Abstract
Background: Ever since the coronavirus disease 2019 (COVID-19) has
become a pandemic, worldwide efforts are being made to “flatten the
curve”. Israel was amongst the first countries to impose significant
restrictions. As a result, cardiac surgeons have been required to scale
down their routine practice, resulting in a significant reduction in the
number of cardiac surgeries. The aim of this study is to characterize
the impact of COVID-19 on cardiac surgery in Israel. Methods: This is a
retrospective observational study performed in two cardiac surgery
departments in Israel and includes all patients who underwent cardiac
surgery in March and April during the years 2019 and 2020. The patient
cohort was divided into two groups based on the year of operation.
Analysis of the patients’ baseline characteristics, operative data, and
postoperative outcome, was performed. Results: The 2019 group (n=173),
and the 2020 group (n=108) were similar regarding their baseline
characteristics, previous medical history, and rates of previous
revascularization interventions. However, compared to the 2019 group,
patients in the 2020 group were found to be more symptomatic (NYHA class
IV; 2.4% vs. 6.2%, p=0.007). While all patients underwent similar
procedures, patients in the 2020 group had significantly longer
procedural time (p<0.001). In-hospital mortality rate was
found to be significantly higher in group 2020 (13% vs. 5.2%,
p=0.037). Conclusions: While the number of patients undergoing cardiac
surgery declined during the outbreak period, the rate of surgical
mortality increased. One explanation for this might be delayed hospital
arrival.