Nationwide Trends in Hospitalizations for Sudden Cardiac Arrest Before and During the COVID Outbreak

<b>Background/Objectives</b>: Sudden cardiac arrest (SCA) accounts for ~50% of cardiovascular mortality in the U.S. Cardiovascular complications are common in acute and post-acute COVID-19 infection. We aimed to examine nationwide trends in SCA-related hospitalizations in the United States before and during the COVID-19 outbreak. <b>Methods</b>: Using data from the National Inpatient Sample, we conducted a retrospective analysis of hospitalizations for SCA in the U.S. between 2016 and 2020. Sociodemographic and clinical characteristics and in-hospital mortality were compared between the pre-COVID (2016-2019) and COVID (2020) eras. Multivariable analysis was performed to identify factors associated with mortality. <b>Results</b>: Among a weighted total of 153,100 SCA hospitalizations between 2016 and 2020, the median age was 65 years, 62.7% were male, and 66.6% were white. There was a trend towards fewer hospitalizations in 2020 compared to prior years (<i>n</i> = 28,585 vs. <i>n</i>_average = 32,129, <i>p</i> = 0.07). In-hospital mortality remained unchanged between the pre-COVID and COVID eras (47.7% vs. 47.3%, <i>p</i> = 0.66). Increased mortality was associated with female sex (OR: 1.21; 95% CI: 1.15-1.28; <i>p</i> < 0.001), non-white race (OR: 1.24; 95% CI: 1.15-1.28; <i>p</i> < 0.001), history of renal failure (OR: 1.08; 95% CI: 1.02-1.15; <i>p</i> = 0.007), and diabetes (OR: 1.32; 95% CI: 1.25-1.39; <i>p</i> < 0.001). In 2020, 1.5% of the study population was diagnosed with COVID-19 infection, which was found to be independently associated with increased in-hospital mortality (OR: 1.57; 95% CI: 1.27-1.95; <i>p</i> < 0.001). <b>Conclusions</b>: In 2020, there was a trend towards a decrease in hospitalizations for SCA, while COVID-19 infection was independently associated with higher in-hospital mortality among patients admitted with SCA.