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Impact Of Covid-19 Pandemic On Pediatric And Congenital Heart Surgery Programs Across Europe
Eleftherios Protopapas, MD1, Mauro Lo Rito, MD,2, Vladimiro Vida, MD,3, Zdizlaw Tobota, MD,4, Bohdan Maruszewski, MD4, Morten Helvind, MD5, Jose Fragata, MD6, George Sarris, MD1.
1Athens Heart Surgery Institute, Athens, Greece, 2IRCCS Policlinico San Donato Milanese, Milano, Italy, 3Paediatric and Congenital Cardiac Surgery Unit, University of Padua, Padova, Italy, 4Children's Memorial Health Institute, Warsaw, Poland, 5Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark, 6Surgery Pediatric Unit Hospital de Santa Marta, Lisbon, Portugal.

Objective(s): In order to assess the impact of the COVID-19 infection on pediatric and congenital heart surgery (PCHS) programs and their patients, a survey was performed, reporting herein its results for Europe. Methods: A volunteer international group sprung as a collaborative effort between ECHSA, WSPCHS, CHSS, and other relevant societies. A survey was developed and widely distributed, capturing responses over the month of April 2020. Responses were collected at the ECHSA Congenital Database and analyzed. Results:46 European PCHS Programs from 18 countries responded. Major social distancing measures were imposed almost universally, and 93% of hospitals cancelled all elective cases. Most (93%) PCHS programs continued to perform only emergency cases. PCHS resources (OR, ICU and staff) were requisitioned for the care of adult COVID-19 patients in 45.6%, while up to 63% of PCHS programs, congenital staff were quarantined due to COVID-19 suspected or actual infection. Very few congenital patients were infected either preoperatively or postoperatively, but an adverse effect on outcome was reported in most. No pediatric patients required ECMO support. Resumption of normal operation for elective procedures for most departments was predicted delayed for 2-4 months
Conclusions: Although COVID-19 infection of congenital patients was rare, the pandemic had major adverse indirect impact on PCHS programs in Europe, mainly due to imposed restrictions and requisition of their resources, resulting in delayed care to non-emergent patients for months. Given the asynchronous nature of the infection spread, a follow-up survey is planned in 3 months.


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