Observational studyJournal of cardiothoracic and vascular anesthesia2022
Bleeding Complications in Patients With Perioperative COVID-19 Infection Undergoing Cardiac Surgery: A Single-Center Matched Case-Control Study.
Observational study in Journal of cardiothoracic and vascular anesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Pharmacokinetic modelling during long-term anesthesia: minimizing the gap.Journal of advanced research · 2026Article
- Emerging role of lisocabtagene maraleucel chimeric antigen receptor-T cell in nodal and gastrointestinal follicular lymphoma.World journal of gastroenterology · 2025Article
- Outcomes of Patients Undergoing Major Surgery for Cancer with COVID-19 in the Postoperative Period.Indian journal of surgical oncology · 2023Article
- COVID-associated complications after reconstructive breast surgery: a retrospective cohort study.Breast cancer research and treatment · 2023Article
- Coronary artery bypass grafting in active or recent COVID-19 infection: a systematic review.Indian journal of thoracic and cardiovascular surgery · 2023Review
- Multidisciplinary paper on patient blood management in cardiothoracic surgery in the UK: perspectives on practice during COVID-19.Journal of cardiothoracic surgery · 2023Review
- Association of major postoperative wound and anastomotic complications in thoracic surgery with COVID-19 infection.Surgery open science · 2022Article
- Coagulation and Transfusion Updates From 2021.Journal of cardiothoracic and vascular anesthesia · 2022Review
- The Impact of COVID-19 Infection During the Postoperative Period After Surgery for Ovarian Cancer.In vivo (Athens, Greece)Article
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Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePrevious studies reported a poor outcome in patients with coronavirus 2019 (COVID-19) undergoing cardiac surgery. Complications most frequently described were respiratory failure, renal failure, and thromboembolic events. In their recent experience, the authors observed a very high incidence of bleeding complications. The purpose of the study was to investigate a possible significant correlation between perioperative COVID-19 infection and hemorrhagic complications compared to non-COVID-19 patients.
designSingle-center, observational, retrospective, matched case-control (1:2) study involving patients who underwent open-heart cardiac surgery from February 2020 and March 2021 with positive perioperative diagnosis of COVID-19 infection, matched with patients without COVID-19 infection.
settingCardiac surgery unit and intensive care unit of a university tertiary center in a metropolitan area.
participantsIn the study period, 773 patients underwent cardiac surgery on cardiopulmonary bypass (CPB). Among them, 23 consecutive patients had perioperative diagnosis of COVID-19 infection (study group). These patients were compared with 46 corresponding controls (control group) that matched for age, sex, body mass index, and Society of Thoracic Surgeons score.
interventionsOpen-heart cardiac surgery on CPB. MEASUREMENTS AND MAIN
resultsIn the study group, 2 patients (9%) died in the intensive care unit from severe respiratory failure, shock, and multiple organ failure. In the study group, patients showed a significantly higher incidence of bleeding complications (48% v 2%, p = 0.0001) and cases of surgical reexploration for bleeding (35% v 2%, p = 0.0001), a higher incidence of severe postoperative thrombocytopenia (39% v 6%, p = 0.0007), and a higher need of blood components transfusions (74% v 30%, p = 0.0006). Chest tubes blood loss and surgical hemostasis time were markedly prolonged (p = 0.02 and p = 0.003, respectively).
conclusionsA worrisome increased risk of early and late bleeding complications in COVID-19 patients was observed, and it should be considered when assessing the operative risk. CPB-related inflammatory reaction could exacerbate the deleterious effect of COVID-19 on the coagulation system and likely deviate it toward a hemorrhagic pattern.
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