Lütfi Çağatay ONAR
Cardiovascular Surgery and Interventions - 2026;13(2):101-110
Objectives: Long coronavirus (COVID) is increasingly encountered in patients undergoing major cardiac surgery. Cardiopulmonary bypass (CPB) induces systemic inflammation that may overlap with proposed mechanisms of Long COVID; however, its contribution to postoperative symptom progression remains unclear. This study evaluated the prevalence of long COVID and predictors of postoperative symptom worsening in patients undergoing coronary artery bypass surgery. Patients and methods: This retrospective analysis used prospectively collected perioperative symptom surveillance data from 1,421 adults undergoing CPB-assisted coronary artery bypass grafting, with or without concomitant valve surgery (November 2020-September 2025). Only patients with a complete 3-month follow-up were included. Symptoms were assessed preoperatively and at 3 months using a structured questionnaire and scoring system. Results: Long COVID symptoms were present in 5.6% of patients. Affected individuals were more often >=65 years, female, and had poor glycemic control, severe obesity, repeated COVID-19 infections, sleep disturbances, and neuropsychiatric or immunologic disorders. The factor V Leiden mutation was more frequent. Symptom worsening was independently associated with HbA1c >9%, multivessel coronary artery disease, severe obesity, and neuropsychiatric or immunologic comorbidities. CPB exposure was not independently associated with symptom progression. Conclusion: CPB was not associated with increased progression of postoperative symptoms. Findings suggest that symptom worsening is primarily related to underlying metabolic and neuropsychiatric vulnerability, supporting the importance of perioperative risk stratification.
