Impact of the COVID‐19 pandemic on coronary artery bypass graft surgery in Brazil: A nationwide perspective

Abstract

Introduction The coronavirus disease 2019 (COVID‐19) pandemic has been a worldwide challenge, and efforts to “flatten the curve,” including restrictions imposed by policymakers and medical societies, have forced a reduction in the number of procedures performed in the Brazilian Health Care System. The aim of this study is to evaluate the outcomes of coronary artery bypass graft (CABG) from 2008 to 2020 in the SUS and to assess the impacts of the COVID‐19 pandemic in the number of procedures and death rate of CABG performed in 2020 through the database DATASUS. Methods This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures and death rates. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports. Results We identified 281,760 CABG procedures performed from January 2008 to December 2020. The average number of procedures until the end of 2019 was of 22,104. During 2020 there was a 25% reduction CABG procedures, to 16,501. There was an increase in the national death rate caused by a statistical significant increase in death rates in Brazil's Southeast and Central‐west regions. Conclusion The COVID‐19 pandemic remains a global challenge for Brazil's health care system. During the year of 2020 there was a reduction in access to CABG related to an increase in the number of COVID‐19 cases. There was also an increase in the national CABG death rate.

Impact of COVID‐19 on coronary artery surgery: Hard lessons learned

“…The results showed that in 2020, during the pandemic period, there was an average reduction of 25% in the number of CABG performed in Brazil, with the majority of procedures (75%) being performed in the south and southeast regions of the country. Regarding postoperative mortality, they observed an opposite effect with an increase in mortality from 5.6% to 6.3% during this pandemic period 6 …”

“…In this context, Kalil and Col 6 . examine the impact of the COVID‐19 pandemic in the number of procedures and death rate of coronary artery bypass graft (CABG) performed in 2020 in Brazil.…”

“…Regarding postoperative mortality, they observed an opposite effect with an increase in mortality from 5.6% to 6.3% during this pandemic period. 6 This study has some limitations due to results extracted from an administrative database, good for epidemiological analysis, such as gender, age, number and type of surgeries performed. Considering the reduction in surgical volume during the pandemic period, surgical status was analyzed altogether (whether elective, or urgent or emergency CABG), expressing a general view of the situation.…”

“…Cardiovascular surgery was particularly affected by the coronavirus outbreak, since most of the elective surgeries were canceled and intensive care unit beds, normally dedicated to the postoperative period of cardiac surgery, were transferred to patients with COVID-19. [3][4][5] In this context, Kalil and Col. 6 examine the impact of the COVID-19 pandemic in the number of procedures and death rate of coronary artery bypass graft (CABG) performed in 2020 in Brazil.…”

Opportunistic non‐communicable diseases in times of COVID‐19

“…A significant number of surgical procedures have been cancelled or postponed due to allocation of resources during the pandemic. In the field of NCDs, remarkable declines in cardiovascular surgery have been reported in several countries [23][24][25][26][27]…”