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
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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.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0003-2409 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Thomas Michael Marti |
Date Deposited: |
09 Aug 2021 16:23 |
Last Modified: |
10 May 2022 13:18 |
Publisher DOI: |
10.1111/anae.15458 |
PubMed ID: |
33690889 |
Additional Information: |
Gregor Kocher is Member of COVIDSurg Collaborative, GlobalSurg Collaborative |
Uncontrolled Keywords: |
COVID-19 SARS-CoV-2 delay surgery timing |
BORIS DOI: |
10.48350/157721 |
URI: |
https://boris.unibe.ch/id/eprint/157721 |
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