clinical NEWS

August 22, 2O23

COVID Antibody Levels Rebound after CPB

Patients who need cardiac surgery often have significant underlying medical condition making them more susceptible to infection. As most of the population is now vaccinated against SARS-CoV-2 (COVID-19), there are now questions on whether the antibodies gained after vaccination still offer adequate protection after cardiopulmonary bypass (CPB).

Vaccines help prevent infection by triggering the immune system to produce antibodies that will recognize and fight bacteria, viruses and other pathogens. Vaccines usually contain deactivated materials from the target pathogen to serve as a stimulus but this time, a new type of vaccine, called messenger RNA (mRNA) vaccine was used for COVID-19. It has a piece of mRNA molecule which tells cells how to produce copies of the inactive spike protein of the COVID-19 virus.

Cardiac surgery using CPB is known to cause systemic inflammatory response and impaired cellular immune response from blood exposure to foreign materials of the extracorporeal circuit. There is limited information whether CPB-induced inflammatory response will have an effect on antibody concentration given the different mechanism of the new COVID-19 mRNA vaccine.

A new study1 published in the Journal of the American Heart Association analyzed the antibody levels of 77 vaccinated patients before and after cardiac surgery with CPB. Results showed that antibody concentrations were not associated with vaccine type, patient characteristics and operational variables. COVID-19 vaccine antibody concentrations dropped significantly right after CPB operation. 2 patients developed COVID-19 pneumonia during the postoperative period with one patient dying. However, antibody levels returned to pre-surgery concentrations within a month.

Because antibody concentrations are reduced during the first month after cardiac surgery with CPB, the study highlighted the importance of patients practicing COVID-19 preventive measures like social distancing, frequent hand-washing and wearing N-95 masks even when already vaccinated during this transition period. The study also confirmed that there is no significant difference in antibody concentrations from mRNA vaccines compared to traditional virus-vector vaccines.

Current guidelines recommend vaccination for all patients prior to cardiac surgery. However, more research is still needed to investigate the precise mechanism of how CPB can affect vaccine antibody production. While restrictions have been eased in most parts of the world, it is important for patients who have just undergone cardiac surgery to still remain vigilant and practice COVID-19 preventive actions.


1. Strobel, R. J., Narahari, A. K., Rotar, E. P., Young, A. M., Vergales, J., Mehaffey, J. H., Teman, N. R., Kern, J. A., Yarboro, L. T., Kron, I. L., Nelson, M. R., & Roeser, M. (2023). Effect of cardiopulmonary bypass on SARS‐COV‐2 vaccination antibody levels. Journal of the American Heart Association.

Related device

Technowood COMPO III Neo

With advancements in cardiopulmonary bypass (CPB) techniques, there are instances when additional pumps are needed which the current heart-lung machine used is not able to support. Since the roller pumps and controller of the COMPO III Neo are compact and modular, they can be integrated to other systems to accommodate this need. Furthermore, additional safety modules can be further added so that pump control is not limited only to the main arterial pump.


Not all products shown are approved for sale in all countries.
Please contact the regional Technowood representative for more information.

Back to NEWSROOM page