Clinical Course of COVID-19 Infection in Patients Urgently Operated of Cardiac Surgical Procedures.
Identifieur interne : 000780 ( Main/Exploration ); précédent : 000779; suivant : 000781Clinical Course of COVID-19 Infection in Patients Urgently Operated of Cardiac Surgical Procedures.
Auteurs : Andrea Garatti [Italie] ; Serenella Castelvecchio ; Andrea Daprati ; Raffaella Molfetta ; Marianna Volpe ; Carlo De Vincentiis ; Alessandro Parolari ; Lorenzo MenicantiSource :
- Annals of surgery [ 1528-1140 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Appréciation des risques (MeSH), Complications postopératoires (physiopathologie), Complications postopératoires (épidémiologie), Femelle (MeSH), Hospitalisation (statistiques et données numériques), Humains (MeSH), Infection croisée (prévention et contrôle), Infections à coronavirus (prévention et contrôle), Infections à coronavirus (épidémiologie), Italie (MeSH), Mortalité hospitalière (tendances), Mâle (MeSH), Pandémies (prévention et contrôle), Pneumopathie virale (prévention et contrôle), Pneumopathie virale (épidémiologie), Procédures de chirurgie cardiaque (mortalité), Procédures de chirurgie cardiaque (méthodes), Procédures de chirurgie cardiaque (statistiques et données numériques), Prévention des infections (méthodes), Sujet âgé (MeSH), Unités de soins intensifs (statistiques et données numériques), Urgences (MeSH), Épidémies de maladies (statistiques et données numériques).
- MESH :
- mortalité : Procédures de chirurgie cardiaque.
- méthodes : Procédures de chirurgie cardiaque, Prévention des infections.
- physiopathologie : Complications postopératoires.
- prévention et contrôle : Infection croisée, Infections à coronavirus, Pandémies, Pneumopathie virale.
- statistiques et données numériques : Hospitalisation, Procédures de chirurgie cardiaque, Unités de soins intensifs, Épidémies de maladies.
- tendances : Mortalité hospitalière.
- épidémiologie : Complications postopératoires, Infections à coronavirus, Pneumopathie virale.
- Adulte d'âge moyen, Appréciation des risques, Femelle, Humains, Italie, Mâle, Sujet âgé, Urgences.
- Wicri :
- geographic : Italie.
English descriptors
- KwdEn :
- Aged (MeSH), Cardiac Surgical Procedures (methods), Cardiac Surgical Procedures (mortality), Cardiac Surgical Procedures (statistics & numerical data), Coronavirus Infections (epidemiology), Coronavirus Infections (prevention & control), Cross Infection (prevention & control), Disease Outbreaks (statistics & numerical data), Emergencies (MeSH), Female (MeSH), Hospital Mortality (trends), Hospitalization (statistics & numerical data), Humans (MeSH), Infection Control (methods), Intensive Care Units (statistics & numerical data), Italy (MeSH), Male (MeSH), Middle Aged (MeSH), Outcome Assessment, Health Care (MeSH), Pandemics (prevention & control), Pneumonia, Viral (epidemiology), Pneumonia, Viral (prevention & control), Postoperative Complications (epidemiology), Postoperative Complications (physiopathology), Risk Assessment (MeSH).
- MESH :
- geographic : Italy.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Postoperative Complications.
- methods : Cardiac Surgical Procedures, Infection Control.
- mortality : Cardiac Surgical Procedures.
- physiopathology : Postoperative Complications.
- prevention & control : Coronavirus Infections, Cross Infection, Pandemics, Pneumonia, Viral.
- statistics & numerical data : Cardiac Surgical Procedures, Disease Outbreaks, Hospitalization, Intensive Care Units.
- trends : Hospital Mortality.
- Aged, Emergencies, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Risk Assessment.
Abstract
OBJECTIVE
The aim of this study was to describe the clinical course of a consecutive series of patients operated of urgent cardiac surgery during COVID-19 outbreak.
BACKGROUND
In Italy, COVID outbreak has mostly occurred in the metropolitan area of Milan, and in the surrounding region of Lombardy, and previously "conventional" hospitals were converted into COVID spokes to increase ICU beds availability, and to allow only urgent CS procedures.
METHODS
Among urgent CS patients (left main stenosis with unstable angina, acute endocarditis, valvular regurgitation with impending heart failure), 10 patients (mean age = 57 ± 9 years), despite a negative admission triage, developed COVID-pneumonia postoperatively, at a median of 7 days after CS.
RESULTS
Patients showed typical lymphopenia, higher prothrombotic profile, and higher markers of inflammation (ferritin and interleukin-6 values). At the zenith of pulmonary distress, patients presented with severe hypoxia (median PaO2/FIO2 ratio = 116), requiring advanced noninvasive ventilation (Venturi mask and continuous positive airway pressure) in the majority of cases. All patients were treated with hydroxychloroquine, azithromycin, and low-molecular-weight heparin at anticoagulant dose. Overall in-hospital mortality was 10% (1/10), peaking 25% in patients who developed COVID pneumonia immediately after CS. The remaining patients, with late infection, were all discharged home without oxygen support, at a median of 25 days after symptom onset.
CONCLUSIONS
As postoperative mortality in case of COVID pneumonia is not negligible, meticulous rules (precise triage, safe hospital path, high level of protection for health-care teams, prompt diagnosis of suspicious symptoms) should be strictly followed in patients undergoing CS during COVID pandemic. The role of therapies alternative to CS should be further assessed.
DOI: 10.1097/SLA.0000000000004393
PubMed: 32932327
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Procedures.</title><author><name sortKey="Garatti, Andrea" sort="Garatti, Andrea" uniqKey="Garatti A" first="Andrea" last="Garatti">Andrea Garatti</name><affiliation><nlm:affiliation>Cardiac Surgery Division.</nlm:affiliation><wicri:noCountry code="no comma">Cardiac Surgery Division.</wicri:noCountry></affiliation><affiliation wicri:level="3"><nlm:affiliation>Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Castelvecchio, Serenella" sort="Castelvecchio, Serenella" uniqKey="Castelvecchio S" first="Serenella" last="Castelvecchio">Serenella Castelvecchio</name><affiliation><nlm:affiliation>Cardiac Surgery Division.</nlm:affiliation><wicri:noCountry 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(MeSH)</term><term>Infection Control (methods)</term><term>Intensive Care Units (statistics & numerical data)</term><term>Italy (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Outcome Assessment, Health Care (MeSH)</term><term>Pandemics (prevention & control)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (prevention & control)</term><term>Postoperative Complications (epidemiology)</term><term>Postoperative Complications (physiopathology)</term><term>Risk Assessment (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Appréciation des risques (MeSH)</term><term>Complications postopératoires (physiopathologie)</term><term>Complications postopératoires (épidémiologie)</term><term>Femelle (MeSH)</term><term>Hospitalisation (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Infection croisée (prévention et contrôle)</term><term>Infections à coronavirus (prévention et contrôle)</term><term>Infections à coronavirus (épidémiologie)</term><term>Italie (MeSH)</term><term>Mortalité hospitalière (tendances)</term><term>Mâle (MeSH)</term><term>Pandémies (prévention et contrôle)</term><term>Pneumopathie virale (prévention et contrôle)</term><term>Pneumopathie virale (épidémiologie)</term><term>Procédures de chirurgie cardiaque (mortalité)</term><term>Procédures de chirurgie cardiaque (méthodes)</term><term>Procédures de chirurgie cardiaque (statistiques et données numériques)</term><term>Prévention des infections (méthodes)</term><term>Sujet âgé (MeSH)</term><term>Unités de soins intensifs (statistiques et données numériques)</term><term>Urgences (MeSH)</term><term>Épidémies de maladies (statistiques et données numériques)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Italy</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, 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postopératoires</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Emergencies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outcome Assessment, Health Care</term><term>Risk Assessment</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Appréciation des risques</term><term>Femelle</term><term>Humains</term><term>Italie</term><term>Mâle</term><term>Sujet âgé</term><term>Urgences</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Italie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>The aim of this study was to describe the clinical course of a consecutive series of patients operated of urgent cardiac surgery during COVID-19 outbreak.</p></div><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>In Italy, COVID outbreak has mostly occurred in the metropolitan area of Milan, and in the surrounding region of Lombardy, and previously "conventional" hospitals were converted into COVID spokes to increase ICU beds availability, and to allow only urgent CS procedures.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Among urgent CS patients (left main stenosis with unstable angina, acute endocarditis, valvular regurgitation with impending heart failure), 10 patients (mean age = 57 ± 9 years), despite a negative admission triage, developed COVID-pneumonia postoperatively, at a median of 7 days after CS.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Patients showed typical lymphopenia, higher prothrombotic profile, and higher markers of inflammation (ferritin and interleukin-6 values). At the zenith of pulmonary distress, patients presented with severe hypoxia (median PaO2/FIO2 ratio = 116), requiring advanced noninvasive ventilation (Venturi mask and continuous positive airway pressure) in the majority of cases. All patients were treated with hydroxychloroquine, azithromycin, and low-molecular-weight heparin at anticoagulant dose. Overall in-hospital mortality was 10% (1/10), peaking 25% in patients who developed COVID pneumonia immediately after CS. The remaining patients, with late infection, were all discharged home without oxygen support, at a median of 25 days after symptom onset.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>As postoperative mortality in case of COVID pneumonia is not negligible, meticulous rules (precise triage, safe hospital path, high level of protection for health-care teams, prompt diagnosis of suspicious symptoms) should be strictly followed in patients undergoing CS during COVID pandemic. The role of therapies alternative to CS should be further assessed.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32932327</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>28</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1528-1140</ISSN><JournalIssue CitedMedium="Internet"><Volume>272</Volume><Issue>4</Issue><PubDate><Year>2020</Year><Month>10</Month></PubDate></JournalIssue><Title>Annals of surgery</Title><ISOAbbreviation>Ann Surg</ISOAbbreviation></Journal><ArticleTitle>Clinical Course of COVID-19 Infection in Patients Urgently Operated of Cardiac Surgical Procedures.</ArticleTitle><Pagination><MedlinePgn>e275-e279</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/SLA.0000000000004393</ELocationID><Abstract><AbstractText Label="OBJECTIVE">The aim of this study was to describe the clinical course of a consecutive series of patients operated of urgent cardiac surgery during COVID-19 outbreak.</AbstractText><AbstractText Label="BACKGROUND">In Italy, COVID outbreak has mostly occurred in the metropolitan area of Milan, and in the surrounding region of Lombardy, and previously "conventional" hospitals were converted into COVID spokes to increase ICU beds availability, and to allow only urgent CS procedures.</AbstractText><AbstractText Label="METHODS">Among urgent CS patients (left main stenosis with unstable angina, acute endocarditis, valvular regurgitation with impending heart failure), 10 patients (mean age = 57 ± 9 years), despite a negative admission triage, developed COVID-pneumonia postoperatively, at a median of 7 days after CS.</AbstractText><AbstractText Label="RESULTS">Patients showed typical lymphopenia, higher prothrombotic profile, and higher markers of inflammation (ferritin and interleukin-6 values). At the zenith of pulmonary distress, patients presented with severe hypoxia (median PaO2/FIO2 ratio = 116), requiring advanced noninvasive ventilation (Venturi mask and continuous positive airway pressure) in the majority of cases. All patients were treated with hydroxychloroquine, azithromycin, and low-molecular-weight heparin at anticoagulant dose. Overall in-hospital mortality was 10% (1/10), peaking 25% in patients who developed COVID pneumonia immediately after CS. The remaining patients, with late infection, were all discharged home without oxygen support, at a median of 25 days after symptom onset.</AbstractText><AbstractText Label="CONCLUSIONS">As postoperative mortality in case of COVID pneumonia is not negligible, meticulous rules (precise triage, safe hospital path, high level of protection for health-care teams, prompt diagnosis of suspicious symptoms) should be strictly followed in patients undergoing CS during COVID pandemic. The role of therapies alternative to CS should be further assessed.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Garatti</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Castelvecchio</LastName><ForeName>Serenella</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Daprati</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Molfetta</LastName><ForeName>Raffaella</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Volpe</LastName><ForeName>Marianna</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Vincentiis</LastName><ForeName>Carlo</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parolari</LastName><ForeName>Alessandro</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Universitary Cardiac Surgery and Translational Research, IRCCS Policlinico San Donato, San Donato Milanese.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Menicanti</LastName><ForeName>Lorenzo</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Cardiac Surgery Division.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Surg</MedlineTA><NlmUniqueID>0372354</NlmUniqueID><ISSNLinking>0003-4932</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName></SupplMeshList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006348" MajorTopicYN="N">Cardiac Surgical Procedures</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical 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MajorTopicYN="Y">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017053" MajorTopicYN="N">Infection Control</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle 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Assessment</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>15</Day><Hour>20</Hour><Minute>23</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32932327</ArticleId><ArticleId IdType="doi">10.1097/SLA.0000000000004393</ArticleId><ArticleId IdType="pii">00000658-202010000-00038</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country><region><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><noCountry><name sortKey="Castelvecchio, Serenella" sort="Castelvecchio, Serenella" uniqKey="Castelvecchio S" first="Serenella" last="Castelvecchio">Serenella Castelvecchio</name><name sortKey="Daprati, Andrea" sort="Daprati, Andrea" uniqKey="Daprati A" first="Andrea" last="Daprati">Andrea Daprati</name><name sortKey="De Vincentiis, Carlo" sort="De Vincentiis, Carlo" uniqKey="De Vincentiis C" first="Carlo" last="De Vincentiis">Carlo De Vincentiis</name><name sortKey="Menicanti, Lorenzo" sort="Menicanti, Lorenzo" uniqKey="Menicanti L" first="Lorenzo" last="Menicanti">Lorenzo Menicanti</name><name sortKey="Molfetta, Raffaella" sort="Molfetta, Raffaella" uniqKey="Molfetta R" first="Raffaella" last="Molfetta">Raffaella Molfetta</name><name sortKey="Parolari, Alessandro" sort="Parolari, Alessandro" uniqKey="Parolari A" first="Alessandro" last="Parolari">Alessandro Parolari</name><name sortKey="Volpe, Marianna" sort="Volpe, Marianna" uniqKey="Volpe M" first="Marianna" last="Volpe">Marianna Volpe</name></noCountry><country name="Italie"><region name="Lombardie"><name sortKey="Garatti, Andrea" sort="Garatti, Andrea" uniqKey="Garatti A" first="Andrea" last="Garatti">Andrea Garatti</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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