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 journalArticleAcademicpeer-review


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 languageEnglish
Pages (from-to)165-173
Number of pages9
JournalJournal of Cardiac Surgery
Issue number1
Early online date30 Oct 2021
Publication statusPublished - Jan 2022


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


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