The impact of COVID-19 pandemic on cardiac surgery in Israel
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(2020) 15:294
RESEARCH ARTICLE
Open Access
The impact of COVID-19 pandemic on cardiac surgery in Israel Eitan Keizman1,2*†, Eilon Ram1†, Erez Kachel1,2, Leonid Sternik1 and Ehud Raanani1
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. Keywords: Cardiac surgery, COVID-19
Introduction Towards the end of 2019 a new disease emerged in Wuhan, China, now known as coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1–3]. Approximately 3 months later, on March 11, 2020, COVID-19 was announced by the World Health Organization as a * Correspondence: [email protected] † Eitan Keizman and Eilon Ram contributed equally to this work. 1 Department of Cardia cSurgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Ramat-Gan, Israel 2 Department of Cardiac Surgery, The Baruch Padeh Medical Center, 52621 Tiberias, Israel
global pandemic. As of May 20, 2020, more than five million people worldwide were affected by the virus with about 325,000 deaths. Since the beginning of COVID-19 the world has changed drastically, and various measures have been taken in an attempt to “flatten the curve”, some of them having an unprecedented effect on world health systems [4]. Israel was amongst the first countries to close its borders and impose significant restrictions on its population, comprising pers
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