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

descriptionPublicationkeyboard_double_arrow_right Article , Preprint , Other literature type 09 Mar 2021 English Publisher:WileyJournal:Anaesthesia, volume 76, pages 748-758 (issn: 0003-2409, eissn: 1365-2044,

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Authors: Dmitri Nepogodiev; Joana Ff Simoes; Elizabeth Li; Maria Picciochi; James C Glasbey; Glauco Baiocchi; Ruth Blanco-Colino; +193 Authors

Dmitri Nepogodiev; Joana Ff Simoes; Elizabeth Li; Maria Picciochi; James C Glasbey; Glauco Baiocchi; Ruth Blanco-Colino; Daoud Chaudhry; Ehab AlAmeer; Kariem El-Boghdadly; Funmilola Wuraola; Dhruva Ghosh; Rohan R Gujjuri; Ewen M Harrison; Herman Lule; Haytham Kaafarani; Mohammad Khosravi; Irmgard Kronberger; Sezai Leventoğlu; Harvinder Mann; Kenneth A Mclean; Mengistu Gebreyohanes Mengesha; Maria Marta Modolo; Faustin Ntirenganya; Lisa Norman; Oumaima Outani; Riinu Pius; Peter Pockney; Ahmad Uzair Qureshi; April Camilla Roslani; Sohei Satoi; Catherine Shaw; Aneel Bhangu; Dmitri Nepogodiev; Omar M Omar; Waheed-Ul-Rahman Ahmed; Leah Argus; Alasdair Ball; Aneel Bhangu; Edward P Bywater; Ruth Blanco-Colino; Amanpreet Brar; Daoud Chaudhry; Brett E Dawson; Irani Duran; Muhammed Elhadi; James C Glasbey; Rohan R Gujjuri; Conor S Jones; Ewen M Harrison; Sivesh K Kamarajah; James M Keatley; Samuel Lawday; Elizabeth Li; Harvinder Mann; Ella J Marson; Kenneth A Mclean; Dmitri Nepogodiev; Lisa Norman; Riinu Ots; Oumaima Outani; Maria Picciochi; Irène Santos; Catherine Shaw; Joana Ff Simoes; Elliott H Taylor; Isobel M Trout; Chris Varghese; Mary L Venn; William Xu; Joana Ff Simoes; Irida Dajti; Arben Gjata; Salah Eddine Oussama Kacimi; Luis Boccalatte; Maria Marta Modolo; Daniel Cox; Peter Pockney; Philip Townend; Felix Aigner; Irmgard Elisabeth Kronberger; Elgun Samadov; Amer Alderazi; Kamral Hossain; Greg Padmore; Gabrielle van Ramshorst; Ismaïl Lawani; Anis Cerovac; Samir Delibegovic; Glauco Baiocchi; Gustavo Mendonça Ataíde Gomes; Igor Lima Buarque; Muhammad Gohar; Mihail Slavchev; Chukwuemeka Nwegbu; Arnav Agarwal; Amanpreet Brar; Janet Martin; Joshua Ng-Kamstra; Maria Marta Modolo; Maricarmen Olivos; Wenhui Lou; Dong-Lin Ren; Jose Andres Calvache; Carlos J Perez Rivera; Ana Danic Hadzibegovic; Tomislav Kopjar; Jakov Mihanovic; Pablo Mijahil Avilés Jiménez; Nikolaos Gouvas; Jaroslav Klat; René Novysedlák; Nicolas Amisi; Peter Christensen; Alaa El-Hussuna; Sylvia Batista; Eddy Lincango-Naranjo; Sameh Emile; Danilo Alfonso Arévalo Sandoval; Hailu Dhufera; Samuel Hailu; Mengistu G Mengesha; Joonas H Kauppila; Alexis P Arnaud; Zaza Demetrashvili; Markus Albertsmeier; Hans Lederhuber; Markus W Löffler; Daniel Kwesi Acquah; Bernard Ofori; Stephen Tabiri; Symeon Metallidis; Georgios Tsoulfas; Maria-Lorena Aguilera-Arevalo; Gustavo Recinos; Tamás Mersich; Dániel Wettstein; Dhruva Ghosh; Gabriele Kembuan; Peiman Brouki Milan; Mohammad Hossein Khosravi; Masoud Mozafari; Ahmed Hilmi; Helen Mohan; Oded Zmora; Gaetano Gallo; Francesco Pata; Gianluca Pellino; Yuki Fujimoto; Naoto Kuroda; Sohei Satoi; Mohamad K Abou Chaar; Faris Ayasra; Ildar Fakhradiyev; Intisar Hisham Said Hamdun; Jang Jin-Young; Mohammad Jamal; Lina Karout; Muhammed Elhadi; Aiste Gulla; Fanjandrainy Rasoaherinomenjanahary; Luc Hervé Samison; April Camilla Roslani; Iran Irani Durán Sánchez; Diana Samantha Gonzalez; Laura Martinez; María José Martínez; Alejandra Nayen; Antonio Ramos-De la Medina; Jade Nunez; Oumaima Outani; Pueya Rashid Nashidengo; Rakesh Shah; Ashish Lal Shrestha; Pascal Jonker; Schelto Kruijff; Milou Noltes; Pieter Steinkamp; Chris Varghese; Deborah Wright; Lukman Abdur-Rahman; Adesoji Ademuyiwa; Adewale Adisa; Babatunde Osinaike; Justina Seyi-Olajide; Omolara Williams; Emmanuel Williams; Sofija Pejkova; Zainab Al Balushi; Ahmad Uzair Qureshi; Raza Sayyed; Mustafa Abo Mohsen; Sadi A Abukhalaf; Moises Cukier; Hugo Gomez-Fernandez; Sebastian Shu Yip; Ximena Paola Vasquez Ojeda; Marie Dione Sacdalan; Piotr Major; José Azevedo;

doi: 10.1111/anae.15458 , 10.13140/rg.2.2.14761.40805

pmid: 33690889

pmc: PMC8206995

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

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Abstract

Summary 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.

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Keywords

Male, SARS-CoV-2;, Epidemiology, MULTICENTER, COVID-19; SARS-CoV-2; Delay; Surgery; Timing, Surgical Procedures, Operative / statistics & numerical data, cirug?a general, Cirugía, Anesthesiology, 80 and over, Prospective Studies, delay;, Child, Lung, Aged, 80 and over, CovidSurge Collaborative, anaesthesia, COVID-19 ; delay ; SARS-CoV-2 ; surgery ; timing, Operative, covid-19, Child, Preschool, Pneumonia & Influenza, Public Health, Infection, delay, Clinical Sciences, Sars-cov-2, 610, GlobalSurg Collaborative, Operative/statistics & numerical data, 618, Clinical Research, COVID‐19, Biodefense, 617, Humans, PULMONARY COMPLICATIONS, Aged, Science & Technology, Cirurgia, Prevention, COVID-19; SARS-CoV-2; delay; surgery; timing, Infant, Pneumonia, COVID-19;, General Surgery, Surgery, 1109 Neurosciences, Internationality, COVID-19; delay; SARS-CoV-2; surgery; timing; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cohort Studies; Female; Humans; Infant; Male; Middle Aged; Prospective Studies; SARS-CoV-2; Surgical Procedures, Operative; Time; Young Adult; COVID-19; Internationality; Practice Guidelines as Topic, SARS‐CoV‐2, surgery, Cohort Studies, 3203 Dentistry, Medical Specialties, Medicine and Health Sciences, timing, COVID-19; delay; SARS-CoV-2; surgery; timing;, ddc:610, Delay, COVID-19; delay; SARS-CoV-2; surgery; timing, Settore MEDS-15/A - Neurochirurgia, Middle Aged, Infectious Diseases, Surgical Procedures, Operative, Practice Guidelines as Topic, Female, Patient Safety, 6.4 Surgery, Life Sciences & Biomedicine, Radboudumc 10: Reconstructive and regenerative medicine RIHS: Radboud Institute for Health Sciences, Adult, 61, Adolescent, COVID-19, SARS-CoV-2, delay, surgery, timing, COVIDSurg Collaborative, Time, Vaccine Related, Young Adult, All institutes and research themes of the Radboud University Medical Center, Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences, Mortalitat, Timing, Mortality, surgery;, Preschool, Surgical Procedures, SARS-CoV-2, Neurosciences, 3202 Clinical sciences, Evaluation of treatments and therapeutic interventions, COVID-19, 1103 Clinical Sciences, COVID-19; delay; SARS-CoV-2; surgery; timing; Adolescent, Adult, Aged, Aged, 80 and over, Child; Child; Preschool; Cohort Studies; Female; Humans; Infant; Male; Middle Aged; Prospective Studies; SARS-CoV-2; Surgical Procedures, Operative; Time; Young Adult; COVID-19; Internationality; Practice Guidelines as Topic, Original Articles, Emerging Infectious Diseases, Good Health and Well Being, Anesthesiology and Pain Medicine, /dk/atira/pure/core/keywords/uob_covid19; name=Covid19, Mortalidad

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