Cardiac surgery during the COVID-19 Pandemic: Fast Strategy Change in a University Center in Brazil - DATA
Description
The coronavirus disease 2019 (COVID-19) pandemic, the hardest challenge of this generation, has increased cardiovascular-related mortality worldwide. This study aimed to report how a university hospital in Brazil adopted fast changes in the cardiovascular surgery practice during the pandemic. Methods: Patients undergoing cardiac surgery during the COVID-19 pandemic in a university center and its main impact were investigated. Since the quarantine in March, only urgent surgeries were performed, setting new strategies considering the hospital context and changes in patient profiles. Results: From March 16 to June 30, 2020, 68 patients underwent major cardiac surgery at Mario Covas State Hospital. In May 13 onward, an active search for preoperative asymptomatic patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was conducted, and all scheduled surgeries for patients positive for SARS-CoV-2 were postponed. Postoperative results between negative and untested groups were observed. Similar epidemiological profile was seen in both groups, with a predominance of hypertensive male patients aged >60 years. Half of the patients were transferred from other hospitals to undergo surgery. The untested group had higher Society of Thoracic Surgeon score (p = 0.019), but both groups had similar EUROSCORE II of 3.2. Global mortality increased from 2.8% in 2019 to 4.3%, which was lower than that of other reports in Europe, USA, and New Zealand, i.e., 20%–30%. Conclusion: Postponing surgery in SARS-CoV-2-positive patients is found to be effective; however, the exact time to perform a safe cardiac surgery in patients previously infected with SARS-CoV-2 remains to be determined.
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