Analysis of the Detection Rate and Results of Surgical Treatment of Patients with Infective Endocarditis With/Without COVID-19

Abstract

   AIM OF STUDY. To analyze results of surgical treatment of infective endocarditis in the context of the COVID-19 pandemic at the N. V. Sklifosovsky Research Institute for Emergency Medicine.   MATERIAL AND METHODS. From January, 2021 to April, 2022 at N.V. Sklifosovsky Research Institute for Emergency Medicine we performed 59 surgical interventions on patients diagnosed with infective endocarditis, of which 20 patients (33.9%) had a competing diagnosis “new coronavirus infection”.   RESULTS. The overall mortality was for the specified period was 18.6 %, 11 patients. In the first group, 5 patients died (25 %). Hospital mortality in the second group was 6 patients (15.4 %).   CONCLUSION. Preoperative preparation, as well as the surgical intervention itself, did not differ significantly between patients in the two groups. Hospital mortality in the group of patients with new coronavirus infection was higher than in patients without the virus, despite the fact that the risk of surgical intervention according to EuroSCORE II was higher in the second group. From which we can conclude that the EuroSCORE risk scale II does not fully reflect the initial severity of the condition of patients with COVID-19. Such risk factors as decreased immunity due to immunosuppressive therapy and respiratory failure and coagulopathy influenced the results of surgical treatment of infective endocarditis in this cohort of patients, but not so significantly as to refuse surgical intervention. The significant difference in the postoperative period was the increase in bed days in intensive care and therapeutic departments among patients with COVID-19. This factor is associated with the initial severity and specifics of management of these patients in the postoperative period, which required greater vigilance and attention from cardiac surgeons, resuscitators and infectious disease doctors in the “red” zones.