Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19 : insight from the multicenter prospective ACICOVID-19 registry
© 2021. The Author(s)..
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 ).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Annals of intensive care - 11(2021), 1 vom: 13. Nov., Seite 155 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chelly, Jonathan [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 18.11.2021 published: Electronic ClinicalTrials.gov: NCT04373759 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1186/s13613-021-00945-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Chelly, Jonathan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19 |b insight from the multicenter prospective ACICOVID-19 registry |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 18.11.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04373759 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 ) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a In-hospital cardiac arrest | |
| 650 | 4 | |a Intensive care unit | |
| 650 | 4 | |a SARS-CoV-2 | |
| 700 | 1 | |a Plantefève, Gaetan |e verfasserin |4 aut | |
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| 700 | 1 | |a Bruel, Cédric |e verfasserin |4 aut | |
| 700 | 1 | |a Nseir, Saad |e verfasserin |4 aut | |
| 700 | 1 | |a Lai, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Cirillo, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Skripkina, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Ehrminger, Sébastien |e verfasserin |4 aut | |
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| 700 | 1 | |a Le Marec, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Paul, Marine |e verfasserin |4 aut | |
| 700 | 1 | |a Autret, Aurélie |e verfasserin |4 aut | |
| 700 | 1 | |a Deye, Nicolas |e verfasserin |4 aut | |
| 700 | 0 | |a ACICOVID-19 study group |e verfasserin |4 aut | |
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| 700 | 1 | |a Brunet, Jennifer |e investigator |4 oth | |
| 700 | 1 | |a Bertrand, Thibault |e investigator |4 oth | |
| 700 | 1 | |a Carpentier, Dorothée |e investigator |4 oth | |
| 700 | 1 | |a Chaoui, Karim |e investigator |4 oth | |
| 700 | 1 | |a Chapelle, Anaïs |e investigator |4 oth | |
| 700 | 1 | |a Chelha, Riad |e investigator |4 oth | |
| 700 | 1 | |a Corno, Gaëlle |e investigator |4 oth | |
| 700 | 1 | |a Daubin, Cédric |e investigator |4 oth | |
| 700 | 1 | |a Descamps, Richard |e investigator |4 oth | |
| 700 | 1 | |a Demoule, Alexandre |e investigator |4 oth | |
| 700 | 1 | |a Deryckere, Stéphanie |e investigator |4 oth | |
| 700 | 1 | |a Donati, Stephane-Yannis |e investigator |4 oth | |
| 700 | 1 | |a Ducros, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Embriaco, Nathalie |e investigator |4 oth | |
| 700 | 1 | |a Engrand, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Foucault, Camille |e investigator |4 oth | |
| 700 | 1 | |a Freeman, Sean Anthony |e investigator |4 oth | |
| 700 | 1 | |a Freita Ramos, Santiago |e investigator |4 oth | |
| 700 | 1 | |a Galbois, Arnaud |e investigator |4 oth | |
| 700 | 1 | |a Garnero, Aude |e investigator |4 oth | |
| 700 | 1 | |a Geay, Cyrille |e investigator |4 oth | |
| 700 | 1 | |a Guérin, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Hong Tuan Ha, Vivien |e investigator |4 oth | |
| 700 | 1 | |a Hullin, Thomas |e investigator |4 oth | |
| 700 | 1 | |a Jochmans, Sébastien |e investigator |4 oth | |
| 700 | 1 | |a Kaidomar, Michel |e investigator |4 oth | |
| 700 | 1 | |a Kelway, Charlotte |e investigator |4 oth | |
| 700 | 1 | |a Labruyere, Marie |e investigator |4 oth | |
| 700 | 1 | |a Larcher, Romaric |e investigator |4 oth | |
| 700 | 1 | |a Legriel, Stéphane |e investigator |4 oth | |
| 700 | 1 | |a Leloup, Maxime |e investigator |4 oth | |
| 700 | 1 | |a Lesieur, Olivier |e investigator |4 oth | |
| 700 | 1 | |a Malissin, Isabelle |e investigator |4 oth | |
| 700 | 1 | |a Mazerand, Sandie |e investigator |4 oth | |
| 700 | 1 | |a Mégarbane, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Mélone, Marie-Anne |e investigator |4 oth | |
| 700 | 1 | |a Menoret, Edouard |e investigator |4 oth | |
| 700 | 1 | |a Metzelard, Matthieu |e investigator |4 oth | |
| 700 | 1 | |a Mongardon, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Vong, Ly Van Phack |e investigator |4 oth | |
| 700 | 1 | |a Persichini, Romain |e investigator |4 oth | |
| 700 | 1 | |a Pichon, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Picos Gil, Santiago |e investigator |4 oth | |
| 700 | 1 | |a Quenot, Jean-Pierre |e investigator |4 oth | |
| 700 | 1 | |a Roux, Damien |e investigator |4 oth | |
| 700 | 1 | |a Schnell, David |e investigator |4 oth | |
| 700 | 1 | |a Sigaud, Florian |e investigator |4 oth | |
| 700 | 1 | |a Suply, Clement |e investigator |4 oth | |
| 700 | 1 | |a Sztrymf, Benjamin |e investigator |4 oth | |
| 700 | 1 | |a Terzi, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Thevenin, Didier |e investigator |4 oth | |
| 700 | 1 | |a Voicu, Sebastian |e investigator |4 oth | |
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