en
Scientific article
Open access
English

Timing of surgery following SARS-CoV-2 infection : an international prospective cohort study

ContributorsCOVIDSurg Collaborative; GlobalSurg Collaborative
CollaboratorsWildhaber, Barbara
Published inAnaesthesia, vol. 76, no. 6, p. 748-758
Publication date2021-06
First online date2021-03-09
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.

eng
Keywords
  • COVID-19
  • SARS-CoV-2
  • Delay
  • Surgery
  • Timing
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Internationality
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Prospective Studies
  • Surgical Procedures, Operative / statistics & numerical data
  • Time
  • Young Adult
Citation (ISO format)
COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection : an international prospective cohort study. In: Anaesthesia, 2021, vol. 76, n° 6, p. 748–758. doi: 10.1111/anae.15458
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Article (Published version)
Secondary files (7)
Identifiers
ISSN of the journal0003-2409
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Technical informations

Creation10/03/2022 9:20:26 AM
First validation04/16/2024 9:16:03 AM
Update time04/16/2024 9:16:03 AM
Status update04/16/2024 9:16:03 AM
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