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Coronavirus disease 2019 convalescent children: outcomes after congenital heart surgery

Part of: Infectious

Published online by Cambridge University Press:  28 October 2021

Shreedhar S. Joshi Open the ORCID record for Shreedhar S. Joshi [Opens in a new window] ,
Manaswini Keshava ,
Keshava S. Murthy ,
Ganesh Sambandamoorthy ,
Riyan Shetty ,
Balasubramanian Shanmugasundaram ,
Sudesh Prabhu Open the ORCID record for Sudesh Prabhu [Opens in a new window] ,
Rajesh Hegde  and
Vijay S. Richard
Shreedhar S. Joshi*
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Manaswini Keshava
Affiliation:
M S Ramaiah Medical College, Bangalore, India
Keshava S. Murthy
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Ganesh Sambandamoorthy
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Riyan Shetty
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Balasubramanian Shanmugasundaram
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Sudesh Prabhu
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bangalore, India
Rajesh Hegde
Affiliation:
Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India
Vijay S. Richard
Affiliation:
Department of Hospital Infection Control, Narayana Institute of Cardiac Sciences, Bangalore, India
*
Author for correspondence: Dr S. S. Joshi, MD., DM., FCA., FTEE (EACVI, NBE), Senior Consultant Cardiac Anaesthesia, Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bangalore, India. Tel: +91-9740067381. E-mail: shreedhar.8181@gmail.com
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Abstract

Background:

Children with exposure to coronavirus disease 2019 in recent times (asymptomatic or symptomatic infection) approaching congenital heart surgery programme are in increasing numbers. Understanding outcomes of such children will help risk-stratify and guide optimisation prior to congenital heart surgery.

Objective:

The objective of the present study was to determine whether convalescent coronavirus disease 2019 children undergoing congenital heart surgery have any worse mortality or post-operative outcomes.

Design:

Consecutive children undergoing congenital heart surgery from Oct 2020 to May 2021 were enrolled after testing for reverse transcription-polymerase chain reaction or rapid antigen test and immunoglobulin G antibody prior to surgery. Convalescent coronavirus disease 2019 was defined in any asymptomatic patient positive for immunoglobulin G antibodies and negative for reverse transcription-polymerase chain reaction or rapid antigen test anytime 6 weeks prior to surgery. Control patients were negative for any of the three tests. Mortality and post-operative outcomes were compared among the groups.

Results:

One thousand one hundred and twenty-nine consecutive congenital heart surgeries were stratified as convalescence and control. Coronavirus disease 2019 Convalescent (n = 349) and coronavirus disease 2019 control (n = 780) groups were comparable for all demographic and clinical factors except younger and smaller kids in control. Convalescent children had no higher mortality, ventilation duration, ICU and hospital stay, no higher support with extracorporeal membrane oxygenation, high flow nasal cannula, no higher need for re-intubations, re-admissions, and no higher infections as central line-associated bloodstream infection, sternal site infection, and ventilator-associated pneumonia on comparison with coronavirus disease 2019 control children.

Conclusions:

Convalescent coronavirus disease 2019 does not have any unfavourable outcomes as compared to coronavirus disease 2019 control children. Positive immunoglobulin G antibody screening prior to surgery is suggestive of convalescence and supports comparable outcomes on par with control peers.

Keywords

Coronavirus disease 2019 convalescent childrencongenital heart surgerylong coronavirus disease 2019 childrencoronavirus disease 2019 cardiopulmonary bypasscoronavirus disease 2019 heart lung
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 9 , September 2022 , pp. 1469 - 1474
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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