ABSTRACT
Background During the coronavirus disease 2019 (COVID-19) pandemic first wave, elective coronary artery bypass graft (CABG) surgeries were postponed. However, urgent surgeries were upheld for high-risk patients. The outcomes and characteristics of patients infected by SARS-CoV-2 in the perioperative period of CABG are unknown. Methods All patients who underwent CABG in a large reference medical center in Brazil between April 2020 and May 2021 were analyzed. COVID-19 infection was confirmed by positive nasal swab PCR testing. We compared mortality, length of hospital stay and need for dialysis as outcomes among patients with and without clinical COVID-19 infection. Results Among the 303 patients who underwent urgent CABG, 30 (9.9%) were infected by SARS-CoV-2. COVID diagnosis was made within 10 days after surgery in 17 patients (56%) while only one patient (3.3%) had a pre-CABG positive test with surgery performed 16 days later. Infected and non-infected patients had similar hypertension, diabetes, dyslipidemia and previous myocardial infarction rates, as well as preoperative left ventricular ejection fraction. There were more smokers among the non-infected group (p < 0.001), and a greater rate of urgent and emergency procedures among COVID positive patients (83.3%) compared to the non-COVID group (62.3%) (p=0.026). No differences were observed with respect to type and number of grafts used. However, we found statistically significant differences in all measured outcomes. Mortality was meaningfully higher in patients infected by SARS-CoV-2 (53.3% vs 8.1%;p <0.001), as well as the need for dialysis (36.7% vs 4.4%;p 0.001). COVID-19 infection was also associated with a longer hospital stay, with a mean time of 40.5 days in the COVID group, compared to 18.2 days in non-COVID group (p=0.026). Conclusion This study showed that COVID-19 infection during hospitalization in which emergency and urgent CABG surgery had to be performed was associated with worse outcome: 6.5 greater mortality and also greater morbidity (need for dialysis and length of hospital stay) were documented in the infected compared to the non-infected group.Copyright © 2023 American College of Cardiology Foundation