Research Article
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Year 2022, Volume: 8 Issue: 2, 290 - 295, 04.03.2022
https://doi.org/10.18621/eurj.1066783

Abstract

References

  • 1. Haft JW, Atluri P, Ailawadi G, Engelman DT, Grant MC, Hassan A, et al. Society of ThoracicSurgeons COVID-19 Task Force and the Work force for Adult Cardiac and Vascular Surgery. Adult cardiac surgery during the COVID-19 pandemic: a tiered patient triage guidance statement. Ann Thorac Surg 2020;110:697-700.
  • 2. Niknam J, Rong LQ. Asymptomatic patients with coronavirus disease and cardiac surgery: when should you operate? J Card Surg 2020;35:2486-8.
  • 3. Karaca U, Ata F, Yilmaz C, Balkaya AN, Onur T. Evaluation of anesthetic approaches to surgical patients during early COVID-19 pandemic. Eur Res J 2022;8:91-7.
  • 4. Uysal A, Erturk E, Abacilar AF, Duman U, Dogan OF. The outcomes of patients incidentally confirmed with COVID-19 after cardiac surgery. Heart Surg Forum 2021;24:E940-6.
  • 5. Barkhordari K, Khajavi MR, Bagheri J, Nikkhah S, Shirzad M, Barkhordari S, et al. Early respiratory outcomes following cardiac surgery in patients with COVID-19. J Card Surg 2020;35:2479-85.
  • 6. Ata F, As AK, Engin M, Kat NK, Ata Y, Turk T. Can blood urea nitrogen-to-albumin ratio predict mortality in patients with moderate-to-severe COVID-19 pneumonia hospitalized in the intensive care unit? Rev Assoc Med Bras (1992) 2021;67:1421-6.
  • 7. Al-Balas M, Al-Balas HI, Al-Balas H. Surgery during the COVID-19 pandemic: a comprehensive overview and perioperative care. Am J Surg 2020;219:903-6.
  • 8. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020;323:1843-4.
  • 9. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al., Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis 2020;34:101623.
  • 10. Engin M, Aydın U, Eskici H, Ata Y, Türk T. Type 1 acute aortic dissection in the early period after COVID-19 infection. Cureus 2021;13:e13751.
  • 11. Yates MT, Balmforth D, Lopez-Marco A, Uppal R, Oo AY. Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31:483-5.
  • 12. As AK, Erdolu B, Duman B, Yazgan E, Eris C, Aydin U, et al. Can a modified-simplified pulmonary embolism severity index (m-sPESI) be used to predict the need for intensive care in hospitalized COVID-19 patients? J Thromb Thrombolysis 2021;52:759-65.
  • 13. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
  • 14. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
  • 15. Ad N, Luc JGY, Nguyen TC. COVID-19 North American Cardiac Surgery Survey Working Group. Cardiac surgery in North America and coronavirus disease 2019 (COVID-19): Regional variability in burden and impact. J Thorac Cardiovasc Surg 2021;162:893-903.e4.
  • 16. Fattouch K, Corrao S, Augugliaro E, Minacapelli A, Nogara A, Zambelli G, et al. Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): a case-series report. J Thorac Cardiovasc Surg 2022;163:1085-92.e3.
  • 17. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine 2020;21:100331.
  • 18. Patel V, Jimenez E, Cornwell L, Tran T, Paniagua D, Denktas AE, et al. Cardiac surgery during the coronavirus disease 2019 pandemic: perioperative considerations and triage recommendations. J Am Heart Assoc 2020;9:e017042.

Management of the early postoperative PCR positive patients in the COVID-19 pandemic: cardiac surgeon's nightmare

Year 2022, Volume: 8 Issue: 2, 290 - 295, 04.03.2022
https://doi.org/10.18621/eurj.1066783

Abstract

Objectives: In the last 2 years with the new type of coronavirus infection (COVID-19) pandemic, it has become inevitable to adapt to this disease in cardiovascular surgery procedures. In this study, we aimed to investigate the effects of the results of respiratory tract samples taken from different places in patients undergoing cardiac surgery on our postoperative patient follow-up procedures and to share our cardiac surgery experiences during the pandemic period.

Methods: A total of 177 patients who underwent cardiac surgery were included in this study. Endobronchial lavage samples were obtained from the intubated patients through the endotracheal tube in the early postoperative period. According to the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) results obtained in the early postoperative period, the patients were divided into 2 groups as Group 1 for those with negative PCR and Group 2 for those with positive PCR. After that a total of 59 patients who were found to have COVID-19 were divided into 2 groups as survivors and non-survivors.

Results: There were 118 (66.6%) patients in Group 1 and 59 (33.3%) in Group 2. The mean ages of patients in Group 1 and Group 2 were 64.5 ± 9.8 years and 61.9 ± 10.1 years, respectively (p = 0.174). Mortality was significantly higher in Group 2 (n = 24, 40.6%) compared Group 1 (n = 2, 1.6%) (p < 0.001). After that a total of 59 patients who were found to have COVID-19 were divided into 2 groups as survivors (n = 35, 59.3%) and non-survivors (n = 24, 40.7%). There was no statistically significant difference between the groups in terms of gender, smoking, diabetes mellitus, hypertension, chronic renal failure, chronic obstructive pulmonary diseas rates and surgery types (p > 0.05).


Conclusions: The COVID-19 pandemic has significantly affected our cardiovascular surgery practice. In addition to being negative for PCR at least 2 times in routine preoperative preparations, obtaining endobronchial lavage samples for PCR testing from the endotracheal tube in the early postoperative period plays an important role in patient management.

References

  • 1. Haft JW, Atluri P, Ailawadi G, Engelman DT, Grant MC, Hassan A, et al. Society of ThoracicSurgeons COVID-19 Task Force and the Work force for Adult Cardiac and Vascular Surgery. Adult cardiac surgery during the COVID-19 pandemic: a tiered patient triage guidance statement. Ann Thorac Surg 2020;110:697-700.
  • 2. Niknam J, Rong LQ. Asymptomatic patients with coronavirus disease and cardiac surgery: when should you operate? J Card Surg 2020;35:2486-8.
  • 3. Karaca U, Ata F, Yilmaz C, Balkaya AN, Onur T. Evaluation of anesthetic approaches to surgical patients during early COVID-19 pandemic. Eur Res J 2022;8:91-7.
  • 4. Uysal A, Erturk E, Abacilar AF, Duman U, Dogan OF. The outcomes of patients incidentally confirmed with COVID-19 after cardiac surgery. Heart Surg Forum 2021;24:E940-6.
  • 5. Barkhordari K, Khajavi MR, Bagheri J, Nikkhah S, Shirzad M, Barkhordari S, et al. Early respiratory outcomes following cardiac surgery in patients with COVID-19. J Card Surg 2020;35:2479-85.
  • 6. Ata F, As AK, Engin M, Kat NK, Ata Y, Turk T. Can blood urea nitrogen-to-albumin ratio predict mortality in patients with moderate-to-severe COVID-19 pneumonia hospitalized in the intensive care unit? Rev Assoc Med Bras (1992) 2021;67:1421-6.
  • 7. Al-Balas M, Al-Balas HI, Al-Balas H. Surgery during the COVID-19 pandemic: a comprehensive overview and perioperative care. Am J Surg 2020;219:903-6.
  • 8. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020;323:1843-4.
  • 9. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al., Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis 2020;34:101623.
  • 10. Engin M, Aydın U, Eskici H, Ata Y, Türk T. Type 1 acute aortic dissection in the early period after COVID-19 infection. Cureus 2021;13:e13751.
  • 11. Yates MT, Balmforth D, Lopez-Marco A, Uppal R, Oo AY. Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31:483-5.
  • 12. As AK, Erdolu B, Duman B, Yazgan E, Eris C, Aydin U, et al. Can a modified-simplified pulmonary embolism severity index (m-sPESI) be used to predict the need for intensive care in hospitalized COVID-19 patients? J Thromb Thrombolysis 2021;52:759-65.
  • 13. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
  • 14. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
  • 15. Ad N, Luc JGY, Nguyen TC. COVID-19 North American Cardiac Surgery Survey Working Group. Cardiac surgery in North America and coronavirus disease 2019 (COVID-19): Regional variability in burden and impact. J Thorac Cardiovasc Surg 2021;162:893-903.e4.
  • 16. Fattouch K, Corrao S, Augugliaro E, Minacapelli A, Nogara A, Zambelli G, et al. Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): a case-series report. J Thorac Cardiovasc Surg 2022;163:1085-92.e3.
  • 17. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine 2020;21:100331.
  • 18. Patel V, Jimenez E, Cornwell L, Tran T, Paniagua D, Denktas AE, et al. Cardiac surgery during the coronavirus disease 2019 pandemic: perioperative considerations and triage recommendations. J Am Heart Assoc 2020;9:e017042.
There are 18 citations in total.

Details

Primary Language English
Subjects Cardiovascular Surgery
Journal Section Original Articles
Authors

Ahmet Kağan As 0000-0001-8098-4393

Senol Yavuz 0000-0001-5246-0808

Publication Date March 4, 2022
Submission Date February 1, 2022
Acceptance Date February 16, 2022
Published in Issue Year 2022 Volume: 8 Issue: 2

Cite

AMA As AK, Yavuz S. Management of the early postoperative PCR positive patients in the COVID-19 pandemic: cardiac surgeon’s nightmare. Eur Res J. March 2022;8(2):290-295. doi:10.18621/eurj.1066783

e-ISSN: 2149-3189 


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