RESUMEN
Background: COVID-19 is responsible for a worldwide pandemic, causing more than 18,000 deaths to date in Portugal. Data already exists regarding the increased risk of adverse events in patients with cardiovascular diseases, however the impact of SARS-CoV-2 infection in patients (P) with congenital heart disease (CHD) is still under investigation. Purpose(s): To study the impact of COVID-19 in a adult patients with CHD Methods: Adult patients seen at the CHD outpatient's clinic at a tertiary centre, who became infected with SARS-CoV-2 infection up to December 2021 were included. Assessment of patients' symptoms, need for hospitalization and admission in an intensive care unit was assessed based on medical records. Result(s): We identified seventy-nine patients (pts) with COVID-19 infection. Symptoms were present in 67 (84%). The median age was 44 (15) years, 52% were females. Eight P (10%) had complex cyanotic disease;seven Tetralogy of Fallot;five (6%) transposition of great arteries;eight (10%) right ventricle obstacle;two (3%) atrioventricular canal defect;sixteen (20%) atrial septal defect;nine (11%) ventricular septal defect;eight (10%) aortic coarctation;two (3%) had Eisenmenger syndrome. 49% of P had previous surgery or percutaneous procedure. 63% of P were at New York Heart Association (NYHA) class of I and 30% at NYHA II. Mild symptoms were reported by 56 P (71%). Ten adults (7,9%) experienced moderate symptoms (dyspnea and hypoxia) that led to hospitalization for oxygen therapy, none required mechanical ventilation. One death was reported in an 83-year-old patient with non-corrected interventricular communication and compromised biventricular function. There was a significant association between the gravity of CHD and hospitalizations (p=0.02). Conclusion(s): Our pts had mainly mild to moderate symptoms and did not appear to have a disproportionately negative outcome;the need for hospitalization was more frequent in patients with higher CHD gravity. These findings are in line with the emerging data regarding COVID-19 in CHD P, and may be in part explained by the patient's young age and functional status.
RESUMEN
Introduction & Objectives: In response to the COVID-19 pandemic, hospitals had to reorganize, and sanitation measures were reinforced. Some of these procedures have been shown to lower the rate of hospital acquired infections, and as a result, we hypothesise that the occurrence of postoperative infection during the pandemic would be lower. The objective of this study is to compare the rate of post-operative infections and patterns of antimicrobial resistance before and during the pandemic in Urology departments. Materials & Methods: An observational retrospective cohort study was carried out in two centers in Portugal. Data from all elective surgical procedures between April and June 2018 and the homologous period in 2020 were collected. Outpatient and non-elective surgeries were excluded. Patient data included age, sex, post-operative in-hospital length of stay, American Society of Anaesthesiologist (ASA) score, type of procedure, antibiotic prophylaxis, pre-operative urine cultures, peri-operative use of medical devices, post-operative infections, microbial culture and antimicrobial susceptibility testing. Infection was defined according to the European Centre for Disease Prevention and Control (ECDC) protocol. Multidrug resistant (MDR) organism was defined asa microorganism resistant toone or more classes of antimicrobial agents tested. Main outcomes were the number of post-operative infections during the pandemic and the number of MDR isolates. Results: Baseline characteristis are presented in Table 1. The post-operative infection rate during the pre-pandemic period was of 14.1% compared to 12.1% during the pandemic (p=0.494). Ninety two percent of isolates were MDR in the pre-pandemic period compared to 52 % during the pandemic (p=0.002). The pandemic period was associated with a reduced risk for MDR isolate's on multivariate logistic regression analysis (OR - 0.1;95% CI:0.07 - 0.57;p=0.010), but not with reduced number of infections (OR - 0.84;95% CI 0.53-1.34;p=0.47). (Table presented.) Conclusions: MDR isolates were lower during the pandemic in Urology wards, possibly as an indirect result of COVID-19 preventive measures, such as increased hand hygiene, room disinfection and reduced family visits to inpatients. No statistically significant difference was found between the number of post-operative infections in our sample. Further reports, such as those from the ECDC are needed to confirm our results.