Early Epidemiological and Survival Characteristics of COVID-19 Patients Undergoing Cardiovascular Surgery

Background: World health organization (WHO) declared the novel coronavirus 2019 outbreak a pandemic on 11 March 2020. No data have been published so far regarding the COVID-19 patients undergoing cardiovascular surgery. In this study, we aimed to evaluate clinical course of patients undergoing cardiovascular surgery at the time of COVID-19 epidemic at a high-volume cardiac tertiary center.Methods: Medical files of 442 patients undergoing cardiovascular surgery were evaluated. Twenty patients (4.5%) had been diagnosed as COVID-19 cases after the surgery following getting symptomatic or detection of abnormality in laboratory results. However, 19 positive COVID-19 patients were finally investigated due to cancelation of valve surgery in one case. The patients’ clinical course and survival status were documented and analyzed.Findings: Coronary artery bypass graft (CABG) was the most type of surgery in both positive and negative COVID-19 groups. In-hospital mortality was demonstrated in 4 (21%) and 12 (2.8%) patients in positive and negative COVID-19 groups, respectively. Among expired patients in positive COVID-19 cases, one underwent valve surgery and the other 3 patients underwent CABG. Leukocytosis and lymphopenia were both present in the two survived and expired positive COVID-19 groups. However, the median of white blood cell (WBC) count and C-reactive protein (CRP) was higher in patients who expired while the percentage of lymphocyte was lower in these individuals.Interpretation:we recommend to postpone all elective surgeries till the end of the crisis and limit the surgeries to only emergency situations. For emergent cases, the patient be tested for COVID-19 and get necessary medications if highly suspected. In borderline surgical indications, especially in individuals with history of contact with any confirmed or suspected COVID-19 patients, we suggest to screen for COVID-19 before the surgery and monitor the patients closely afterward. All health-care staffs involved in any procedures use full personal protective equipment.Funding Statement: The present work was supported by Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Declaration of Interests: The authors declare no conflict of interests.Ethics Approval Statement: The study protocol was approved by local review board and ethical committee of the hospital and all authors adhered to Helsinki's statement.