The arrival of COVID‐19 in Brazil and the impact on coronary artery bypass surgery

Background and Aim of the Study This study analyzed the arrival of coronavirus disease 2019 (COVID‐19) in Brazil and its impact on coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing isolated CABG in six hospitals in Brazil were divided into two periods: pre‐COVID‐19 (March–M...

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Published in:	Journal of cardiac surgery Vol. 36; no. 9; pp. 3070 - 3077
Main Authors:	Mejia, Omar A. V., Borgomoni, Gabrielle B., Silveira, Lucas M.V., Guerreiro, Gustavo P., Falcão Filho, Alexandre. T. G., Goncharov, Maxim, Dallan, Luís R. P., Oliveira, Marco A. P., Sousa, Alexandre G., Nakazone, Marcelo A., Tiveron, Marcos G., Campagnucci, Valquíria P., Barros e Silva, Pedro G. M., Dallan, Luís A. O., Lisboa, Luiz A. F., Jatene, Fábio B.
Format:	Journal Article
Language:	English
Published:	01-09-2021
Subjects:	coronary artery bypass grafting COVID‐19 mortality outcomes
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Summary:	Background and Aim of the Study This study analyzed the arrival of coronavirus disease 2019 (COVID‐19) in Brazil and its impact on coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing isolated CABG in six hospitals in Brazil were divided into two periods: pre‐COVID‐19 (March–May 2019, N = 468) and COVID‐19 era (March–May 2020, N = 182). Perioperative data were included on a dedicated REDCap platform. Patients with clinical and tomographic criteria and/or PCR (+) for severe acute respiratory syndrome coronavirus 2 infection were considered COVID‐19 (+). Logistic regression analysis was performed to create a multiple predictive model for mortality after CABG in COVID‐19 era. Results Compared to 2019, in 2020, CABG surgeries had a 2.8‐fold increased mortality risk (95% confidence interval [CI]: 1–7.6, p = .041), patients who evolved with COVID‐19 had a 11‐fold increased mortality risk (95% CI: 2.2–54.9, p < .003), rates of morbidities and readmission to the intensive care unit. The surgical volume was decreased by 60%. The model to predict mortality after CABG in the COVID‐19 era was validated with good calibration (Hosmer–Lemeshow = 1.43) and discrimination (receiver operating characteristic = 0.78). Conclusion The COVID‐19 pandemic had an adverse impact on mortality, morbidity and volume of patients undergoing CABG.
Bibliography:	Impact of COVID‐19 arrival on CABG procedures ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0886-0440 1540-8191
DOI:	10.1111/jocs.15712