Thoracic surgery outcomes for patients with Coronavirus Disease 2019

J Thorac Cardiovasc Surg. 2021 Dec;162(6):1654-1664. doi: 10.1016/j.jtcvs.2021.01.069. Epub 2021 Jan 30.

Abstract

Objective: As the Coronavirus Disease 2019 pandemic continues, appropriate management of thoracic complications from Coronavirus Disease 2019 needs to be determined. Our objective is to evaluate which complications occurring in patients with Coronavirus Disease 2019 require thoracic surgery and to report the early outcomes.

Methods: This study is a single-institution retrospective case series at New York University Langone Health Manhattan campus evaluating patients with confirmed Coronavirus Disease 2019 infection who were hospitalized and required thoracic surgery from March 13 to July 18, 2020.

Results: From March 13 to August 8, 2020, 1954 patients were admitted to New York University Langone Health for Coronavirus Disease 2019. Of these patients, 13 (0.7%) required thoracic surgery. Two patients (15%) required surgery for complicated pneumothoraces, 5 patients (38%) underwent pneumatocele resection, 1 patient (8%) had an empyema requiring decortication, and 5 patients (38%) developed a hemothorax that required surgery. Three patients (23%) died after surgery, 9 patients (69%) were discharged, and 1 patient (8%) remains in the hospital. No healthcare providers were positive for Coronavirus Disease 2019 after the surgeries.

Conclusions: Given the 77% survival, with a majority of patients already discharged from the hospital, thoracic surgery is feasible for the small percent of patients hospitalized with Coronavirus Disease 2019 who underwent surgery for complex pneumothorax, pneumatocele, empyema, or hemothorax. Our experience also supports the safety of surgical intervention for healthcare providers who operate on patients with Coronavirus Disease 2019.

Keywords: COVID-19; empyema; hemothorax; pneumatocele; pneumothorax.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • COVID-19 / surgery*
  • Empyema, Pleural / diagnosis
  • Empyema, Pleural / etiology
  • Empyema, Pleural / surgery*
  • Female
  • Follow-Up Studies
  • Hemothorax / diagnosis
  • Hemothorax / etiology
  • Hemothorax / surgery*
  • Humans
  • Male
  • Middle Aged
  • New York / epidemiology
  • Pandemics*
  • Pneumothorax / diagnosis
  • Pneumothorax / etiology
  • Pneumothorax / surgery*
  • RNA, Viral / analysis
  • Retrospective Studies
  • SARS-CoV-2 / genetics
  • Thoracic Surgical Procedures / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • RNA, Viral