Premium
The arrival of COVID‐19 in Brazil and the impact on coronary artery bypass surgery
Author(s) -
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.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15712
Subject(s) - medicine , perioperative , covid-19 , confidence interval , intensive care unit , bypass grafting , logistic regression , coronary artery bypass surgery , cardiology , receiver operating characteristic , surgery , artery , disease , infectious disease (medical specialty)
Abstract 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.