Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels
Background Adults undergoing heart surgery are particularly vulnerable to respiratory complications, including COVID‐19. Immunization can significantly reduce this risk; however, the effect of cardiopulmonary bypass (CPB) on immunization status is unknown. We sought to evaluate the effect of CPB on...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.029406 |
| _version_ | 1797689820755001344 |
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| author | Raymond J. Strobel Adishesh K. Narahari Evan P. Rotar Andrew M. Young Jeffrey Vergales J. Hunter Mehaffey Nicholas R. Teman John A. Kern Leora T. Yarboro Irving L. Kron Michael R. Nelson Mark Roeser |
| author_facet | Raymond J. Strobel Adishesh K. Narahari Evan P. Rotar Andrew M. Young Jeffrey Vergales J. Hunter Mehaffey Nicholas R. Teman John A. Kern Leora T. Yarboro Irving L. Kron Michael R. Nelson Mark Roeser |
| author_sort | Raymond J. Strobel |
| collection | DOAJ |
| description | Background Adults undergoing heart surgery are particularly vulnerable to respiratory complications, including COVID‐19. Immunization can significantly reduce this risk; however, the effect of cardiopulmonary bypass (CPB) on immunization status is unknown. We sought to evaluate the effect of CPB on COVID‐19 vaccination antibody concentration after cardiac surgery. Methods and Results This prospective observational clinical trial evaluated adult participants undergoing cardiac surgery requiring CPB at a single institution. All participants received a full primary COVID‐19 vaccination series before CPB. SARS‐CoV‐2 spike protein‐specific antibody concentrations were measured before CPB (pre‐CPB measurement), 24 hours following CPB (postoperative day 1 measurement), and approximately 1 month following their procedure. Relationships between demographic or surgical variables and change in antibody concentration were assessed via linear regression. A total of 77 participants were enrolled in the study and underwent surgery. Among all participants, mean antibody concentration was significantly decreased on postoperative day 1, relative to pre‐CPB levels (−2091 AU/mL, P<0.001). Antibody concentration increased between postoperative day 1and 1 month post CPB measurement (2465 AU/mL, P=0.015). Importantly, no significant difference was observed between pre‐CPB and 1 month post CPB concentrations (P=0.983). Two participants (2.63%) developed symptomatic COVID‐19 pneumonia postoperatively; 1 case of postoperative COVID‐19 pneumonia resulted in mortality (1.3%). Conclusions COVID‐19 vaccine antibody concentrations were significantly reduced in the short‐term following CPB but returned to pre‐CPB levels within 1 month. One case of postoperative COVID 19 pneumonia‐specific mortality was observed. These findings suggest the need for heightened precautions in the perioperative period for cardiac surgery patients. |
| first_indexed | 2024-03-12T01:51:00Z |
| format | Article |
| id | doaj.art-20e4b10b914c4770abd56f8b2a01c285 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-12T01:51:00Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-20e4b10b914c4770abd56f8b2a01c2852023-09-08T12:39:35ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-09-01121710.1161/JAHA.123.029406Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody LevelsRaymond J. Strobel0Adishesh K. Narahari1Evan P. Rotar2Andrew M. Young3Jeffrey Vergales4J. Hunter Mehaffey5Nicholas R. Teman6John A. Kern7Leora T. Yarboro8Irving L. Kron9Michael R. Nelson10Mark Roeser11Division of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USASchool of Medicine University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Pediatric Cardiology, Department of Pediatrics University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USADivision of Allergy and Clinical Immunology, Department of Medicine University of Virginia Charlottesville VA USADivision of Cardiac Surgery, Department of Surgery University of Virginia Charlottesville VA USABackground Adults undergoing heart surgery are particularly vulnerable to respiratory complications, including COVID‐19. Immunization can significantly reduce this risk; however, the effect of cardiopulmonary bypass (CPB) on immunization status is unknown. We sought to evaluate the effect of CPB on COVID‐19 vaccination antibody concentration after cardiac surgery. Methods and Results This prospective observational clinical trial evaluated adult participants undergoing cardiac surgery requiring CPB at a single institution. All participants received a full primary COVID‐19 vaccination series before CPB. SARS‐CoV‐2 spike protein‐specific antibody concentrations were measured before CPB (pre‐CPB measurement), 24 hours following CPB (postoperative day 1 measurement), and approximately 1 month following their procedure. Relationships between demographic or surgical variables and change in antibody concentration were assessed via linear regression. A total of 77 participants were enrolled in the study and underwent surgery. Among all participants, mean antibody concentration was significantly decreased on postoperative day 1, relative to pre‐CPB levels (−2091 AU/mL, P<0.001). Antibody concentration increased between postoperative day 1and 1 month post CPB measurement (2465 AU/mL, P=0.015). Importantly, no significant difference was observed between pre‐CPB and 1 month post CPB concentrations (P=0.983). Two participants (2.63%) developed symptomatic COVID‐19 pneumonia postoperatively; 1 case of postoperative COVID‐19 pneumonia resulted in mortality (1.3%). Conclusions COVID‐19 vaccine antibody concentrations were significantly reduced in the short‐term following CPB but returned to pre‐CPB levels within 1 month. One case of postoperative COVID 19 pneumonia‐specific mortality was observed. These findings suggest the need for heightened precautions in the perioperative period for cardiac surgery patients.https://www.ahajournals.org/doi/10.1161/JAHA.123.029406cardiac surgerycardiopulmonary bypasscoronavirus disease 2019 |
| spellingShingle | Raymond J. Strobel Adishesh K. Narahari Evan P. Rotar Andrew M. Young Jeffrey Vergales J. Hunter Mehaffey Nicholas R. Teman John A. Kern Leora T. Yarboro Irving L. Kron Michael R. Nelson Mark Roeser Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac surgery cardiopulmonary bypass coronavirus disease 2019 |
| title | Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels |
| title_full | Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels |
| title_fullStr | Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels |
| title_full_unstemmed | Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels |
| title_short | Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels |
| title_sort | effect of cardiopulmonary bypass on sars cov 2 vaccination antibody levels |
| topic | cardiac surgery cardiopulmonary bypass coronavirus disease 2019 |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.029406 |
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