| Title: |
Timing of surgery following SARS-CoV-2 infection : an international prospective cohort study |
| Authors: |
COVIDSurg Collaborative; GlobalSurg Collaborative; Nepogodiev, D.; Simoes, Joana F. F.; Li, Elizabeth; Sund, Malin |
| Contributors: |
Department of Surgery; HUS Abdominal Center |
| Publisher Information: |
Wiley Blackwell |
| Publication Year: |
2022 |
| Collection: |
Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| Subject Terms: |
COVID-19; delay; SARS-CoV-2; surgery; timing; PULMONARY COMPLICATIONS; MULTICENTER; anesthesiology; intensive care; radiology |
| 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. ; Peer reviewed |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Trial registration at clinicaltrials.gov (NCT04509986). The authors would like to thank the RCS Covid Research Group for their support. Funding was provided by: the National Institute for Health Research (NIHR) Global Health Research Unit; Association of Coloproctology of Great Britain and Ireland; Bowel and Cancer Research; Bowel Disease Research Foundation; Association of Upper Gastrointestinal Surgeons; British Association of Surgical Oncology; British Gynaecological Cancer Society; European Society of Coloproctology; Medtronic; NIHR Academy; Sarcoma UK; the Urology Foundation; Vascular Society for Great Britain and Ireland; and Yorkshire Cancer Research. The views expressed are those of the authors and not necessarily those of the funding partners. No other competing interests.; https://hdl.handle.net/10138/341206; 000626707000001 |
| Availability: |
https://hdl.handle.net/10138/341206 |
| Rights: |
cc_by ; info:eu-repo/semantics/openAccess ; openAccess |
| Accession Number: |
edsbas.4BA76FFD |
| Database: |
BASE |