| Title: |
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. |
| Authors: |
GlobalSurg Collaborative, COVIDSurg Collaborative |
| Source: |
GlobalSurg Collaborative, COVIDSurg Collaborative (2021). Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia, 76(6), pp. 748-758. Wiley-Blackwell 10.1111/anae.15458 |
| Publisher Information: |
Wiley-Blackwell |
| Publication Year: |
2021 |
| Collection: |
BORIS (Bern Open Repository and Information System, University of Bern) |
| Subject Terms: |
610 Medicine & health |
| 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://boris.unibe.ch/157721/ |
| Availability: |
https://boris.unibe.ch/157721/1/anae.15458.pdf; https://boris.unibe.ch/157721/ |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.F89F61E4 |
| Database: |
BASE |