key: cord-0905633-bbkxie0f
authors: Annie, Frank H; Dave, Sahil; Nanjundappa, Aravinda; Mukherjee, Debabrata
title: Effect SARS-COV-2 on Cases of Transcatheter Aortic Valve Implantation
date: 2021-04-13
journal: Am J Cardiol
DOI: 10.1016/j.amjcard.2021.04.005
sha: 67d1980d75c159d16999ee3f2cf0a5df3659e2f8
doc_id: 905633
cord_uid: bbkxie0f

nan

The effect of SARS-COV-2 diagnosis on cases of aortic stenosis that requires a transcatheter aortic valve implantation (TAVI) is poorly understood, and the long-term effects are not well reported. The researchers aimed to determine whether there exists a difference in allcause mortality between patients with a SARS-COV-2 diagnosis that received a TAVI compared to those that did not contract SARS-COV-2.

The researchers queried the TriNetX database, a COVID-19 research network of 61 health care organizations. They analyzed the data using the ICD 10 codes used for TAVI procedures from January 20 th , 2020 to January 30 th , 2021, and identified 3,075 patients aged 18-90 between the two groups: 224 SARS-COV-2 TAVI and 2,851 non-SARS-COV-2 TAVI patients. Descriptive statistics were used to measure association, and the Kaplan-Meier survival curve was used to assess the endpoints of mortality. A propensity score matching of 1:1 was performed with the covariates (i.e., age, male, female, hypertension, coronary artery disease, heart failure, diabetes, smoking history, chronic obstructive pulmonary disease, and body mass index < 30) to reduce possible differences, which resulted in a matched cohort (n = 224/224) over a 365-day time frame. Adjusted hazard ratios of mortality were compared by SAR-COV-2 diagnosis using the Cox proportional hazards model. 29.4%; P < 0.01), chronic obstructive pulmonary disease (38.3% vs. 16.8%; P < 0.01), and body mass index < 30 (66.5% vs. 40.7%; P < 0.01). A log rank test illustrated that the SARS-COV-2 TAVI group had a lower survival probability at end of time window compared to the non-SARS-COV-2 TAVI group (70.7% vs. 92.9%; P < 0.01; see Figure 1 ). A hazards ratio further verified the results (9.8, P < 0.02).

Patients in the SARS-COV-2 TAVI group seemed to have higher all-cause mortality in the unmatched and matched groups than those in the non-SARS-COV-2 TAVI group based on the log rank test. The SARS-COV-2 TAVI group also had a high prevalence of hypertension, coronary artery disease, heart failure, diabetes, smoking history, chronic obstructive pulmonary disease, and body mass index < 30. The potential effect of SARS-COV-2 on TAVI cases is still poorly understand and potential long term consequences need to be further explored. A recent study suggested that whenever possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection [Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study] 1 . The decision to delay TAVI should be tailored for each patient, factoring possible advantages of delaying TAVI after SARS-CoV-2 infection versus potential risks of delay. However, there is a need for further prospective studies to define optimal timing for TAVI after SARS-CoV-2 infection to minimize adverse outcomes as reported in our analysis. 

☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study