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Published on: September 15, 2023
Coronary artery bypass grafting in active or recent COVID-19 infection: a systematic review
Rajat Agarwal1, Shiv Mudgal2, Amiy Arnav3
1Department of Cardiothoracic Surgery, All India Institute of Medical Sciences (AIIMS) Deoghar, PTI Campus, Jasidih, Deoghar, 814142 Jharkhand India.
Insights
Outcomes for patients undergoing coronary artery bypass grafting (CABG) after coronavirus disease-2019 (COVID-19) infection are influenced by the timing of surgery. Delaying CABG post-COVID-19 diagnosis may reduce mortality risk and lead to comparable outcomes to non-infected patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Cardiac surgery, including coronary artery bypass grafting (CABG), has demonstrated poor outcomes in patients with coronavirus disease-2019 (COVID-19).
- Limited studies exist on CABG outcomes in COVID-19 patients, necessitating a comprehensive review.
Purpose of the Study:
- To systematically review and determine the outcomes of COVID-19 patients who underwent CABG.
- To analyze the impact of the timing of CABG relative to COVID-19 diagnosis on patient outcomes.
Main Methods:
- A systematic review of studies published between December 2019 and October 2022 from PubMed, DOAJ, and Google Scholar.
- Data extraction on clinical profiles and outcomes from 12 eligible studies involving 99 patients.
- Quality assessment of included studies using a standardized tool.
Main Results:
- A total of 99 patients undergoing CABG within 30 days of COVID-19 infection were analyzed.
- Postoperative complications occurred in 76 patients, with 11 deaths reported.
- Median mechanical ventilation, ICU, and hospital stays were 0.9, 4.5, and 12.5 days, respectively.
Conclusions:
- Increasing the time between COVID-19 diagnosis and CABG surgery is associated with reduced mortality risk.
- Postoperative outcomes for COVID-19 patients undergoing CABG were comparable to high-risk, non-COVID-19 urgent/emergent CABG patients.
Introduction:
Even though there have been few studies on coronary artery bypass grafting (CABG), data on patients with coronavirus disease-2019 (COVID-19) infection show that cardiac surgery has poor outcomes in this subset. From the available studies in the literature, we conducted a systematic review with the aim of determining the outcome of COVID-19 patients who underwent CABG.
Methods:
Between December 2019 and October 2022, searches were conducted in PubMed, the Directory of Open Access Journals, and Google Scholar to find studies reporting results of COVID-19 patients undergoing CABG. We extracted data on the clinical profile and outcomes of the patients from the eligible studies. The quality of the studies was assessed using a standardised tool.
Results:
The total sample size across the 12 included studies was 99 patients who underwent CABG in active disease or within 30 days of COVID-19 infection. The median and interquartile range (IQR) for the length of time spent on a mechanical ventilator, stay in the intensive care unit (ICU), and the total hospital stay were 0.9 (0.47-2), 4.5 (2.5-8), and 12.5 (8.5-22.5) days respectively. Seventy-six patients developed postoperative complications, and there were eleven deaths.
Conclusion:
The findings of the present study indicate that mortality risk goes down when the time between COVID-19 diagnosis and surgery increases. When compared to data from other high-risk urgent or emergent CABG patients around the world who were not infected with COVID-19, patients who underwent CABG in the COVID-19 subgroup had similar postoperative outcomes.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s12055-023-01495-7.
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