Surgical Triage and Timing for Patients With Coronavirus Disease: A Guidance Statement from The Society of Thoracic Surgeons

Nonelective coronary artery bypass graft outcomes are adversely impacted by Coronavirus disease 2019 infection, but not altered processes of care: A National COVID Cohort Collaborative and National Surgery Quality Improvement Program analysis

“…Although there have been no large analyses of outcomes for active COVID-19 patients undergoing CABG, several small case series of patients with active COVID have reported higher rates of morbidity and mortality. 9 , 10 , 27 , 28 , 29 , 30 In agreement with this analysis, active COVID-19 infection in patients undergoing urgent or emergent surgical procedures appears to confer an increased risk of perioperative morbidity and mortality. 31 , 32 , 33 , 34 Indeed, Knisely and colleagues' 33 recent examination of COVID-19 patients demonstrated that those undergoing urgent and emergent surgical procedures were at increased risk of severe complications regardless of preoperative American Society of Anesthesiologists category, with a reported risk ratio for death in active COVID-19 patients of 55.00 for those undergoing urgent surgical procedures.…”

“…The Society of Thoracic Surgeons supports guidance providing recommendations for the management of patients with active COVID-19 undergoing cardiac surgery that includes the use of personal protective equipment, careful preoperative optimization when able, and consideration for alternative surgical approaches. 10 The treatment of active COVID-19 patients requiring urgent/emergent CABG likely is best provided through a multidisciplinary approach, with input from infectious disease physicians, cardiac anesthesiologists, and cardiac critical care physicians to optimize patient outcomes while minimizing the risk of viral transmission to other patients and healthcare workers.…”

“…The COVID-active and COVID-conv time frames were based on the 2022 Guidance Statement by the Society for Thoracic Surgeons for surgical timing in patients with COVID-19. 10 …”