Discussion:
To our knowledge, this is the first report of cardiovascular surgery
patients who have been identified as positive COVID-19 cases.
We found that patients with SARS-COV-2 who underwent surgery had 4 times
higher in-hospital mortality rate as those who did not have COVID-19
(9.4% versus 2.3%). CABG was the most type of surgery in both groups
of survived and expired positive COVID patients. In all of our patients,
as has been mentioned in the literature, lymphopenia and increased CRP
was one of the most findings 10,11.
In our center, on 5 March 2020; two weeks after the official
announcement of COVID-19 in the country by ministry of health and
medical education; the THC management team decided to implement a
special protocol for patients referring to the hospital including
suspending all elective procedures. Till the mentioned date, elective
surgeries were being performed and all 6 positive COVID-19 mortality
cases in this study, had undergone elective surgeries and they were
diagnosed as COVID-19 cases after the operation following getting
symptomatic or detection of blood test abnormalities.
After 5 March 2020, all elective surgeries were canceled according to
the hospital’s management instructions and cardiovascular surgeries were
limited to only emergency situations. Before implementing this protocol,
there were patients who were admitted at the hospital one month before
their surgery being done and they were probably infected during or after
the operation and then underwent COVID-19 testing following getting
symptomatic or development of respiratory distress.
As described before, in one of our patients, the surgery was canceled
before induction of the anesthesia, because the operation team got
suspected to COVID-19 due to the patient’s weird symptoms and his
abnormal complete blood count (CBC) findings.