Abstract

Background

Initial reports have described the poor outcome of unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19 patients in China and the USA. However, there are scarce data on characteristics and outcomes of such CA patients in Europe.

Methods

Prospective registry in 35 French ICUs, including all in-ICU CA in COVID-19 adult patients with cardiopulmonary resuscitation (CPR) attempt. Favorable outcome was defined as modified Rankin scale ranging from 0 to 3 at day 90 after CA.

Results

Among the 2425 COVID-19 patients admitted to ICU from March to June 2020, 186 (8%) experienced in-ICU CA, of whom 146/186 (78%) received CPR. Among these 146 patients, 117 (80%) had sustained return of spontaneous circulation, 102 (70%) died in the ICU, including 48 dying within the first day after CA occurrence and 21 after withdrawal of life-sustaining therapy. Most of CA were non-shockable rhythm (90%). At CA occurrence, 132 patients (90%) were mechanically ventilated, 83 (57%) received vasopressors and 75 (51%) had almost three organ failures. Thirty patients (21%) had a favorable outcome. Sepsis-related organ failure assessment score > 9 before CA occurrence was the single parameter constantly associated with unfavorable outcome in multivariate analysis.

Conclusions

In-ICU CA incidence remains high among a large multicenter cohort of French critically ill adults with COVID-19. However, 21% of patients with CPR attempt remained alive at 3 months with good functional status. This contrasts with other recent reports showing poor outcome in such patients.

Trial registration: This study was retrospectively registered in ClinicalTrials.gov (NTC04373759) in April 2020 (https://www.clinicaltrials.gov/ct2/show/NCT04373759?term=acicovid&draw=2&rank=1).

Details

Title
Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
Author
Chelly, Jonathan 1   VIAFID ORCID Logo  ; Plantefève Gaetan 2 ; Kamel Toufik 3 ; Bruel Cédric 4 ; Nseir Saad 5 ; Lai, Christopher 6 ; Cirillo Giulia 7 ; Skripkina Elena 8 ; Ehrminger Sébastien 9 ; Fernando-Daniel, Berdaguer-Ferrari 10 ; Julien, Le Marec 11 ; Marine, Paul 12 ; Autret Aurélie 13 ; Deye Nicolas 14 ; Jean-Michel, Arnal; Badie Julio; Berric Audrey; Brunet, Jennifer; Thibault, Bertrand; Carpentier Dorothée; Chaoui Karim; Chapelle Anaïs; Chelha Riad; Corno Gaëlle; Daubin Cédric; Descamps, Richard; Demoule Alexandre; Deryckere Stéphanie; Donati Stephane-Yannis; Ducros Laurent; Embriaco Nathalie; Engrand Nicolas; Foucault Camille; Freeman, Sean Anthony; Freita Ramos Santiago; Galbois Arnaud; Garnero Aude; Geay Cyrille; Guérin, Laurent; Hong Tuan Ha Vivien; Hullin, Thomas; Jochmans Sébastien; Kaidomar Michel; Kelway Charlotte; Labruyere Marie; Larcher Romaric; Legriel Stéphane; Leloup Maxime; Lesieur Olivier; Malissin Isabelle; Mazerand Sandie; Mégarbane Bruno; Marie-Anne, Mélone; Menoret Edouard; Metzelard Matthieu; Mongardon Nicolas; Vong Ly Van Phack; Persichini Romain; Pichon, Nicolas; Picos Gil Santiago; Jean-Pierre, Quenot; Roux, Damien; Schnell, David; Sigaud Florian; Clement, Suply; Sztrymf Benjamin; Terzi, Nicolas; Thevenin Didier; Voicu, Sebastian

 Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer, Hôpital Sainte Musse, Intensive Care Unit, Toulon, France (GRID:grid.489910.d) 
 Centre Hospitalier Victor Dupouy, Intensive Care Unit, Argenteuil, France (GRID:grid.414474.6) (ISNI:0000 0004 0639 3263) 
 Université de Paris, Intensive Care Unit, Centre Hospitalier Régional d’Orléans, Orléans. Inserm UMR1153, ECSTRRA, Paris, France (GRID:grid.508487.6) (ISNI:0000 0004 7885 7602) 
 Groupe Hospitalier Paris Saint Joseph, Intensive Care Unit, Paris, France (GRID:grid.414363.7) (ISNI:0000 0001 0274 7763) 
 Médecine Intensive Réanimation, CHU Lille, Inserm U1285, Université de Lille, CNRS, UMR 8576-UGSF, Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France (GRID:grid.410463.4) (ISNI:0000 0004 0471 8845) 
 Hôpital de Bicêtre, Université Paris-Saclay, Assistance Publique Hôpitaux de Paris (AP-HP), Medical Intensive Care Unit, Le Kremlin-Bicêtre, France (GRID:grid.413784.d) (ISNI:0000 0001 2181 7253) 
 Groupe Hospitalier Sud Ile de France, Intensive Care Department, Melun, France (GRID:grid.413784.d) 
 DHU A-TVB, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service d’anesthésie-réanimation chirurgicale, DMU CARE, Créteil, France (GRID:grid.412116.1) (ISNI:0000 0001 2292 1474) 
 Grand Hôpital de l’Est Francilien-site de Marne la Vallée, Intensive Care Unit, Jossigny, France (GRID:grid.412116.1) 
10  Hôpital Nord Franche-Comté, Intensive Care Unit, Trévenans, France (GRID:grid.492689.8) (ISNI:0000 0004 0640 1948) 
11  Pitié-Salpétrière hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Intensive Care Unit, Département R3S, Paris, France (GRID:grid.411439.a) (ISNI:0000 0001 2150 9058) 
12  Centre Hospitalier de Versailles-site André Mignot, Intensive Care Unit, Le Chesnay, France (GRID:grid.418080.5) (ISNI:0000 0001 2177 7052) 
13  Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer, Clinical Research Department, Toulon, France (GRID:grid.489910.d) 
14  Assistance Publique Hôpitaux de Paris (AP-HP), Centre Hospitalier Universitaire Lariboisière, Medical and Toxicological Intensive Care Unit, Inserm U942, Paris, France (GRID:grid.50550.35) (ISNI:0000 0001 2175 4109) 
Publication year
2021
Publication date
Dec 2021
Publisher
Springer Nature B.V.
e-ISSN
21105820
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2597012706
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.