Discussion:
To our knowledge, this is the first report of cardiovascular surgery patients who have been identified as positive COVID-19 cases.
We found that patients with SARS-COV-2 who underwent surgery had 4 times higher in-hospital mortality rate as those who did not have COVID-19 (9.4% versus 2.3%). CABG was the most type of surgery in both groups of survived and expired positive COVID patients. In all of our patients, as has been mentioned in the literature, lymphopenia and increased CRP was one of the most findings 10,11.
In our center, on 5 March 2020; two weeks after the official announcement of COVID-19 in the country by ministry of health and medical education; the THC management team decided to implement a special protocol for patients referring to the hospital including suspending all elective procedures. Till the mentioned date, elective surgeries were being performed and all 6 positive COVID-19 mortality cases in this study, had undergone elective surgeries and they were diagnosed as COVID-19 cases after the operation following getting symptomatic or detection of blood test abnormalities.
After 5 March 2020, all elective surgeries were canceled according to the hospital’s management instructions and cardiovascular surgeries were limited to only emergency situations. Before implementing this protocol, there were patients who were admitted at the hospital one month before their surgery being done and they were probably infected during or after the operation and then underwent COVID-19 testing following getting symptomatic or development of respiratory distress.
As described before, in one of our patients, the surgery was canceled before induction of the anesthesia, because the operation team got suspected to COVID-19 due to the patient’s weird symptoms and his abnormal complete blood count (CBC) findings.