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Effect of Hospital-associated SARS-CoV-2 Infections in Cardiac Surgery. A Multicenter Study

BACKGROUND: The effect of hospital-associated SARS-CoV-2 infections in cardiac surgery patients remains poorly investigated, and current data are limited to small case series with conflicting results. METHODS: A multicenter European collaboration was organized to analyze the outcomes of patients who...

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Detalles Bibliográficos
Autores principales: Spadaccio, Cristiano, Rose, David, Candura, Dario, Lopez Marco, Ana, Cerillo, Alfredo, Stefano, Pierluigi, Nasso, Giuseppe, Ramoni, Enrico, Fattouch, Khalil, Minacapelli, Alberto, Oo, Aung Y., Speziale, Giuseppe, Shelton, Kenneth, Berra, Lorenzo, Bose, Amal, Moscarelli, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by The Society of Thoracic Surgeons 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174100/
https://www.ncbi.nlm.nih.gov/pubmed/35690139
http://dx.doi.org/10.1016/j.athoracsur.2022.05.034
Descripción
Sumario:BACKGROUND: The effect of hospital-associated SARS-CoV-2 infections in cardiac surgery patients remains poorly investigated, and current data are limited to small case series with conflicting results. METHODS: A multicenter European collaboration was organized to analyze the outcomes of patients who tested positive with hospital-associated SARS-CoV-2 infection after cardiac surgery. The study investigators hypothesized that early infection could be associated with worse postoperative outcomes; hence 2 groups were considered: (1) an early hospital-associated SARS-CoV-2 infection group comprising patients who had a positive molecular test result ≤7 days after surgery, with or without symptoms; and (2) a late hospital-associated SARS-CoV-2 infection group comprising patients whose test positivity occurred >7 days after surgery, with or without symptoms. The primary outcome was 30-day mortality. Secondary outcomes included all-cause mortality or morbidity at early follow-up and SARS-CoV-2–related hospital readmission. RESULTS: A total of 87 patients were included in the study. Of those, 30 were in the early group and 57 in the late group. Overall, 30-day mortality was 8%, and in-hospital mortality was 11.5%. The reintubation rate was 11.4%. Early infection was significantly associated with higher mortality (adjusted OR, 26.6; 95% CI, 2, 352.6; P < .01) when compared with the late group. At 6-month follow-up, survival probability was also significantly higher in the late infection group: 91% (95% CI, 83%, 98%) vs 75% (95% CI, 61%, 93%) in the early infection group (P = .036). Two patients experienced COVID-19–related rehospitalization. CONCLUSIONS: In this multicenter analysis, hospital-associated SARS-CoV-2 infection resulted in higher than expected postoperative mortality after cardiac surgery, especially in the early infection group.