METHODS
Analysis of all patients undergoing elective, urgent or emergency cardiac surgery at Barts Heart Centre from 1st March to 30th April 2020, focusing the review in those who tested positive for COVID-19 in the PCR-RNA analysis of nasal and throat swabs carried out as a part of the pre-operative work-up.
Our local COVID-19 screening protocol consists of requirement for two consecutive negative nasopharyngeal swabs for polymerase chain reaction for ribonucleic acid (PCR-RNA) analysis of Covid-19, before accepting the patient for surgery. [5]
We also request a non-contrasted CT of the chest to assess changes in the lung parenchyma suggested of COVID-19 disease (e.g. ground-glass opacities, interstitial infiltrates). As adjuncts, we also record lymphocyte count and Lactate Dehydrogenase (LDH) levels [5-8].
Only when time is not permitting due to clinical emergency, the screening results are not awaited; instead the patients are considered COVID-19 positive and treated accordingly with the necessary precautions during the surgery and the perioperative period until the results of a deep tracheal swab and bronchial aspirate come back negative.
Data was obtained retrospectively from the individual clinical records and the national cardiac surgery database. Individual consent from patients was waived by the Ethics Institutional Board since there is no identifiable data.