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Early Respiratory Outcomes Following Cardiac Surgery in Patients with COVID-19
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  • khosro barkhordari,
  • mohamad reza khajavi,
  • sepideh nikkhah,
  • Mahmoud Shirzad,
  • sepehr barkhordari,
  • jamshid bagheri,
  • katayun kharazemian,
  • marjan nosrati
khosro barkhordari
Tehran University of Medical Sciences
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mohamad reza khajavi
Tehran University of Medical Sciences
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sepideh nikkhah
Ministry of Health and Medical Education
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Mahmoud Shirzad
Tehran Heart Center
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sepehr barkhordari
University of California Davis
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jamshid bagheri
Tehran University of Medical Sciences
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katayun kharazemian
Tehran Heart Center
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marjan nosrati
Tehran Heart Center
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Abstract

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.

Peer review status:Published

05 May 2020Submitted to Journal of Cardiac Surgery
09 May 2020Submission Checks Completed
09 May 2020Assigned to Editor
09 May 2020Reviewer(s) Assigned
11 May 2020Review(s) Completed, Editorial Evaluation Pending
11 May 2020Editorial Decision: Revise Major
24 May 20201st Revision Received
26 May 2020Assigned to Editor
26 May 2020Submission Checks Completed
26 May 2020Reviewer(s) Assigned
03 Jun 2020Review(s) Completed, Editorial Evaluation Pending
03 Jun 2020Editorial Decision: Revise Minor
13 Jun 20202nd Revision Received
15 Jun 2020Submission Checks Completed
15 Jun 2020Assigned to Editor
15 Jun 2020Reviewer(s) Assigned
21 Jun 2020Review(s) Completed, Editorial Evaluation Pending
22 Jun 2020Editorial Decision: Accept
13 Aug 2020Published in Journal of Cardiac Surgery. 10.1111/jocs.14915