Patient recovery from heart surgery during the Covid-19 pandemic [COVID-19]
Research type
Research Study
Full title
An observational cohort study to explore patient outcome from heart surgery during the Covid-19 pandemic (CardiacCovid)
IRAS ID
282411
Contact name
Julie Sanders
Contact email
Sponsor organisation
Barts Health NHS Trust Joint Research Management Office
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
Summary of Research:
The effect of having heart surgery during a pandemic/national emergency on patient recovery is not known. Thus, we aim to describe and explore the recovery process of patients undergoing cardiac surgery during the covid-19 pandemic\n\nWe will recruit adult (>18 years) patients undergoing cardiac surgery and who are being prepared for discharge/transfer to another organization during the pandemic. Those unable/willing to provide written informed consent, or are unable/willing to complete the questionnaires will not be eligible to participate.\n\nThe areas of recovery we wish to follow-up on are survival, morbidity/health service usage (collected using a standardized form to record visits to the general practitioner, hospital etc), health-related quality of life (measured using the EQ5D-5L questionnaire), event-specific distress (measured using the IES-R questionnaire) and depression (measured using the CES-D) questionnaire. We would measure them all at discharge/transfer from hospital, 6 weeks, 6 months and 1 year after surgery. At 1 week after surgery we will also ask for completion of the IES-R. At each time-point a member of the research team will contact the patient (telephone call or videocall, depending on participant preference) to remind/support questionnaire completion. For the early time-points (at discharge from hospital, 1 week and perhaps also 6 weeks) questionnaires may need to be completed on paper while a secure online platform is developed. All data will be held securely at the local hospital while this is being done.\n\nWe will undertake this study at St Bartholomew’s Hospital, which is the command centre for cardiac surgery in London during the pandemic. However, we have written this application on the basis that other UK centres can participate, if they wish to do so. In this instance, St Bartholomew’s Hospital will be the lead centre.Summary of Results:
"During the first UK lockdown (March 2020-July 2020) 196 participants completed the study. Most participants were male (75.0%), of white background (79.6%) and undergoing urgent or emergency surgery (59.7%). Length of post-operative stay was nine days (median) and of those enrolled into the study one patient (0.5%) died in-hospital. No patients had COVID-19 at time of surgery. Questionnaire completion was >75.0% at all timepoints, except one week after surgery (67.3%).
Overall, anxiety due to the pandemic was high (baseline to 6 months after surgery) and was greater in women and younger patients at all timepoints. Women also had lower quality of life and higher depression (all time-points), although overall rates of depression were within ranges observed in other studies in non-COVID-19 times. Therefore, psychological support pre- and post-operatively in further crises or traumatic times, should be considered to aid recovery.A copy of the full results can be accessed at: https://doi.org/10.1093/eurjcn/zvac083
In lockdown 2 and 3 we recruited 45 and 12 participants, respectively, over the first 2 weeks of the lockdown. There were too few patients to analyse in lockdown 3 so comparisons between patients in lockdown 1 and lockdown 2 were made. Overall, we found some difference at 1-year in relation to distress but no other differences at other time-points.
Conference presentations: We have presented the results at national (Society of Cardiothoracic Surgery in 2021 and 2022) and international (EuroHeartCare in 2021) conferences.
-Sanders J, Bueser T, Beaumont E, Dodd M, Owens G, Murray S, Clayton T, Oo AY. Patient recovery from cardiac surgery during the COVID-19 pandemic: 1-year outcomes from the CardiacCovid study. SCTS 2022 (oral presentation) and conference newspaper article
-Bueser T, Clayton T, Owens G, Murray S, Sepehripour, Oo A, Sanders J. The impact of COVID-19 on recovery after heart surgery: Preliminary findings from the CardiacCovid study. EuroHeartCare 2021 (oral presentation)
-Sanders J, Bueser T, Beaumont E, Dodd M, Owens G, Murray S, Sepehripour A, Clayton T, Oo A. Patient recovery from heart surgery during the Covid-19 pandemic: The CardiacCovid study. Society of Cardiothoracic Surgery 2021 (oral presentation).We were also invited to speak at the British Society of Cardiology Cardiovascular Care Partnership (CCPUK) conference (2022) in relation to the patient and public engagement work conducted in relation to this study
Peer reviewed journal paper: The first paper from the study has been accepted for publication in the European Journal of Cardiovascular Nursing:
Sanders J, Bueser T, Beaumont E, Dodd M, Murray SE, Owens G, Berry A, Hyde E, Clayton T and Oo AY. The impact of the COVID-19 pandemic on recovery from cardiac surgery: 1 year outcomes. DOI: https://doi.org/10.1093/eurjcn/zvac083Results to participants: A summary of the results were disseminated to participants in a newsletter in September 2022
Website: We have posted updates on the Aortic dissection Awareness UK website in relation to the study: https://aorticdissectionawareness.org/cardiaccovid-study-close-to-publishing-1-year-outcomes/"
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
20/YH/0132
Date of REC Opinion
16 Apr 2020
REC opinion
Further Information Favourable Opinion