Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery

G. Bonalumi; A.P. Casado; A. Barbone; A. Garatti; A. Colli; I. Giambuzzi; L. Torracca; G. Ravenni; G. Folesani; G. Murara; A. Pantaleo; M. Piciche; E. Villa; F. Ferraro; I. Vendramin; U. Livi; A. Montalto; F. Musumeci; V. Tarzia; C. Trumello; M. De Bonis; V. Margari; D. Paparella; A. Salsano; F. Santini; S. Nicolardi; F. Patane; L. Mammana; E.C. Stura; M. Rinaldi; F. Massi; M. Triggiani; V. Grazioli; L. Giroletti; A. Rubino; M. De Feo; A. Audo; T. Regesta; F. Barili; G. Gerosa; M. Di Mauro; A. Parolari

doi:10.1111/jocs.16106

Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery

G. Bonalumi^*, A.P. Casado, A. Barbone, A. Garatti, A. Colli, I. Giambuzzi, L. Torracca, G. Ravenni, G. Folesani, G. Murara, A. Pantaleo, M. Piciche, E. Villa, F. Ferraro, I. Vendramin, U. Livi, A. Montalto, F. Musumeci, V. Tarzia, C. TrumelloM. De Bonis, V. Margari, D. Paparella, A. Salsano, F. Santini, S. Nicolardi, F. Patane, L. Mammana, E.C. Stura, M. Rinaldi, F. Massi, M. Triggiani, V. Grazioli, L. Giroletti, A. Rubino, M. De Feo, A. Audo, T. Regesta, F. Barili, G. Gerosa, M. Di Mauro, A. Parolari

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	165-173
Number of pages	9
Journal	Journal of Cardiac Surgery
Volume	37
Issue number	1
Early online date	30 Oct 2021
DOIs	https://doi.org/10.1111/jocs.16106
Publication status	Published - Jan 2022

Keywords

cardiac surgical procedures
COVID-19
emergent cardiac surgery
SARS-CoV-2
INFECTION

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10.1111/jocs.16106

Cite this

Bonalumi, G., Casado, A. P., Barbone, A., Garatti, A., Colli, A., Giambuzzi, I., Torracca, L., Ravenni, G., Folesani, G., Murara, G., Pantaleo, A., Piciche, M., Villa, E., Ferraro, F., Vendramin, I., Livi, U., Montalto, A., Musumeci, F., Tarzia, V., ... Parolari, A. (2022). Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery. Journal of Cardiac Surgery, 37(1), 165-173. https://doi.org/10.1111/jocs.16106

@article{e1fb9b8587014596954bd19db7dfb7cf,

title = "Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery",

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 = "cardiac surgical procedures, COVID-19, emergent cardiac surgery, SARS-CoV-2, INFECTION",

author = "G. Bonalumi and A.P. Casado and A. Barbone and A. Garatti and A. Colli and I. Giambuzzi and L. Torracca and G. Ravenni and G. Folesani and G. Murara and A. Pantaleo and M. Piciche and E. Villa and F. Ferraro and I. Vendramin and U. Livi and A. Montalto and F. Musumeci and V. Tarzia and C. Trumello and {De Bonis}, M. and V. Margari and D. Paparella and A. Salsano and F. Santini and S. Nicolardi and F. Patane and L. Mammana and E.C. Stura and M. Rinaldi and F. Massi and M. Triggiani and V. Grazioli and L. Giroletti and A. Rubino and {De Feo}, M. and A. Audo and T. Regesta and F. Barili and G. Gerosa and {Di Mauro}, M. and A. Parolari",

note = "Funding Information: The authors received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

year = "2022",

month = jan,

doi = "10.1111/jocs.16106",

language = "English",

volume = "37",

pages = "165--173",

journal = "Journal of Cardiac Surgery",

issn = "0886-0440",

publisher = "Wiley",

number = "1",

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Bonalumi, G, Casado, AP, Barbone, A, Garatti, A, Colli, A, Giambuzzi, I, Torracca, L, Ravenni, G, Folesani, G, Murara, G, Pantaleo, A, Piciche, M, Villa, E, Ferraro, F, Vendramin, I, Livi, U, Montalto, A, Musumeci, F, Tarzia, V, Trumello, C, De Bonis, M, Margari, V, Paparella, D, Salsano, A, Santini, F, Nicolardi, S, Patane, F, Mammana, L, Stura, EC, Rinaldi, M, Massi, F, Triggiani, M, Grazioli, V, Giroletti, L, Rubino, A, De Feo, M, Audo, A, Regesta, T, Barili, F, Gerosa, G, Di Mauro, M & Parolari, A 2022, 'Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery', Journal of Cardiac Surgery, vol. 37, no. 1, pp. 165-173. https://doi.org/10.1111/jocs.16106

TY - JOUR

T1 - Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery

AU - Bonalumi, G.

AU - Casado, A.P.

AU - Barbone, A.

AU - Garatti, A.

AU - Colli, A.

AU - Giambuzzi, I.

AU - Torracca, L.

AU - Ravenni, G.

AU - Folesani, G.

AU - Murara, G.

AU - Pantaleo, A.

AU - Piciche, M.

AU - Villa, E.

AU - Ferraro, F.

AU - Vendramin, I.

AU - Livi, U.

AU - Montalto, A.

AU - Musumeci, F.

AU - Tarzia, V.

AU - Trumello, C.

AU - De Bonis, M.

AU - Margari, V.

AU - Paparella, D.

AU - Salsano, A.

AU - Santini, F.

AU - Nicolardi, S.

AU - Patane, F.

AU - Mammana, L.

AU - Stura, E.C.

AU - Rinaldi, M.

AU - Massi, F.

AU - Triggiani, M.

AU - Grazioli, V.

AU - Giroletti, L.

AU - Rubino, A.

AU - De Feo, M.

AU - Audo, A.

AU - Regesta, T.

AU - Barili, F.

AU - Gerosa, G.

AU - Di Mauro, M.

AU - Parolari, A.

PY - 2022/1

Y1 - 2022/1

N2 - 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.

AB - 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.

KW - cardiac surgical procedures

KW - COVID-19

KW - emergent cardiac surgery

KW - SARS-CoV-2

KW - INFECTION

U2 - 10.1111/jocs.16106

DO - 10.1111/jocs.16106

M3 - Article

C2 - 34717007

SN - 0886-0440

VL - 37

SP - 165

EP - 173

JO - Journal of Cardiac Surgery

JF - Journal of Cardiac Surgery

IS - 1

ER -