Analysis of the influence of COVID-19 infection on the early clinical efficacy of patients undergoing single valve replacement surgery: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XU Liu , HUO Yongfeng , TIAN Lijun , ZHU Yun , XIAO Juan ,  MA Ruiyan

The Second Affiliated Hospital of Chinese People's Liberation Army Medical University, Chongqing, 400000, P. R. China;

Corresponding author：

MA Ruiyan, Email: 762602072@qq.com

Keywords：

Cardiopulmonary bypass; valve replacement; COVID-19

DOI：

10.7507/1007-4848.202308043

Video：

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Objective To explore the impact of COVID-19 infection on the early clinical efficacy of valve replacement patients. Methods The perioperative data of patients who underwent single valve replacement in our center from January to February 2023 were collected continuously. According to the COVID-19 infection situation, the patients were divided into a COVID-19 infected group and a non-infected group. The relevant data of the two groups were compared, including general situation, comorbidities, operation time, aortic occlusion time, postoperative ventilator use time, intensive care unit (ICU) stay time, myocardial enzyme profile and respiratory related complications were statistically analyzed. The primary end point of the study was the incidence of postoperative respiratory and circulatory system complications, and the secondary end point was postoperative myocardial enzyme profiles in both groups. Results A total of 136 patients were included, including 53 males and 83 females, with an average age of 53.4±10.2 years. Thirty-two patients underwent aortic valve replacement, 102 mitral valve replacement, and 2 tricuspid valve replacement.There was no significant difference in the incidence of postoperative disease between the two groups (9.09% vs. 11.43%, P=0.654), and the duration of postoperative mechanical ventilation in the novel coronavirus infection group [913.50 (465.50, 1 251.00) min vs. 1 201.00 (1 003.75,1 347.75) min, P=0.001], ICU stay time [2 (2, 3) d vs. 3 (2, 3) d, P＜0.001) was a new champions league group, the myocardial enzyme spectrum [TnI-I: 2.66(1.19, 5.65) ng/mL vs. 4.76 (2.55, 7.93) ng/mL, P=0.001; BNP: 192.00 (100.93, 314.75) pg/mL vs. 608.5 (249.75, 1150) pg/mL, P＜0.001], and the difference was statistically significant. Conclusion For single valvular disease patients undergoing elective surgery, the short-term efficacy of surgical treatment after recovery from COVID-19 infection was relatively good, and the incidence of in-hospital mortality and postoperative complications was not significantly increased.

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1. Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol, 2020, 5(11): 1265-1273.
2. Mohamed Abdel Shafi A, Hewage S, Harky A. The impact of COVID-19 on the provision of cardiac surgical services. J Card Surg, 2020, 35(6): 1295-1297.
3. 刘炫, 康盼, 江霞等. 新型冠状病毒肺炎常态化疫情防控期间胸心外科住院患者心理状态研究. 现代医药卫生, 2021, 37(21): 3688-3690.
4. 中华人民共和国国家卫生健康委员会. 新型冠状病毒感染诊疗方案(试行第十版). 中华临床感染病杂志, 2023, 16(1): 1-9.
5. 孟庆义, 李玉柱. 解析新型冠状病毒肺炎肌钙蛋白升高现象. 中国急救医学, 2020, 40(3): 218-221.
6. Gunaydin S, Stammers AH. Perioperative management of COVID-19 patients undergoing cardiac surgery with cardiopulmonary bypass. Perfusion, 2020, 35(6): 465-473.
7. Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol, 2020, 5(7): 802-810.
8. WHO Coronavirus (COVID-19) Dashboard. WHO Coronavirus (COVID-19) Dashboard with vaccination data. (2023-1-19).https:// covid19.who.int/?gclid.
9. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet, 2020, 396(10243): 27-38.
10. Zhao YM, Shang YM, Song WB, et al. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. EClinicalMedicine, 2020 Aug: 25: 100463.
11. El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 2021, 76(7): 940-946.
12. Rohatgi N, Smilowitz NR, Reejhsinghani R. Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of COVID-19. JAMA Surg, 2022, 157(3): 187-188.
13. 廖春晓, 王波, 吕筠, 等. 新型冠状病毒Omicron变异株病原学及流行病学研究进展. 中华流行病学杂志, 2022, 43(11): 1691-1698.
14. 夏锋, 陈孝平. 新冠病毒感染对外科择期手术的影响. 临床外科杂志, 2023, 31(2): 190-194.
15. 郭浩. 体外循环下心脏术后小剂量甘露醇缓慢应用临床疗效及安全性的研究. 新乡医学院, 2022.
16. Li B, Yang J, Zhao F, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol, 2020, 109(5): 531-538.
17. 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(11): 1061-1069.
18. 师艳菲, 李佩远, 黄达, 等. 血清LDH与CK-MB水平对不同类型COVID-19患者心肌损伤状况的Meta分析. 第十二届全国体育科学大会论文摘要汇编—墙报交流 (运动医学分会), 2022: 353-354.
19. El-Boghdadly K, Cook TM, Goodacre T, et al. Timing of elective surgery and risk assessment after SARS-CoV-2 infection: An update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England. Anaesthesia, 2022, 77(5): 580-587.
20. El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 2021, 76(7): 940-946.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesAnalysis of the influence of COVID-19 infection on the early clinical efficacy of patients undergoing single valve replacement surgery: A retrospective cohort study

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