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Stuck Between a Rock and a Hard Place: The Clinical Conundrum of Managing Cardiac Surgical Patients During the SARS-CoV-2 Pandemic
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  • Nitish Dhingra ,
  • Subodh Verma,
  • Terrence Yau,
  • Bobby Yanagawa ,
  • Makoto Hibino
Nitish Dhingra
University of Toronto
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Subodh Verma
University of Toronto
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Terrence Yau
Toronto General Hospital
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Bobby Yanagawa
University of Toronto
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Makoto Hibino
University of Toronto
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Abstract

Deferring non-emergent cardiac surgery became the strategy of choice for several international healthcare systems afflicted by high case burdens of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) in order to both conserve valuable healthcare resources and protect patients from possible exposure. Missing from the available dataset to help guide policy development has been a clear understanding of the extent to which COVID-19 infection modulates cardiac surgery outcomes. In their investigation, Bonalumi and colleagues uncovered an inpatient COVID-19 positivity rate of almost 10 times higher than that of the general Italian population, as well as a mortality rate over 20 times higher amongst cardiac surgery patients with perioperative COVID-19 infection compared to those COVID-negative. While the summation of available evidence points to the serious consideration cardiac surgeons must give to delaying surgeries during the COVID-19 pandemic, recognition must be given to the risks that postponing cardiac surgery may have on patient outcomes. Emerging data is beginning to demonstrate the efficacy of vaccination in preventing postoperative COVID-19 infection and morbidity.

Peer review status:Published

18 Oct 2021Submitted to Journal of Cardiac Surgery
18 Oct 2021Assigned to Editor
18 Oct 2021Submission Checks Completed
18 Oct 2021Editorial Decision: Accept
Jan 2022Published in Journal of Cardiac Surgery volume 37 issue 1 on pages 174-175. 10.1111/jocs.16111