Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Mediterranean Pediatric Cardiac Surgery Unit, San Vincenzo Hospital, Taormina, Italy.
Eur J Cardiothorac Surg. 2020 Dec 1;58(6):1254-1260. doi: 10.1093/ejcts/ezaa352.
Italy has been one of the countries most severely affected by the coronavirus disease 2019 (COVID-19). The Italian government was forced to introduce quarantine measures quickly, and all elective health services were stopped or postponed. This emergency has dramatically changed the management of paediatric and adult patients with congenital heart disease. We analysed data from 14 Italian congenital cardiac surgery centres during lockdown, focusing on the impact of the pandemic on surgical activity, patients and healthcare providers and resource allocation.
Fourteen centres participated in this study. The period analysed was from 9 March to 4 May. We collected data on the involvement of the hospitals in the treatment of patients with COVID-19 and on limitations on regular activity and on the contagion among patients and healthcare providers.
Four hospitals (29%) remained COVID-19 free, whereas 10 had a 39% reduction in the number of beds for surgical patients, especially in the northern area. Two hundred sixty-three surgical procedures were performed: 20% elective, 62% urgent, 10% emergency and 3% life-saving. Hospital mortality was 0.4%. Compared to 2019, the reduction in surgical activity was 52%. No patients operated on had positive test results before surgery for severe acute respiratory syndrome coronavirus 2, the virus responsible for COVID-19. Three patients were infected during the postoperative period. Twenty-nine nurses and 12 doctors were infected. Overall, 80% of our infected healthcare providers were in northern centres.
Our study shows that the pandemic had a different impact on the various Italian congenital cardiac surgery centres based on the different patterns of spread of the virus across the country. During the lockdown, the system was able to satisfy all emergency clinical needs with excellent results.
意大利是受 2019 年冠状病毒病（COVID-19）影响最严重的国家之一。意大利政府被迫迅速采取隔离措施，所有非紧急保健服务均被停止或推迟。这一紧急情况极大地改变了小儿和成人先天性心脏病患者的管理方式。我们分析了封锁期间来自 14 家意大利先天性心脏手术中心的数据，重点研究了大流行对手术活动、患者和医疗保健提供者以及资源分配的影响。
有 14 家中心参与了这项研究。分析的时间段为 2020 年 3 月 9 日至 5 月 4 日。我们收集了有关医院参与治疗 COVID-19 患者以及对常规活动的限制以及患者和医疗保健提供者之间的传染的数据。
有 4 家医院（29%）未受到 COVID-19 的影响，而 10 家医院外科患者的床位减少了 39%，尤其是在北部地区。共进行了 263 例手术：20%为择期手术，62%为紧急手术，10%为急诊手术，3%为挽救生命的手术。医院死亡率为 0.4%。与 2019 年相比，手术活动减少了 52%。在手术前，没有进行过针对严重急性呼吸系统综合征冠状病毒 2 的检测，该病毒是 COVID-19 的病原体，对接受手术的患者进行了检测，结果均为阴性。有 3 名患者在术后期间被感染。有 29 名护士和 12 名医生被感染。总体而言，80%的受感染医护人员在北部中心。
我们的研究表明，大流行对意大利各个先天性心脏手术中心的影响不同，这取决于病毒在全国的传播方式。在封锁期间，该系统能够出色地满足所有紧急临床需求。
