Monthly COVID-19 mortality rates for each hospital's county were categorized, per 1,000,000 residents, as very low (0-10), low (11-50), moderate (51-100), or high (>100). RESULTS: During each COVID-19 surge period in 2020, rates of survival to discharge for IHCA were lower, as compared with the same period in 2015-2019: Surge 1: adjusted OR: 0.81 (0.75-0.88); Surge 2: adjusted OR: 0.88 (0.79-0.97), Surge 3: adjusted OR: 0.79 (0.73-0.86). Lower survival was most pronounced at hospitals located in counties with moderate to high monthly COVID-19 mortality rates. In contrast, during the two post-surge periods, survival rates were similar in 2020 vs. 2015-2019: post-Surge 1: adjusted OR 0.93 (0.83-1.04) and post-Surge 2: adjusted OR 0.94 (0.86-1.03), even at hospitals with the highest county-level COVID-19 mortality rates. CONCLUSIONS: During the three COVID-19 surges in the U.S. during 2020, rates of survival to discharge for IHCA dropped substantially, especially in communities with moderate to high COVID-19 mortality rates.

Full Text

Duke Authors

Cited Authors

  • Gupta, K; Girotra, S; Nallamothu, BK; Kennedy, K; Starks, MA; Chan, PS; American Heart Association's Get With the Guidelines®-Resuscitation Investigators (listed in Supplementary Appendix),

Published Date

  • January 2022

Published In

Volume / Issue

  • 170 /

Start / End Page

  • 134 - 140

PubMed ID

  • 34838661

Pubmed Central ID

  • PMC8611825

Electronic International Standard Serial Number (EISSN)

  • 1873-1570

Digital Object Identifier (DOI)

  • 10.1016/j.resuscitation.2021.11.025


  • eng

Conference Location

  • Ireland