Non-elective CABG Outcomes are Adversely Impacted by COVID Infection, but not by Altered Processes of Care

Non-elective CABG Outcomes are Adversely Impacted by COVID Infection, but not by Altered Processes of Care

As thoracic researchers consider the myriad effects of COVID-19, they are looking at the impacts of the disease on patients and treatments, as well as care and treatment during the pandemic. Emily Grimsley, MD, at the University of South Florida, and co-authors looked at the differential effects of COVID-19 active viral infection, viral convalescence, and altered care processes on coronary artery bypass grafting (CABG) outcomes.

Using data from the National COVID Cohort Collaborative (N3C) about CABG cases between 2020 and 2022, the group looked at patients who had tested negative for COVID-19, tested positive less than two weeks prior to surgery (COVID-Active infection), and tested positive more than two weeks prior to surgery. For control data, they used data from the National Surgical Quality Improvement Program (NSQIP).

The incidence of in-hospital mortality, 30-day mortality, and infectious complications were significantly higher in the COVID-Active cohort compared to the other two groups. Adjusted analyses indicated in-hospital mortality, 30- and 90-day mortality, and infectious complications were significantly greater in the COVID-Active group compared to COVID-negative patients.

Comparing the equivalent mortality data for pre-COVID and the N3C data for COVID-negative patients, Grimsley’s group concluded that although the processes of care were altered by the pandemic, patient mortality did not change for COVID-negative patients. Their results indicate it is the COVID-19 infection that caused worse outcomes. Per Dr. Grimsley, “Even though healthcare delivery was significantly altered during the pandemic, it did not negatively affect patient mortality after CABG. In line with various other studies, we did see that patients with active COVID-19 infection did have higher mortality than their COVID-negative counterparts.” The group proposes further study to define the optimal timing of CABG in those with recent COVID-19 infection.

Dr. Grimsley will present the results of this study Saturday, May 6, at the American Association for Thoracic Surgery (AATS) 103rd Annual Meeting in Los Angeles.