Association Between COVID-19 Infection and Postoperative Outcomes Following Coronary Artery Bypass Grafting: A Retrospective Cohort Study.

Objective: To investigate the association between preoperative Coronavirus disease 2019 (COVID-19) infection and complications in patients undergoing coronary artery bypass grafting (CABG), focusing on the timing of infection.

Design: A retrospective cohort study using the National Covid Cohort Collaborative (N3C) database SETTING: Multi-institutional data from the National COVID Cohort Collaborative, representing diverse US healthcare settings PARTICIPANTS: Adult patients undergoing CABG during the COVID-19 pandemic, identified through CPT codes. COVID-19 infection timing was stratified into 3 groups: 0 to 2 weeks, 2 to 6 weeks, and 6 to 12 weeks before surgery. Outcomes were analyzed based on the timing of COVID-19 infection and compared to patients without a history of COVID-19.

Interventions: No direct interventions were performed. Outcomes were analyzed based on the timing of COVID-19 infection.

Measurements And Main Results: Postoperative complications were assessed using International Classification of Disease, Tenth Revision codes, including venous thromboembolism (VTE), sepsis, acute kidney injury, surgical site infection, acute myocardial infarction (AMI), 30-day mortality, and 1-year mortality. For COVID-19 infection occurring within 0 to 2 weeks before surgery, significantly increased odds were observed for VTE (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.36-3.59]; p = 0.001), sepsis (OR, 1.74; 95% CI, 1.01-2.81; p = 0.032), 30-day mortality (OR, 3.60; 95% CI, 2.32-5.35; p < 0.0001), and 1-year mortality (OR, 3.10; 95% CI, 2.24-4.21; p < 0.0001), with no significant associations for surgical site infection (OR, .94; 95% CI, 0.48-1.64; p = 0.849), or AMI (OR, 1.21; 95% CI, 0.84-1.69; p = 0.274) compared to COVID-19-negative patients.

Conclusions: COVID-19 infection within 2 weeks before CABG is associated with a significantly increased risk of complications. Further research is needed to understand the mechanisms and optimize care for these patients.