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Effects of COVID-19 pandemic on cardiac surgery practice in 61 Hospitals worldwide: results of a survey


Onorati, Francesco; Myers, Patrick; Bajona, Pietro; Perrotti, Andrea; Mestres, Carlos A; Quintana, Eduard (2020). Effects of COVID-19 pandemic on cardiac surgery practice in 61 Hospitals worldwide: results of a survey. Journal of Cardiovascular Surgery, 61(6):763-768.

Abstract

BACKGROUND

The aim of this study was to investigate the impact of COVID-19 infection on cardiac surgery community and practice.

METHODS

A 43-question survey was sent to cardiac surgery centers worldwide. The survey analyzed the prepandemic organization of the center, the center's response to Covid-19 in terms of re-organization pathways, surveillance methods, personal-protective equipment (PPE), and allowed surgical practice with results.

RESULTS

Sixty-one out of 64 centers (95.3%) fulfilled the survey. One third of ICUs were transformed into COVID-19 dedicated-ICUs and one-third moved to another location inside the hospital. Negative-pressure rooms were available in 60.6% centers. Informative measures from hospital administration were received after the first COVID-19 admitted case in 36.1% and during the spread of the infection inside the hospital in 19.6%. Inadequate supply of PPE was common, with no COVID-surveillance of the medical personnel in 4.9% of centers. COVID-19 infected 7.4% of staff surgeons, 8.3% of residents and 9.5% of anesthetists. Cardiac surgery caseload declined in 93.4% centers. COVID-19 infection in patients receiving cardiac surgery resulted in 41-50% mortality in 9.5% centers, and 91-100% mortality in 4.7% centers. Successful weaning with survival from veno-venous extra corporeal membrane oxygenation (ECMO) and veno-arterial ECMO was <50% in 79.2% and 80.0% centers respectively. COVID-19 infection in transplanted patients was rare, with a reported mortality of 0.5% and 1% in one center each.

CONCLUSIONS

There is room for improvement in hospital surveillance, informative measures and PPE to the personnel. These measurements will reduce current spread of COVID-19 infection among medical personnel and patients, helping the rump up of cardiac surgical practice.

Abstract

BACKGROUND

The aim of this study was to investigate the impact of COVID-19 infection on cardiac surgery community and practice.

METHODS

A 43-question survey was sent to cardiac surgery centers worldwide. The survey analyzed the prepandemic organization of the center, the center's response to Covid-19 in terms of re-organization pathways, surveillance methods, personal-protective equipment (PPE), and allowed surgical practice with results.

RESULTS

Sixty-one out of 64 centers (95.3%) fulfilled the survey. One third of ICUs were transformed into COVID-19 dedicated-ICUs and one-third moved to another location inside the hospital. Negative-pressure rooms were available in 60.6% centers. Informative measures from hospital administration were received after the first COVID-19 admitted case in 36.1% and during the spread of the infection inside the hospital in 19.6%. Inadequate supply of PPE was common, with no COVID-surveillance of the medical personnel in 4.9% of centers. COVID-19 infected 7.4% of staff surgeons, 8.3% of residents and 9.5% of anesthetists. Cardiac surgery caseload declined in 93.4% centers. COVID-19 infection in patients receiving cardiac surgery resulted in 41-50% mortality in 9.5% centers, and 91-100% mortality in 4.7% centers. Successful weaning with survival from veno-venous extra corporeal membrane oxygenation (ECMO) and veno-arterial ECMO was <50% in 79.2% and 80.0% centers respectively. COVID-19 infection in transplanted patients was rare, with a reported mortality of 0.5% and 1% in one center each.

CONCLUSIONS

There is room for improvement in hospital surveillance, informative measures and PPE to the personnel. These measurements will reduce current spread of COVID-19 infection among medical personnel and patients, helping the rump up of cardiac surgical practice.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiac Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Cardiology and Cardiovascular Medicine
Language:English
Date:December 2020
Deposited On:11 Feb 2021 13:28
Last Modified:12 Feb 2021 21:01
Publisher:Edizioni Minerva Medica
ISSN:0021-9509
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.23736/S0021-9509.20.11556-8
PubMed ID:32964896

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