tetano
Editor, Senior Moderator
J Card Surg
. 2021 Oct 30.
doi: 10.1111/jocs.16106. Online ahead of print.
Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery
Giorgia Bonalumi[SUP] 1 [/SUP], Alberto Pilozzi Casado[SUP] 2 [/SUP], Alessandro Barbone[SUP] 3 [/SUP], Andrea Garatti[SUP] 4 [/SUP], Andrea Colli[SUP] 5 [/SUP], Ilaria Giambuzzi[SUP] 1 6 [/SUP], Lucia Torracca[SUP] 3 [/SUP], Giacomo Ravenni[SUP] 5 [/SUP], Gianluca Folesani[SUP] 7 [/SUP], Giacomo Murara[SUP] 7 [/SUP], Antonio Pantaleo[SUP] 8 [/SUP], Marco Picichè[SUP] 9 [/SUP], Emmanuel Villa[SUP] 10 [/SUP], Francesco Ferraro[SUP] 10 11 [/SUP], Igor Vendramin[SUP] 12 [/SUP], Ugolino Livi[SUP] 12 [/SUP], Andrea Montalto[SUP] 13 [/SUP], Francesco Musumeci[SUP] 13 [/SUP], Vincenzo Tarzia[SUP] 14 [/SUP], Cinzia Trumello[SUP] 15 [/SUP], Michele De Bonis[SUP] 15 [/SUP], Vito Margari[SUP] 16 [/SUP], Domenico Paparella[SUP] 16 17 [/SUP], Antonio Salsano[SUP] 18 [/SUP], Francesco Santini[SUP] 18 [/SUP], Salvatore Nicolardi[SUP] 19 [/SUP], Francesco Patanè[SUP] 20 [/SUP], Liborio Mammana[SUP] 20 [/SUP], Erik Cura Stura[SUP] 21 [/SUP], Mauro Rinaldi[SUP] 21 [/SUP], Francesco Massi[SUP] 22 [/SUP], Michele Triggiani[SUP] 22 [/SUP], Valentina Grazioli[SUP] 23 [/SUP], Laura Giroletti[SUP] 23 [/SUP], Antonino Rubino[SUP] 24 [/SUP], Marisa De Feo[SUP] 24 [/SUP], Andrea Audo[SUP] 25 [/SUP], Tommaso Regesta[SUP] 25 [/SUP], Fabio Barili[SUP] 2 [/SUP], Gino Gerosa[SUP] 14 [/SUP], Michele Di Mauro[SUP] 26 [/SUP], Alessandro Parolari[SUP] 27 28 [/SUP]
Affiliations
Abstract
Objective: To analyze Italian Cardiac Surgery experience during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identifying risk factors for overall mortality according to coronavirus disease 2019 (COVID-19) status.
Methods: From February 20 to May 31, 2020, 1354 consecutive adult patients underwent cardiac surgery at 22 Italian Centers; 589 (43.5%), patients came from the red zone. Based on COVID-19 status, 1306 (96.5%) were negative to SARS-CoV-2 (COVID-N), and 48 (3.5%) were positive to SARS-CoV-2 (COVID-P); among the COVID-P 11 (22.9%) and 37 (77.1%) become positive, before and after surgery, respectively. Surgical procedures were as follows: 396 (29.2%) isolated coronary artery bypass grafting (CABG), 714 (52.7%) isolated non-CABG procedures, 207 (15.3%) two associate procedures, and three or more procedures in 37 (2.7%). Heart failure was significantly predominant in group COVID-N (10.4% vs. 2.5%, p = .01).
Results: Overall in-hospital mortality was 1.6% (22 cases), being significantly higher in COVID-P group (10 cases, 20.8% vs. 12, 0.9%, p < .001). Multivariable analysis identified COVID-P condition as a predictor of in-hospital mortality together with emergency status. In the COVID-P subgroup, the multivariable analysis identified increasing age and low oxygen saturation at admission as risk factors for in-hospital mortality.
Conclusion: As expected, SARS-CoV-2 infection, either before or soon after cardiac surgery significantly increases in-hospital mortality. Moreover, among COVID-19-positive patients, older age and poor oxygenation upon admission seem to be associated with worse outcomes.
Keywords: COVID-19; SARS-CoV-2; cardiac surgical procedures; emergent cardiac surgery.
. 2021 Oct 30.
doi: 10.1111/jocs.16106. Online ahead of print.
Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery
Giorgia Bonalumi[SUP] 1 [/SUP], Alberto Pilozzi Casado[SUP] 2 [/SUP], Alessandro Barbone[SUP] 3 [/SUP], Andrea Garatti[SUP] 4 [/SUP], Andrea Colli[SUP] 5 [/SUP], Ilaria Giambuzzi[SUP] 1 6 [/SUP], Lucia Torracca[SUP] 3 [/SUP], Giacomo Ravenni[SUP] 5 [/SUP], Gianluca Folesani[SUP] 7 [/SUP], Giacomo Murara[SUP] 7 [/SUP], Antonio Pantaleo[SUP] 8 [/SUP], Marco Picichè[SUP] 9 [/SUP], Emmanuel Villa[SUP] 10 [/SUP], Francesco Ferraro[SUP] 10 11 [/SUP], Igor Vendramin[SUP] 12 [/SUP], Ugolino Livi[SUP] 12 [/SUP], Andrea Montalto[SUP] 13 [/SUP], Francesco Musumeci[SUP] 13 [/SUP], Vincenzo Tarzia[SUP] 14 [/SUP], Cinzia Trumello[SUP] 15 [/SUP], Michele De Bonis[SUP] 15 [/SUP], Vito Margari[SUP] 16 [/SUP], Domenico Paparella[SUP] 16 17 [/SUP], Antonio Salsano[SUP] 18 [/SUP], Francesco Santini[SUP] 18 [/SUP], Salvatore Nicolardi[SUP] 19 [/SUP], Francesco Patanè[SUP] 20 [/SUP], Liborio Mammana[SUP] 20 [/SUP], Erik Cura Stura[SUP] 21 [/SUP], Mauro Rinaldi[SUP] 21 [/SUP], Francesco Massi[SUP] 22 [/SUP], Michele Triggiani[SUP] 22 [/SUP], Valentina Grazioli[SUP] 23 [/SUP], Laura Giroletti[SUP] 23 [/SUP], Antonino Rubino[SUP] 24 [/SUP], Marisa De Feo[SUP] 24 [/SUP], Andrea Audo[SUP] 25 [/SUP], Tommaso Regesta[SUP] 25 [/SUP], Fabio Barili[SUP] 2 [/SUP], Gino Gerosa[SUP] 14 [/SUP], Michele Di Mauro[SUP] 26 [/SUP], Alessandro Parolari[SUP] 27 28 [/SUP]
Affiliations
- PMID: 34717007
- DOI: 10.1111/jocs.16106
Abstract
Objective: To analyze Italian Cardiac Surgery experience during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identifying risk factors for overall mortality according to coronavirus disease 2019 (COVID-19) status.
Methods: From February 20 to May 31, 2020, 1354 consecutive adult patients underwent cardiac surgery at 22 Italian Centers; 589 (43.5%), patients came from the red zone. Based on COVID-19 status, 1306 (96.5%) were negative to SARS-CoV-2 (COVID-N), and 48 (3.5%) were positive to SARS-CoV-2 (COVID-P); among the COVID-P 11 (22.9%) and 37 (77.1%) become positive, before and after surgery, respectively. Surgical procedures were as follows: 396 (29.2%) isolated coronary artery bypass grafting (CABG), 714 (52.7%) isolated non-CABG procedures, 207 (15.3%) two associate procedures, and three or more procedures in 37 (2.7%). Heart failure was significantly predominant in group COVID-N (10.4% vs. 2.5%, p = .01).
Results: Overall in-hospital mortality was 1.6% (22 cases), being significantly higher in COVID-P group (10 cases, 20.8% vs. 12, 0.9%, p < .001). Multivariable analysis identified COVID-P condition as a predictor of in-hospital mortality together with emergency status. In the COVID-P subgroup, the multivariable analysis identified increasing age and low oxygen saturation at admission as risk factors for in-hospital mortality.
Conclusion: As expected, SARS-CoV-2 infection, either before or soon after cardiac surgery significantly increases in-hospital mortality. Moreover, among COVID-19-positive patients, older age and poor oxygenation upon admission seem to be associated with worse outcomes.
Keywords: COVID-19; SARS-CoV-2; cardiac surgical procedures; emergent cardiac surgery.