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Thorac Cardiovasc Surg
DOI: 10.1055/a-2489-6268
Original Cardiovascular

Early Surgical Outcomes in Infective Endocarditis Before and During COVID-19 Pandemic

Jang-Sun Lee 
1   Department of Heart Surgery, Kerckhoff-Klinik GmbH Herzzentrum Abteilung fur Kardiologie and Abteilung fur Herzchirurgie, Bad Nauheim, Hesse, Germany
,
Virna L. Sales
2   Department of Cardiology, Katholisches Klinikum Koblenz Montabaur gGmbH Marienhof Koblenz, Koblenz, Rheinland-Pfalz, Germany
,
Annette Moter
3   Biofilmzentrum, Deutsches Herzzentrum Berlin, Berlin, Deutschland, Germany
,
Walter Eichinger
4   Department of Cardiac Surgery, Städtisches Krankenhaus München-Bogenhausen, Munchen, Bayern, Germany
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Abstract

Background Infective endocarditis (IE) is associated with extremely high surgical mortality. During the SARS-CoV-2 pandemic, hospitals restructured their intensive care units and outpatient services to prioritize COVID-19 care, which may have affected the outcomes of patients requiring urgent procedures. This study aimed to evaluate the impact of the pandemic on surgical outcomes of IE patients in Southern Germany.

Methods This observational, community-based study compared two cohorts of surgical candidates: a pandemic cohort from March 2020 to November 2021 (n = 84) and a pre-pandemic cohort from August 2018 to March 2020 (before the lockdown, n = 94). Preoperative status and postoperative in-hospital complications were analyzed and compared between the groups.

Results The pandemic cohort experienced longer symptom onset to diagnosis intervals (14.5 versus 8 days, p = 0.529). A higher incidence of definite IE was observed after the lockdown according to the modified Duke criteria (82.1% versus 68.1%, p = 0.035). Patients presented with more severe symptoms post-lockdown (NYHA Class III: 50% versus 33%; Class IV: 22.6% versus 11.7%, p = 0.001). Postoperative complications, such as re-thoracotomy due to bleeding and hemofiltration for acute renal failure, were significantly more frequent after the lockdown (p < 0.05). However, in-hospital survival rates did not differ significantly between the groups.

Conclusion The COVID-19 pandemic and related lockdown measures were associated with delayed diagnoses and worse perioperative outcomes for surgical IE patients, highlighting the need for improved management strategies during public health crises.

Keywords

COVID-19 - heart surgery - endocarditis


Publication History

Received: 18 August 2024

Accepted: 25 November 2024

Accepted Manuscript online:
27 November 2024

Article published online:
20 January 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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