Decrease of surgical heart disease treatment during the COVID-19 pandemic (Cardiac Surgery COVID-19 Study – CSC 19 Study)

Introduction
There are gaps of knowledge regarding the impact of the COVID-19 pandemic on cardiac surgery hospitalization and treatment.

Aim
To evaluate patient characteristics, patient morbidity, type of procedures, length of hospital stay, early mortality, and outcomes of surgical treatment for the heart diseases during one year after the COVID-19 pandemic compared with the corresponding pre-pandemic year.

Material and methods
This was a retrospective, observational, single-center study of 2881 consecutive patients, who underwent all types of cardiac surgery procedures. The time interval between 1st of March 2019 and 29th of February 2020 was designated as the pre-pandemic control period and between 1st of March 2020 and 28th of February 2021 as the study period.

Results
In the first year of the COVID-19 pandemic, the number of procedures was reduced by 37%. The greatest decrease was observed during the peak of the pandemic, while during the summer months the number of operations was comparable. During the pandemic, patients waited 22 days longer for surgery, and had a higher surgical risk. There were 135% more urgent procedures performed during the COVID-19 time (433 vs. 184). There was no difference in surgery times, intensive care unit stay period, or hospital stay.

Conclusions
We have confirmed a sharp decline in cardiac surgery during the first year of the COVID-19 pandemic in comparison to the pre-pandemic times. Patients waited longer for surgery, had a higher surgical risk and urgent interventions were performed more frequently during the COVID-19 pandemic.