The effect of COVID-19 vaccination on 30-day mortality after cardiac surgery - Insights from the Israel national registries.

Autor:	Blumenfeld O; Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel., Rosenberg A; Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel., Reuven M; Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel., Caspi I; Internal Medicine Department, Tel Aviv Medical Center, Tel Aviv, Israel., Sharoni E; Department of Cardiac Surgery, Carmel Medical Center, Haifa, Israel.; The Ruth & Baruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel., Leviner DB; Department of Cardiac Surgery, Carmel Medical Center, Haifa, Israel.; The Ruth & Baruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Jazyk:	angličtina
Zdroj:	Infection prevention in practice [Infect Prev Pract] 2023 Dec 16; Vol. 6 (1), pp. 100334. Date of Electronic Publication: 2023 Dec 16 (Print Publication: 2024).
DOI:	10.1016/j.infpip.2023.100334
Abstrakt:	Background: We compared the effect of perioperative COVID-19, before and after vaccination, on 30-day mortality after cardiac surgery. Methods: Data was extracted from several national registries. The study period was March 1 st , 2020-March 31 st , 2022. Results: 2594 adult patients underwent cardiac surgery before the availability of a universal COVID-19 vaccine. 33 patients were diagnosed with COVID-19 prior to surgery (mean age 58.3±10.0, mean length of time 73.6±60.1 days) and 7 patients were diagnosed with COVID-19 0-14 days after surgery (age 66.4±7.6). These were compared to 4426 patients who underwent cardiac surgery after the availability of a universal vaccine: 469 patients were diagnosed with COVID-19 prior to surgery (age 62.1±10.1, length of time 175.8±158.2) and 32 patients diagnosed with COVID-19 0-14 days after surgery (age 60.8±14.5). In patients diagnosed with COVID-19 prior to surgery, there was no excess 30-day mortality either before or after vaccination (1 (3.0%) vs. 57 (2.2%), respectively, P <0.8, and 8 (1.7%) vs. 87 (2.2%), respectively, P <0.5). Patients diagnosed with COVID-19 after surgery, but before vaccination, had significantly higher 30-day mortality compared to COVID-19 negative patients (2 (28.6%) vs. 56 (2.2%) respectively, P <0.0001). This excess mortality disappeared after universal vaccination (1 (3.1%) vs. 94 (2.1%) respectively, P <0.7). Conclusions: COVID-19, when diagnosed in the early post-operative period, was a risk factor for mortality before available vaccinations, but not after vaccination was widely available. Pre-surgery screening and post-surgical isolation is essential until vaccines are available. This data may be useful for patient management in future respiratory pandemics. (© 2023 The Authors.)
Databáze:	MEDLINE
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