Outcomes of pediatric patients with COVID-19 and in-hospital cardiopulmonary resuscitation.
Outcomes of pediatric patients with COVID-19 and in-hospital cardiopulmonary resuscitation.
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DOI：
10.1016/j.resuscitation.2022.02.018
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发表时间：
2022-04
期刊：
影响因子：
6.5
通讯作者：
American Heart Association's Get With the Guidelines®-Resuscitation Investigators
中科院分区：
文献类型：
--
作者：
El-Zein RS;Chan ML;Su L;Chan PS;American Heart Association's Get With the Guidelines®-Resuscitation Investigators
早期的研究发现，感染COVID-19和住院心脏骤停（IHCA）的成年人存活率很低。我们评估了COVID-19感染与接受心肺复苏（CPR）的儿科患者生存结局的相关性。在Get-With-The-Guidelines®-Resuscitation中，我们确定了在2020年3月至12月期间因IHCA或心动过缓而接受CPR的儿科患者。我们使用多变量分层回归比较了疑似/确诊COVID-19感染患者和非COVID-19患者的生存结局（出院和恢复自主循环≥20分钟[ROSC]的生存率），其中医院地点作为随机效应，患者和心脏骤停变量具有显著（p < 0.05）的双变量关联作为固定效应。总体而言，确定了1328例儿科院内CPR事件（590例IHCA，738例心动过缓伴灌注不良），其中46例（32例IHCA，14例心动过缓）疑似/确诊COVID-19感染。有和无COVID-19感染的患者的出院存活率相似（39.1% vs. 44.9%;调整后RR，1.14 [95% CI：0.55-2.36]），IHCA和心动过缓伴灌注不良的患者的这些估计值相似（调整后RR为1.03和1.05;相互作用p = 0.96）。总体而言，有和无COVID-19的儿科患者之间的ROSC发生率也相似（67.4% vs. 76.9%;调整后的RR，0.87 [0.43，1.77]），对于IHCA或需要CPR的心动过缓亚组（调整后的RR为0.95和0.86，相互作用p = 0.26）。在一项大型多中心国家心肺复苏事件登记研究中，COVID-19感染与接受心肺复苏的儿科患者的ROSC率或出院生存率较低无关。
Early studies found low survival rates for adults with COVID-19 infection and in-hospital cardiac arrest (IHCA). We evaluated the association of COVID-19 infection on survival outcomes in pediatric patients undergoing cardiopulmonary resuscitation (CPR). Within Get-With-The-Guidelines®-Resuscitation, we identified pediatric patients who underwent CPR for an IHCA or bradycardia with poor perfusion between March and December, 2020. We compared survival outcomes (survival to discharge and return of spontaneous circulation for ≥20 minutes [ROSC]) between patients with suspected/confirmed COVID-19 infection and non-COVID-19 patients using multivariable hierarchical regression, with hospital site as a random effect and patient and cardiac arrest variables with a significant (p < 0.05) bivariate association as fixed effects. Overall, 1328 pediatric in-hospital CPR events were identified (590 IHCA, 738 bradycardia with poor perfusion), of which 46 (32 IHCA, 14 bradycardia) had suspected/confirmed COVID-19 infection. Rates of survival to discharge were similar between those with and without COVID-19 infection (39.1% vs. 44.9%; adjusted RR, 1.14 [95% CI: 0.55–2.36]), and these estimates were similar for those with IHCA and bradycardia with poor perfusion (adjusted RRs of 1.03 and 1.05; interaction p = 0.96). Rates of ROSC were also similar between pediatric patients with and without COVID-19 overall (67.4% vs. 76.9%; adjusted RR, 0.87 [0.43, 1.77]), and for the subgroups with IHCA or bradycardia requiring CPR (adjusted RRs of 0.95 and 0.86, interaction p = 0.26). In a large multicenter national registry of CPR events, COVID-19 infection was not associated with lower rates of ROSC or survival to hospital discharge in pediatric patients undergoing CPR.
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DOI：
10.15585/mmwr.mm7023e1
发表时间：
2021-06-11
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
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作者：
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发表时间：
2020-09-30
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影响因子：
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影响因子：
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