An Evaluation of the Impact of COVID-19 on Cardiovascular Surgery

Abstract

Introduction: We aimed to describe the impact of COVID-19 among the patients who had cardiac surgery, with particular emphasis on pulmonary complications and 30-day mortality. Patients and Methods: From March 2020 to June 2021, a total of 2267 patients underwent cardiovascular surgery at Koşuyolu High Specialization Training and Research Hospital.. Patients who tested SARSCoV-2-positive by PCR perioperatively (seven days before or 30 days after surgery), despite testing negative at admission, were included. The primary endpoint of the study was 30-day mortality following surgery. The secondary endpoint was the development of pulmonary complications including acute respiratory distress syndrome (ARDS) or respiratory failure, which were defined according to the Berlin definition, and the need for mechanical ventilation for >48 h after the operation or the need for re-intubation after extubation. Results: Eleven patients out of 2267 (0.48%) had a positive PCR test for COVID-19. In the postoperative period, seven patients were diagnosed with COVID-19 in the clinical wards, of whom three patients were readmitted to the ICU. Nine patients had radiological pulmonary involvement. Five patients (45.5%) developed ARDS within four to seven days after a positive PCR test. Eight patients (72.7%) developed respiratory failure and required re-intubation, of whom two could not be extubated. Five patients (45.5%) died within 30 days, and seven (63.6) died during their hospital stay. Conclusion: COVID-19 has a severe negative impact on the postoperative course of cardiac surgery patients in terms of cardiovascular outcomes, pulmonary complications, and mortality. Given the dramatic impact of COVID-19 infection on postoperative outcomes, it appears that deferring cardiovascular surgeries may be more suitable if COVID-19 positivity is detected.