Effect of the COVID-19 pandemic on complications and mortality of patients with cardiac surgery

Abstract

Objectives The purpose of this study was to assess changes in cardiovascular disease severity, types, postoperative complications and prognosis during the COVID-19 pandemic and to explore possible influencing factors. Methods A total of 422 patients were enrolled in this study, and hospitalization and short-term follow-up data were retained. The patient population included 273 men and 149 women. Patients had a median (IQR) age of 54 (45–62) years and were divided into an observation group (130) and a control group (292), primarily according to severity of disease, disease types, baseline indexes, biochemical indexes, cardiac function indexes, complications and prognosis. Results During the COVID-19 pandemic, compared with the same period last year, there was a significant increase in patients with aortic dissection (27.69% vs 5.82%), a significant decrease in patients with valvular heart disease (43.08% vs 66.78%), and significantly increased emergency admission (50.00% vs 21.23%) and severity (54.62% vs 27.40%). Family company (76.37% vs 64.62%) was decreased, EuroSCORE [6.5 (2–9) vs 2 (0–5)] score, Pro-BNP [857.50 (241.00–2222.50) vs 542.40 (113.45–1776.75)] ng/L, six months mortality rate (18.46% vs 8.90%), and postoperative complications, including infected patients, atelectasis, pulmonary edema, and so on were increased, with longer length of stay in the ICU and hospital in COVID-19 pandemic. Survival analysis curve further demonstrated that it had an impact on the deaths of patients during the COVID-19 pandemic period. Through ROC analysis of the death factors of patients, it was concluded that Family company affected the death of patients, and the area under the curve was 0.654 (P < 0.05). Conclusions In this study, we found that the admission rate of critically ill patients with cardiovascular disease, complications of cardiac surgery, and short-term mortality of patients all exhibited a short-term increase, family company may be a risk factors for short-term mortality, that may be related to public pressure caused by the COVID-19 pandemic.

Year in Review 2021: Noteworthy Literature in Cardiothoracic Critical Care

“…Moreover, the demand for non-COVID care has increased, which may be the result of lockdowns, hesitancy to pursue treatment, or delay of surgery as sequelae of COVID-19 burden on healthcare systems. 30 Intensivists remain on the frontlines caring for large numbers of critically ill COVID-19 patients, while now also facing an increased number of non-COVID patients in the ICU. In the procedural realm, the optimal timing and management of tracheostomies for COVID-19 patients remains a frequent question for intensivists, surgeons, and anesthesiologists.…”

Heart transplantation in the era of corona virus disease 2019: Impact of the pandemic on donors, recipients and outcome

“…In contrast to that, Wang et al recently reported an increase in perioperative adverse events as well as mortality in cardiac surgery patients during the pandemic. 22 However, the study has not included HTx patients but focused on valvular heart and coronary artery disease during the early phase of the pandemic instead. 22…”

“…22 However, the study has not included HTx patients but focused on valvular heart and coronary artery disease during the early phase of the pandemic instead. 22…”

Fatal association of COVID‐19 and acute type A aortic dissection

“…It has been suggested that complications and mortality of cardiovascular emergencies and number of severe cases had been increased during the COVID‐19 pandemic 7,8 . Moreover, in another study, postoperative mortality was higher in COVID‐19 patients who needed cardiovascular surgery, compared to the patients without COVID‐19 9 .…”

“…It has been suggested that complications and mortality of cardiovascular emergencies and number of severe cases had been increased during the COVID‐19 pandemic. 7 , 8 Moreover, in another study, postoperative mortality was higher in COVID‐19 patients who needed cardiovascular surgery, compared to the patients without COVID‐19. 9 Type A aortic dissection in COVID‐19 patients seems to associate with increased severity that even with immediate and proper diagnosis, it has higher mortality.…”