Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study
Author
Rubio-Palau, Josep
COVIDSurg Collaborative
GlobalSurg Collaborative
Publication date
2021ISSN
1365-2044
Abstract
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.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
617 - Surgery. Orthopaedics. Ophthalmology
Keywords
Sars-cov-2
COVID-19
Cirurgia
Mortalitat
Sars-cov-2
COVID-19
Cirugía
Mortalidad
Sars-cov-2
COVID-19
Surgery
Mortality
Pages
11
Publisher
John Wiley & Sons
Collection
76; 6
Is part of
Anaesthesia
Citation
COVIDSurg Collaborative; GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia, 2021, 76, p. 748-758. Disponible en: <https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15458>. Fecha de acceso: 21 oct. 2022. DOI: 10.1111/anae.15458
Link to the related item
This item appears in the following Collection(s)
- Ciències de la Salut [738]
Rights
©2021 The Authors.Anaesthesiapublished by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use,distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc/4.0/