The COVID-19 pandemic has resulted in a substantial decline in the overall volume of heart surgery in the US. It has also led to an unexplained increase in deaths after coronary artery bypass grafting. These results were presented on January 30 at the annual meeting of the Society of Thoracic Surgeons.
The researchers scoured data from the STS Adult Cardiac Surgery Database dating from January 1, 2018 to June 30, 2020. Their study also included data from the Johns Hopkins COVID-19 Dashboard from February 1, 2020 to January 1, 2021.
In total, they examined data from 717,103 adult heart surgery patients, and more than 20 million COVID-19 patients. Their goal was to determine how the pandemic affected adult heart surgery on both the national and regional levels.
A nationwide 53% decrease in heart surgery
The study found a 53% decrease nationwide in the overall volume of adult heart surgery volume compared to 2019. In addition, there were 65% fewer elective surgeries, and a 40% drop in non-elective cases.
The drops occurred across all types of procedures, including coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, and many others.
The researchers found strong regional differences. The Mid-Atlantic area (New York, New Jersey, and Pennsylvania) was among the most affected regions. There, the decrease in overall case volume was 71%. Likewise, the region saw 75% fewer elective cases, and a 59% reduction in non-elective cases.
Another highly impacted region was New England (Maine, Vermont, New Hampshire, Massachusetts, Connecticut, and Rhode Island), with a 63% reduction in overall case volume.
An increase in mortality rates
The study also found that before the COVID pandemic, the Mid-Atlantic and New England regions had excellent outcomes in terms of mortality rates. But since the pandemic began, more patients have been dying.
Though the data did not directly address the cause of the increased mortality, many surgeons say they are currently limited to operating on only the most urgent coronary bypass cases, and on patients who tend to be sicker.
As this research shows, COVID-19 has altered or halted virtually every aspect of society, and heart surgery has not been immune. The abrupt decrease in surgery starting in March 2020 has proven to have had far-reaching implications. And the the negative effects of canceled and postponed procedures are now finally being realized.
“We clearly demonstrated that if you have heart surgery during COVID, you have an increased risk of morbidity and mortality,” said the study’s lead author Tom Nguyen of the University of California San Francisco.
Nguyen said this study is only the first of many to come. The researchers plan to examine trends and outcomes of COVID patients vs. non-COVID patients, as well as investigate the pandemic’s role on specific heart procedures such as aortic dissections.
Recent research has also found many other unexpected links to the pandemic. One recent study, for example, found that elder loneliness in the US has more than doubled since the pandemic began.
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