Postoperative Nosocomial COVID 19 infection in Cardiac Surgery: An Uncommon event with High Mortality

Ridwan, Khalid; DeVarennes, Benoit; Tchervenkov, Christo; Shum-Tim, Dominique; Cecere, Renzo; Lachapelle, Dr. Kevin

The COVID-19 pandemic has had a major impact on cardiac surgery patients. Significant reductions in access to surgical treatment have forced surgeons to prioritise patients and follow strict COVID-19 protocols to protect surgeons, staff, and patients.(1) Nosocomial infections among Cardiac Surgery patients have been reported and are associated with a high mortality.(2) As a COVID-19 tertiary care centre and a tertiary cardiac centre, we tried to balance the need to operate on urgent cardiac cases while protecting patients and staff from COVID-19. During the first wave of the pandemic, a total of 579 surgeries were performed. We report findings from an outbreak of four nosocomial infections. All patients tested negative within 24 hours of surgery or admission. Three patients were positive following surgery, suggesting an overall nosocomial rate during the first wave of 0.5% (3/579). One patient admitted for evaluation tested positive during mass screening. Two of the four patients died following respiratory complications. No healthcare worker (HCW) or family member with direct contact with these patients tested positive for COVID-19. Nosocomial COVID-19 infection is uncommon when adhering to safety protocols. Although uncommon, the mortality rate is high (50%) in our series. As widespread vaccination of HCWs and high-risk individuals susceptible to COVID-19 is in progress, we suggest that cardiac surgery patients, when feasible, be vaccinated prior to surgery given this could prevent excess mortality, protect HCWs and reduce resource use.