COVID-19 pandemic implications in paediatric and congenital heart surgery in Brazil

• Published in: Cardiology in the Young 2022-01, Vol.32 (1), p.31-35
• Main Authors: Miana, Leonardo A., Manuel, Valdano, Antoniali, Fernando, Jatene, Marcelo B., Jatene, Fábio Biscegli
• Format: Article
• Language: English
• Subjects: Brazil - epidemiology; Child; Congenital diseases; Contamination; Coronaviruses; COVID-19; Disease transmission; Elective surgery; Global health; Health care; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - surgery; Heart surgery; Humans; Mortality; Original; Original Article; Pandemics; Patients; Pediatrics; Postoperative period; Pulmonary arteries; Questionnaires; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Surgery; Transplants & implants; Veins & arteries; Viral diseases
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951121001608

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. To study the COVID-19 pandemic implications in Brazilian Pediatric and Congenital Heart Surgery programmes. 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. 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). 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.