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

Anaesthesia, 2021-06, Vol.76 (6), p.748-758 [Peer Reviewed Journal]

2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 0003-2409 ;ISSN: 1365-2044 ;EISSN: 1365-2044 ;DOI: 10.1111/anae.15458 ;PMID: 33690889

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Title:
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study
Author: Nepogodiev, Dmitri ; Cherkaoui, Zineb ; D’urso, Antonio ; Felli, Emanuele ; Gonzalez, Cristians Alejandro ; Ignat, Mihaela ; Mutter, Didier ; Pessaux, Patrick ; Seeliger, Barbara ; Vix, Michel
Subjects: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cohort Studies ; COVID-19 ; Emerging diseases ; Female ; Human health and pathology ; Humans ; Infant ; Infectious diseases ; Internationality ; Life Sciences ; Male ; Medicin och hälsovetenskap ; Middle Aged ; Practice Guidelines as Topic ; Prospective Studies ; SARS-CoV-2 ; Surgery ; Surgical Procedures, Operative - statistics & numerical data ; Time ; Young Adult
Is Part Of: Anaesthesia, 2021-06, Vol.76 (6), p.748-758
Description: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
Publisher: England: Wiley
Language: English
Identifier: ISSN: 0003-2409
ISSN: 1365-2044
EISSN: 1365-2044
DOI: 10.1111/anae.15458
PMID: 33690889
Source: SWEPUB Freely available online

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

2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 0003-2409 ;ISSN: 1365-2044 ;EISSN: 1365-2044 ;DOI: 10.1111/anae.15458 ;PMID: 33690889

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