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

J Cardiovasc Surg (Torino). 2020 Dec;61(6):763-768. doi: 10.23736/S0021-9509.20.11556-8. Epub 2020 Sep 23.

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.

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • Cardiac Surgical Procedures / statistics & numerical data*
  • Hospitals
  • Humans
  • Infection Control / organization & administration*
  • Pandemics
  • Patient Selection
  • Personal Protective Equipment
  • Procedures and Techniques Utilization
  • SARS-CoV-2
  • Surveys and Questionnaires