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

Tijdschriftbijdrage - Tijdschriftartikel

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.

Tijdschrift: Anaesthesia
ISSN: 0003-2409
Issue: 6
Volume: 76
Pagina's: 748-758
Jaar van publicatie:2021
Trefwoorden:surgery, SARS‐CoV‐2 infection
  • DOI: https://doi.org/10.1111/anae.15458
  • Scopus Id: 85102236123
  • WoS Id: 000626707000001
  • ORCID: /0000-0001-5758-9547/work/121047812
  • ORCID: /0000-0002-4806-2775/work/121047998
  • ORCID: /0000-0002-8352-9756/work/121056656
BOF-keylabel:ja
IOF-keylabel:ja
BOF-publication weight:6
Auteurs:Regional
Authors from:Higher Education
Toegankelijkheid:Open