Clinical Course of COVID-19 Infection in Patients Urgently Operated of Cardiac Surgical Procedures
Authors/Creators
- 1. Department of Universitary Cardiac Surgery and Translational Research, IRCCS Policlinico San Donato, San Donato Milanese.
Description
Dataset from the article Garatti A, Castelvecchio S, Daprati A, Molfetta R, Volpe M, De Vincentiis C, Parolari A, Menicanti L. Clinical Course of COVID-19 Infection in Patients Urgently Operated of Cardiac Surgical Procedures. Ann Surg. 2020 Oct;272(4):e275-e279. doi: 10.1097/SLA.0000000000004393. PMID: 32932327.
Abstract
Objective: The aim of this study was to describe the clinical course of a consecutive series of patients operated of urgent cardiac surgery during COVID-19 outbreak.
Background: In Italy, COVID outbreak has mostly occurred in the metropolitan area of Milan, and in the surrounding region of Lombardy, and previously "conventional" hospitals were converted into COVID spokes to increase ICU beds availability, and to allow only urgent CS procedures.
Methods: Among urgent CS patients (left main stenosis with unstable angina, acute endocarditis, valvular regurgitation with impending heart failure), 10 patients (mean age = 57 ± 9 years), despite a negative admission triage, developed COVID-pneumonia postoperatively, at a median of 7 days after CS.
Results: Patients showed typical lymphopenia, higher prothrombotic profile, and higher markers of inflammation (ferritin and interleukin-6 values). At the zenith of pulmonary distress, patients presented with severe hypoxia (median PaO2/FIO2 ratio = 116), requiring advanced noninvasive ventilation (Venturi mask and continuous positive airway pressure) in the majority of cases. All patients were treated with hydroxychloroquine, azithromycin, and low-molecular-weight heparin at anticoagulant dose. Overall in-hospital mortality was 10% (1/10), peaking 25% in patients who developed COVID pneumonia immediately after CS. The remaining patients, with late infection, were all discharged home without oxygen support, at a median of 25 days after symptom onset.
Conclusions: As postoperative mortality in case of COVID pneumonia is not negligible, meticulous rules (precise triage, safe hospital path, high level of protection for health-care teams, prompt diagnosis of suspicious symptoms) should be strictly followed in patients undergoing CS during COVID pandemic. The role of therapies alternative to CS should be further assessed.
Files
Restricted
The record is publicly accessible, but files are restricted. Log in to check if you have access.
Request access
If you would like to request access to these files, please fill out the form below.
You need to satisfy these conditions in order for this request to be accepted:
These data are available upon duly motivated request to the corresponding author of the article
You are currently not logged in. Do you have an account? Log in here