Cardiopulmonary Resuscitation of Patients with Coronavirus Disease 2019: A One-Year Survey in The West of Iran

Abstract

Background The coronavirus disease 2019 (COVID-19) is associated with high risk of cardiac arrest (CA). Therefore, assessing cardiopulmonary resuscitation (CPR) success among patients with COVID-19 and employing effective strategies for its improvement are essential. The present study aimed at assessing the one-year epidemiology and outcomes of CPR among patients with COVID-19. Methods This cross-sectional descriptive-analytical study was conducted in January 2021 in the emergency departments of two hospitals in Hamadan and Kermanshah, Iran. Participants were 487 patients with confirmed COVID-19 and CA who had undergone CPR during the one-year period between January 20, 2020 and January 20, 2021. Data were collected using the available CPR documentation forms developed based on the Utstein Style. Data analysis was performed via the Chi-square, Fisher’s exact, and Mann-Whitney U tests and the logistic regression analysis. Results Participants’ age was 69.31 ± 14.73 years and most of them were male (61.8%) and suffered from at least one underlying disease (58.1%). The rate of total and in-hospital CA was 9.67% and 9.39%, respectively. The most prevalent first documented rhythm was asystole and the highest responsivity to CPR was for shockable rhythms. The rate of the return of spontaneous circulation was 9% and the rate of survival to hospital discharge was 2%. The significant predictors of CPR success were age, epinephrine administration time interval, and CPR duration. Conclusion CPR outcomes among patients with COVID-19 are poor, particularly among those with asystole and bradycardia. Old age and high or low doses of epinephrine can reduce CPR success, while CPR prolongation can improve CPR outcomes.

Healthcare providers’ experiences in hospital resuscitation of patients with COVID-19: a qualitative study

“…According to the findings of two studies on in-hospital and out-of-hospital cardiac arrest, none of the patients was discharged alive after successful initial resuscitation [7,14]. Elsewhere, the present study's authors [15] showed that the primary success rate of CPR was 9% and survival to discharge rate was 2%.…”

COVID-19 and its cardiovascular complications

“…14,15 Part of the systemic inflammatory response in severe COVID-19 is the release of high levels of cytokines (known as cytokine release syndrome) that can injure multiple tissues, including vascular endothelium and cardiac myocytes. [15][16][17][18][19]…”