Effect of Previous Coronavirus Disease 2019 Infection on Patients Undergoing Open-Heart Surgery

Objectives: This study aimed to evaluate the effects of previous coronavirus disease 2019 (COVID-19) infection on mortality, factors influencing mortality, and potential postoperative complications in on-pump cardiac surgery.
Methods: This single-center, retrospective, observational study included 233 adult patients who underwent on-pump cardiac surgery between June 2021 and February 2022. Patients with preoperative history of COVID-19 infection confirmed by nasopharyngeal swab polymerase chain reaction (PCR) test were compared to those without COVID-19 history.
Results: Patients’ mean age was 60.12±11.26 years (range, 23–81 years), and 77.3% were male. The mean time from PCR positivity to surgery was 191.11±169.9 days (median, 108 days). No between-group differences were observed in anesthesia, cross-clamp time, pump time, operative time, extubation time, length of intensive care unit and hospital stay, or mortality (p>0.05). The post-COVID-19 group had higher rates of preoperative acute neurologic events and arrhythmias, pump lactate levels, and intraoperative inotropic scores (p<0.05). These factors were not associated with survival. Postoperative pneumothorax was more frequent in the post-COVID-19 group (p=0.002) and associated with longer length of hospital stay. No significant difference was observed in preoperative, postoperative, or changes in neutrophil/lymphocyte ratio (NLR) between groups.
Conclusion: Patients with and without COVID-19 history had similar outcomes after open-heart surgery. Nevertheless, the former had increased frequency of postoperative pneumothorax and prolonged length of hospital stay. Open-heart surgery seems safe after COVID-19. However, larger, prospective studies including inflammatory markers other than NLR are needed to further investigate the potential complications.