Effect of COVID-19 on emergency CABG outcomes

Editor's Note

Though the processes of care for emergency coronary artery bypass graft (CABG) surgery were altered by the COVID-19 pandemic, patient mortality did not change for COVID-19-negative patients; however, COVID-19 positive patients did have significantly higher mortality as well as infectious complications, finds this study presented May 6 at the American Association for Thoracic Surgery 103^rd Annual Meeting in Los Angeles.

A total of 16,757 patients (16,262 COVID-19 negative; 125 COVID-19 positive less than 2 weeks before surgery; 370 COVID-19 positive more than 2 weeks before surgery) in the National COVID Cohort Collaborative and 546 pre-COVID-19 control patients in the National Surgical Quality Improvement Program database were included in the analysis.

Among the findings:

• Incidence of hospital mortality, 30-day mortality, infectious complications, and renal impairment were significantly higher in patients who were COVID-19 positive less than 2 weeks before surgery, compared to those who were COVID-19 positive more than 2 weeks before surgery and those who were COVID-19 negative.
• After propensity matching, length of stay, in-hospital death, death within 30 and 90 days of discharge, renal impairment, infectious complications, and pneumonia were significantly greater in those who were COVID-19 positive less than 2 weeks before surgery, compared to those who were COVID-19 negative.
• Length of stay and incidence of death were greater in those who were COVID-19 positive less than 2 weeks before surgery, compared to those who had COVID-19 more than 2 weeks before surgery.

The researchers concluded that equivalent mortality in COVID-19 negative patients and pre-COVID-19 patients indicates that COVID-19 associated changes in processes of care did not affect CABG outcomes. Research into optimal timing of CABG surgery after COVID-19 positivity is warranted.