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Impact of early Coronavirus Disease 2019 pandemic on pediatric cardiac surgery in China
Authors:Guocheng Shi  Jihong Huang  Mingan Pi  Xinxin Chen  Xiaofeng Li  Yiqun Ding  Hao Zhang
Institution:7. Department of Cardiothoracic Surgery, Hunan Children''s Hospital, Changsha, China;8. Department of Cardiothoracic Surgery, Jiangxi Children''s Hospital, Nanchang, Jiangxi, China;9. Department of Cardiothoracic Surgery, Shanxi Children''s Hospital, Taiyuan, Shanxi, China;10. Department of Cardiothoracic Surgery, Yuying Children''s Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China;11. Department of Cardiac Surgery, 2nd Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China;12. Heart Center, Hainan Women and Children Medical Center, Haikou, Hainan, China;13. Department of Cardiothoracic Surgery, Xi''an Children''s Hospital, Xi''an, Shaanxi, China;14. Department of Cardiac Surgery, Yan''an Hospital, Kunming, Yunnan, China;1. Department of Cardiothoracic Surgery, Heart Center and Shanghai Institution of Pediatric Congenital Heart Diseases, Shanghai Children''s Medical Center, National Children''s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. Clinical Research Center, Shanghai Children''s Medical Center, National Children''s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China;1. Department of Cardiothoracic Surgery, Heart Center and Shanghai Institution of Pediatric Congenital Heart Diseases, Shanghai Children''s Medical Center, National Children''s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. Clinical Research Center, Shanghai Children''s Medical Center, National Children''s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China;3. Department of Cardiothoracic Surgery, Wuhan Children''s Hospital, Wuhan, Hubei, China;4. Department of Cardiothoracic Surgery, Guangzhou Woman and Children''s Hospital, Guangzhou, Guangdong, China;5. Department of Cardiac Surgery, Beijing Children''s Hospital, National Center for Children Health, Beijing, China;6. Department of Cardiothoracic Surgery, Shenzhen Children''s Hospital, Shenzhen, Guangdong, China
Abstract:ObjectiveThis study aimed to provide an insight into the impact of the early outbreak of the novel Coronavirus Disease 2019 on the care management for patients with congenital heart disease.MethodsThis study respectively enrolled a cohort of surgical patients who underwent surgery in 2018 (group I), 2019 (group II), and 2020 (group III) and a cohort of follow-up patients who had follow-up in 2017 (group A), 2018 (group B), and 2019 (group C) in 13 children hospitals.ResultsDuring the Coronavirus Disease 2019 era, there was a significant decrease in total surgical volume and a change in case mix in terms of an increase in the proportion of emergency operations. Decrease in migration scale index was correlated to the decrease in both surgical volume (r = 0.64, P = .02) and outpatient visit volume (r = 0.61, P = .03). There was a significantly higher proportion of patients who had follow-up through the internet or phone in group C (26.4% vs 9.6% in group B and 8.9% in group A; P < .0001). There was no statistical difference in death or rehospitalization among the 3 follow-up groups (P = .49). There was higher parents' anxiety score (P < .0001) and more use of telemedicine (P = .004) in group C compared with groups A and B.ConclusionsThe Coronavirus Disease 2019 pandemic has resulted in a considerable decrease in total surgical volume and a change of case mix, which seems to be related to the strict traffic ban. Follow-up through the online medical service appears to be an effective alternative to the conventional method.
Keywords:congenital heart disease  COVID-19  follow-up  surgery  CCHD"}  {"#name":"keyword"  "$":{"id":"kwrd0035"}  "$$":[{"#name":"text"  "_":"complex congenital heart disease  CHD"}  {"#name":"keyword"  "$":{"id":"kwrd0045"}  "$$":[{"#name":"text"  "_":"congenital heart disease  COVID-19"}  {"#name":"keyword"  "$":{"id":"kwrd0055"}  "$$":[{"#name":"text"  "_":"Coronavirus Disease 2019  MSI"}  {"#name":"keyword"  "$":{"id":"kwrd0065"}  "$$":[{"#name":"text"  "_":"migration scale index  IQR"}  {"#name":"keyword"  "$":{"id":"kwrd0075"}  "$$":[{"#name":"text"  "_":"interquartile range
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