Abstract The objective of this study was to describe early respiratory outcomes of asymptomatic COVID-19 patients after cardiac surgery. In this retrospective clinical study (case series) we reviewed and analyzed patient clinical data of 25 covid-19 asymptomatic patients that underwent urgent or emergent cardiac surgery between February 29 and April 10, 2020 in Tehran Heart Center Hospital. Median of age was 63 years (IQR, 52-67), Euro SCORE 7.50 (IQR, 6.5-8.5) and body mass index 26.3 (IQR, 22.5-28.6). 68% of patients had one or more comorbidities. Hypertension (56%) was the most common followed by Diabetes type 2 (40%). Off-pump cardiac surgery was done in 4 patients and on-pump on 21 patients with median CPB time of 85 minutes (IQR, 50-147.50). Median anesthesia time was 4.5 hours (IQR, 4-5). Median oxygen index and Fio2 on ventilator were 10 cmH20 (IQR, 9.5-10.5) and 0.64(IQR, 0.60-0.64) respectively. Median pao2/Fio2 was 231(IQR, 184-261). There was one case of extubation failure. The Median intubation time and length of ICU stay were 13 hours (IQR, 9.5-18) and 3 days (IQR, 2-4) respectively. Overall mortality was 16%. Readmission rate to ICU was 16% with. In this group respiratory outcome was worse with median Pao2/Fio2 84.5 (75-122), oxygen index of 4.38(IQR, 3.77-5.1) and morality rate of 75%. Conclusion: Based on the results of this study, very early post-cardiac surgery respiratory outcomes in asymptomatic COVID-19 patients are apparently smooth; nonetheless, readmission to the ICU is high. Overall respiratory outcomes are poor especially for those who readmitted to ICU.
background and aim: world health organization (WHO) declared the novel coronavirus 2019 outbreak a pandemic on 11 March 2020. No data have been published so far regarding the COVID-19 patients undergoing cardiovascular surgery. Methods: Medical files of 503 patients undergoing cardiovascular surgery were evaluated. Sixty-four patients (12.7%) was diagnosed as COVID-19 cases after the surgery following getting symptomatic or detection of abnormality in their laboratory results. The valve surgery in one positive COVID-19 case was canceled due to his abnormal laboratory finding and suspicion to COVID-19. The patients’ clinical course and survival status were documented and analyzed. Results: Coronary artery bypass graft (CABG) was the most type of surgery in both positive and negative COVID-19 groups. In-hospital mortality was demonstrated in 6 (9.4%) and 10 (2.3%) patients in positive and negative COVID-19 groups, respectively. CABG had been performed in five COVID-19 deaths while one of the expired cases underwent valve surgery. The median of white blood cell (WBC) count and C-reactive protein (CRP) was higher and the percentage of lymphocyte was lower in patients who expired. Conclusions: We recommend to postpone all elective surgeries till the end of the crisis and limit the surgeries to only emergency situations. In these cases, the patient should be screened and get necessary medications if highly suspected. In borderline surgical indications, especially in individuals with history of contact to infection, we suggest to screen for COVID-19 before the surgery and monitor the patients closely afterward. All health-care staffs should use full personal protective equipment.