ABSTRACT
Introduction:
COVID-19 pandemic negatively impacted global healthcare. Consequences in Pediatric and Congenital Heart Surgery programs and mortality of congenital heart patients infected with Sars-Cov2 is still to be determined.
Objective:
Study the COVID-19 pandemic implications in Brazilian Pediatric and Congenital Heart Surgery programs.
Methods:
We conducted a national online survey covering all states that perform Pediatric and Congenital Heart Surgery from November 10th to 22nd, 2020, using a Google forms questionnaire. We formulated questions related to impact on surgical volume, case-mix, and mortality. Then we asked about short-term postoperative COVID-19 infection and outcomes.
Results:
We received responses from 46 centers representing all states where there were a Pediatric and Congenital Heart Surgery program and all high-volume centers across the country. All but one center experienced a significant decrease in surgical volume, and 23.9% of the responders revealed less than one-quarter of volume decrement. On the other hand, in over 70% of the centers, there was a significant surgical volume reduction. In addition to this, there was a shift in case-mix in 41 centers (89.1%) towards more complex cases. More than one-third of the responders revealed increased mortality in 2020 compared to previous years, and 43.5% of the programs (20 centers) had at least one patient contaminated by Sars-Cov2, accounting for 48 patients. Mortality in postoperative infected patients was 45.8% (22 patients).
Conclusions:
In general, Brazilian Pediatric and Congenital Heart Surgery programs were severely affected by decreased surgical volume, unbalanced case-mix towards more complex cases, and increased mortality. Almost half of the programs related postoperative COVID-19 contamination with high mortality.
Covid-19 pandemic implications in pediatric and congenital heart surgery in Brazil