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COVID-19 pandemic implications in paediatric and congenital heart surgery in Brazil

Part of: Infectious Surgery

Published online by Cambridge University Press:  06 April 2021

Leonardo A. Miana Open the ORCID record for Leonardo A. Miana [Opens in a new window] ,
Valdano Manuel Open the ORCID record for Valdano Manuel [Opens in a new window] ,
Fernando Antoniali ,
Marcelo B. Jatene  and
Fábio Biscegli Jatene
Leonardo A. Miana*
Affiliation:
Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Board of the Pediatric and Congenital Cardiovascular Surgery Department from the Brazilian Society of Cardiovascular Surgery, Catholic University (PUC), São Paulo, Brazil
Valdano Manuel
Affiliation:
Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Fernando Antoniali
Affiliation:
Board of the Pediatric and Congenital Cardiovascular Surgery Department from the Brazilian Society of Cardiovascular Surgery, Catholic University (PUC), São Paulo, Brazil
Marcelo B. Jatene
Affiliation:
Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Fábio Biscegli Jatene
Affiliation:
Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
*
Author for correspondence: Leonardo A. Miana, Heart Institute (Incor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, Av. Dr Enéias de Carvalho Aguiar, 44 – Pinheiros, Sao Paulo - Brazil. ZIP 05403-000. Tel: +55 11 2661-5399. E-mail: leonardo.miana@hc.fm.usp.br
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Abstract

Introduction:

The Coronavirus Disease 2019 (COVID-19) pandemic negatively impacted global healthcare. Consequences in Pediatric and Congenital Heart Surgery programmes and mortality of congenital heart patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) is still to be determined.

Objective:

To study the COVID-19 pandemic implications in Brazilian Pediatric and Congenital Heart Surgery programmes.

Methods:

We conducted a national online survey covering all states that perform Pediatric and Congenital Heart Surgery from 10 November to 22 November, 2020, using a Google forms questionnaire. We formulated questions related to impact on surgical volume, case-mix, and mortality. Then we asked about short-term post-operative COVID-19 infection and outcomes.

Results:

We received responses from 46 centres representing all states where there were a Pediatric and Congenital Heart Surgery programme and all high-volume centres across the country. All but one centre experienced a significant decrease in surgical volume, and 23.9% of the responders revealed less than one-quarter of volume decrement. On the other hand, in over 70% of the centres, there was a significant surgical volume reduction. In addition to this, there was a shift in case-mix in 41 centres (89.1%) towards more complex cases. More than one-third of the responders revealed increased mortality in 2020 compared to previous years, and 43.5% of the programmes (20 centres) had at least one patient contaminated by SARS-Cov-2, accounting for 48 patients. Mortality in post-operative infected patients was 45.8% (22 patients).

Conclusions:

In general, Brazilian Pediatric and Congenital Heart Surgery programmes were severely affected by decreased surgical volume, unbalanced case-mix towards more complex cases, and increased mortality. Almost half of the programmes related post-operative COVID-19 contamination with high mortality.

Keywords

SARS-CoV-2COVID-19online surveycongenital heart surgerypandemicCHD
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 1 , January 2022 , pp. 31 - 35
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Wang, C, Horby, PW, Hayden, FG, Gao, GF A novel coronavirus outbreak of global health concern. Lancet 2020; 395: 470–473.CrossRefGoogle ScholarPubMed
Zhu, N, Zhang, D, Wang, W, et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382: 727–733.CrossRefGoogle Scholar
Wang, D, Hu, B, Hu, C, et al. Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323: 1061–1069.CrossRefGoogle ScholarPubMed
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline?gclid=CjwKCAiAgJWABhArEiwAmNVTB0k2uu0IyjByBbJmvWlSRJeAF9-tg9vl7d4_4BBnkf0dhNTPP-J4WxoCLekQAvD_BwE#event-43 (accessed Jan18st, 2021).Google Scholar
Johns Hopkins – Coronavirus resource center. Available at: https://coronavirus.jhu.edu/map.html (Accessed March 27st, 2020).Google Scholar
Hillesheim, D, Tomasi, YT, Figueiró, TH, Paiva, KM Severe Acute Respiratory Syndrome due to COVID-19 among children and adolescents in Brazil: profile of deaths and hospital lethality as at Epidemiological Week 38, 2020. Epidemiol Serv Saude 2020; 29: e2020644.CrossRefGoogle ScholarPubMed
Lima, FET, Albuquerque, NLS, Florencio, SSG, et al. Time interval between onset of symptoms and COVID-19 testing in Brazilian state capitals, August 2020. Epidemiol Serv Saude 2020; 30: e2020788.CrossRefGoogle ScholarPubMed
Stephens, EH, Dearani, JA, Guleserian, KJ, et al. COVID-19: crisis management in congenital heart surgery. Ann Thorac Surg 2020; 110: 701–706.CrossRefGoogle ScholarPubMed
https://coronavirus.es.gov.br/Media/Coronavirus/NotasTecnicas/NOTA%20TECNICA%20COVID.19%20N.%2062.20%20Recomendacoes%20Cirurgias%20eletivas.pdf.Google Scholar
Rosa, RC, Rosa, RF, Zen, PR, Paskulin, GA Congenital heart defects and extracardiac malformations. Rev Paul Pediatr 2013; 31: 243–251.CrossRefGoogle ScholarPubMed
Pinto, VC Jr, Fraga Mde, N, Freitas, SM, Croti, UA Regionalization of Brazilian pediatric cardiovascular surgery. Rev Bras Cir Cardiovasc 2013; 28: 256–262.CrossRefGoogle ScholarPubMed
Protopapas, EM, Rito, ML, Vida, VL, et al. COVID-19 International Congenital Heart Surgery Taskforce. Early Impact of the COVID-19 Pandemic on Congenital Heart Surgery Programs Across the World: Assessment by a Global Multi-Societal Consortium. World J Pediatr Congenit Heart Surg 2020; 26: 2150135120949462.Google Scholar
https://www.worldometers.info/world-population/population-by-country/ (accessed Jan18st, 2021).Google Scholar
Pinto Júnior, VC, Branco, KM, Cavalcante, RC, et al. Epidemiology of congenital heart disease in Brazil. Rev Bras Cir Cardiovasc 2015; 30: 219–224. doi: 10.5935/1678-9741.20150018.Google ScholarPubMed
Miana, LA, Manuel, VM, Caneo, LF, et al. Impact of covid-19 pandemic in a pediatric and congenital cardiovascular surgery program in Brazil. Braz J Cardiovasc Surg 2021. doi: 10.21470/1678-9741-2020-0657.CrossRefGoogle Scholar
Atalay, A, Soran Türkcan, B, Taşoğluİ, İ, et al. Management of congenital cardiac surgery during COVID-19 pandemic. Cardiol Young 2020; 24: 1–9. doi: 10.1017/S1047951120002760.Google Scholar
Hiremath, CS, Yadava, OP, Meharwal, ZS, et al. COVID-19 Task Force of the Indian Association of Cardiovascular-Thoracic Surgeons. IACTS guidelines: practice of cardiovascular and thoracic surgery in the COVID-19 era. Indian J Thorac Cardiovasc Surg 2020; 36: 1–13. doi: 10.1007/s12055-020-01016-w.CrossRefGoogle Scholar
http://conselho.saude.gov.br/ultimas-noticias-cns/1537-covid-19-no-brasil-volta-a-crescer-indicando-2-onda-sem-que-primeira-tenha-terminado-conclui-live-do-cns (accessed Jan28st, 2021).Google Scholar
Wahlster, S, Sharma, M, Lewis, AK, et al. The COVID-19 pandemic’s impact on critical care resources and providers: a global survey. CHEST 2020; S0012–3692(20)34438-X.Google Scholar
Kruglikov, IL, Shah, M, Scherer, PE Obesity and diabetes as comorbidities for COVID-19: Underlying mechanisms and the role of viral–bacterial interactions. eLife 2020; 9: e61330.CrossRefGoogle ScholarPubMed
Manuel, V, Miana, LA, Guerreiro, GP, et al. Prognostic value of the preoperative neutrophil-lymphocyte ratio in patients undergoing the bidirectional Glenn procedure. J Card Surg 2020; 35: 328–334. doi: 10.1111/jocs.14381.CrossRefGoogle ScholarPubMed
Nepogodiev, D, Bhangu, A, glasbey, JC, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: an international cohort study. Lancet 2020; 396: 27–38. doi: 10.1016/S0140-6736(20)31182-X.CrossRefGoogle Scholar
Ogunjimi, M, Haiduc, AA, Harky, A Congenital heart disease and incremental risks of COVID-19. J Card Surg 2021; 36: 433–435. doi: 10.1111/jocs.15246.CrossRefGoogle ScholarPubMed
Sabatino, J, Ferrero, P, Chessa, M, et al. COVID-19 and Congenital Heart Disease: results from a Nationwide Survey. J Clin Med 2020; 9: 1774. doi: 10.3390/jcm9061774.CrossRefGoogle ScholarPubMed