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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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