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.