| Title: |
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study |
| Authors: |
COVIDSurg Collaborative; GlobalSurg Collaborative; Silvia Palmisano; Nicolò de Manzini |
| Contributors: |
Collaborative, Covidsurg; Collaborative, Globalsurg; Palmisano, Silvia; de Manzini, Nicolo' |
| Publication Year: |
2021 |
| Collection: |
Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste) |
| Subject Terms: |
COVID-19; SARS-CoV-2; delay; surgery; timing |
| 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 0-2weeks, 3-4weeks and 5-6weeks 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 ≥7weeks 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 ≥7week 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 7weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥7weeks from diagnosis may benefit from further delay. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/33690889; info:eu-repo/semantics/altIdentifier/wos/WOS:000626707000001; volume:76; issue:6; firstpage:748; lastpage:758; numberofpages:11; journal:ANAESTHESIA; https://hdl.handle.net/11368/2982091 |
| DOI: |
10.1111/anae.15458 |
| Availability: |
https://hdl.handle.net/11368/2982091; https://doi.org/10.1111/anae.15458; https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15458 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.C29C0263 |
| Database: |
BASE |