Effect of COVID-19 on cardiac surgery volumes in Sweden

Abstract

Objectives. The coronavirus disease 2019 (COVID-19) pandemic, which commenced in 2020, is known to frequently cause respiratory failure requiring intensive care, with occasional fatal outcomes. In this study, we aimed to conduct a retrospective nationwide observational study on the influence of the pandemic on cardiac surgery volumes in Sweden. Results. In 2020, 9.4% (n = 539) fewer patients underwent open-heart operations in Sweden (n = 5169) than during 2019 (n = 5708), followed by a 5.8% (n = 302) increase during 2021 (n = 5471). The reduction was greater than 15% in three of the eight hospitals in Sweden performing open-heart operations. Compared to 2019, in 2020, the waiting times for surgery were longer, and the patients were slightly younger, had better renal function, and a lower European System for Cardiac Operative Risk Evaluation; moreover, few patients had a history of myocardial infarction. However, more patients had insulin-treated diabetes mellitus, hypertension, peripheral vascular disease, reduced left ventricular function, and elevated pulmonary artery pressure. Urgent procedures were more common, but acute surgery was less common in 2020 than in 2019. Early mortality and postoperative complications were low and did not differ during the three years. Conclusion. The 9.4% decrease in the number of heart surgeries performed in Sweden during the 2020 COVID-19 pandemic, compared to 2019, partially recovered during 2021; however, there was no backlog of patients awaiting heart surgery.

Keywords:

• COVID-19
• cardiac surgery
• surgery volume
• mortality
• backlog

Ethics approval

This study was approved by the Swedish Ethical Review Authority (DNR. 2020-05209).

Consent form

Informed consent was obtained from the surgical patients to analyse and publish anonymised data.

Author contributions

TI, MD, and ÖF contributed equally to this work and participated in the design, acquisition of data, analyses, and drafting and revision of the manuscript. All the authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Due to the study’s ethical consent, data are not available for sharing.

Additional information

Funding

Magnus Dalén was supported by a research grant from Fredrik Lundberg.