The Enhanced Recovery After Surgery (ERAS) protocol affected traditional cardiac surgery processes and COVID-19 is expected to accelerate its scalability. The aim of this study was to assess the impact of an ERAS-based protocol on the length of hospital stay after cardiac surgery. From January 2019 to June 2020, 664 patients underwent consecutive cardiac surgery at a Latin American center. Here, 46 patients were prepared for a rapid recovery through a multidisciplinary institutional protocol based on the ERAS concept, the “TotalCor protocol”. After the propensity score matching, 46 patients from the entire population were adjusted for 12 variables. Patients operated on the TotalCor protocol had reduced intensive care unit time (P < 0.025), postoperative stay (P ≤ 0.001) and length of hospital stay (P ≤ 0.001). In addition, there were no significant differences in the occurrence of complications and death between the two groups. Of the 10-central metrics of TotalCor protocol, 6 had > 70% adherences. In conclusion, the TotalCor protocol was safe and effective for a 3-day discharge after cardiac surgery. Postoperative atrial fibrillation and renal failure were predictors of postoperative stay > 5 days.

The novel coronavirus SARS-COV-2 (COVID-19) pandemic dramatically changed the workflow of healthcare professionals around the world. Surgical procedures were withheld and postponed in a scenario of fear and uncertainty. Despite numerous medical institutions having swiftly and widely implemented pre-operative screening protocols, cost-effective studies remain scarce specially when comparing to other mitigation measures such as the donning of masks and social distancing measures. The objective of our study is to report the monthly positivity rates of SARS-COV-2 infection in our service and compare our data with monthly positivity rates reported by the State Health Department. Between April, 2020, to February, 2022, 7,199 patients had the RT-PCR for SARS-COV-2 collected, with 187 (2.59%) testing positive for COVID-19. Most of them (62.1%) were asymptomatic. The most common symptoms were coryza (10.7%), fever (10%), and diarrhea (8.7%). Nonetheless, there were two deaths due to COVID-19 reported in our center. Further studies are necessary to elucidate the impact of pre-operative screening for SARS-COV-2 in asymptomatic patients.

RESUMO A pandemia causada pelo novo coronavírus (SARS-COV-2) alterou a rotina de pacientes, profissionais e serviços de saúde em todo o mundo levando ao adiamento ou suspensão de muitos procedimentos cirúrgicos. Muitos serviços implementaram protocolos de triagem sistemática pré-operatória para SARS-COV-2. No entanto, segue incerta a eficácia da triagem sistemática de pacientes assintomáticos para SARS-COV-2 quando comparada com outras medidas de mitigação como o uso de máscaras e o distanciamento social apesar da aparente sensação de segurança conferida pela testagem pré-operatória de pacientes para SARS-COV-2. Sendo assim, descrevemos a experiência de dois anos de um hospital pediátrico (n=7.199) na triagem sistemática pré-operatória para SARS-COV-2 e comparamos a taxa de positividade mensal reportada pelo serviço em relação a taxa de positividade mensal regional do Estado de São Paulo. No período de Abril de 2020 a Fevereiro de 2022 houveram 187 (2,56%) RT-PCR positivos para COVID-19 dos quais 62.1% assintomáticos. Os sintomas mais comuns foram coriza (10,7%), febre (10%) e diarreia (8,7%). Dois pacientes faleceram em decorrência de sintomas relacionados a COVID-19. Mais estudos são necessários para determinar o impacto da testagem pré-operatória de RT-PCR para SARS-COV-2 em pacientes assintomáticos na mitigação da transmissão intra-hospitalar e na morbidade cirúrgica.