Abstract
Background/purpose
Predictors for out-of-hospital cardiac arrest (OHCA) in COVID-19 patients remain unclear. We identified the predictors for OHCA and in-hospital mortality among such patients in community isolation centers.
Methods
From May 15 to June 20, 2021, this cohort study recruited 2555 laboratory-confirmed COVID-19 patients admitted to isolation centers in Taiwan. All patients were followed up until death, discharge from the isolation center or hospital, or July 16, 2021. OHCA was defined as cardiac arrest confirmed by the absence of circulation signs and occurring outside the hospital. Multinomial logistic regressions were used to determine factors associated with OHCA and in-hospital mortality.
Results
Of the 37 deceased patients, 7 (18.9%) had OHCA and 30 (81.1%) showed in-hospital mortality. The mean (SD) time to OHCA was 6.6 (3.3) days from the symptom onset. After adjusting for demographics and comorbidities, independent predictors for OHCA included age ≥65 years (adjusted odds ratio [AOR]: 13.24, 95% confidence interval [CI]: 1.85–94.82), fever on admission to the isolation center (AOR: 12.53, 95% CI: 1.68–93.34), and hypoxemia (an oxygen saturation level below 95% on room air) (AOR: 26.54, 95% CI: 3.18–221.73). Predictors for in-hospital mortality included age ≥65 years (AOR: 10.28, 95% CI: 2.95–35.90), fever on admission to the isolation centers (AOR: 7.27, 95% CI: 1.90–27.83), and hypoxemia (AOR: 29.87, 95% CI: 10.17–87.76).
Conclusions
Time to OHCA occurrence is rapid in COVID-19 patients. Close monitoring of patients’ vital signs and disease severity during isolation is important, particularly for those with older age, fever, and hypoxemia.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Hypoxemia, Out-of-hospital cardiac arrest, 【초록키워드】 disease severity, hospital, Comorbidities, discharge, cohort study, oxygen saturation, Fever, Patient, Older age, Isolation, death, Community, Logistic regression, age, vital sign, predictor, circulation, Taiwan, Admission, patients, in-hospital mortality, COVID-19 patients, Deceased, COVID-19 patient, demographics, symptom onset, Factor, adjusted odds ratio, 95% confidence interval, laboratory-confirmed, time, Occurrence, Result, defined, recruited, were used, determine, absence, independent predictor, 【제목키워드】 in-hospital mortality, retrospective cohort study,