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

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Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. / COVIDSurg Collaborative; GlobalSurg Collaborative.

In: Anaesthesia, Vol. 76, No. 6, 06.2021, p. 748-758.

Research output: Contribution to journal › Article › peer-review

Author

COVIDSurg Collaborative ; GlobalSurg Collaborative. / Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. In: Anaesthesia. 2021 ; Vol. 76, No. 6. pp. 748-758.

BibTeX

@article{116e4190d1da42489d63f798de96f83b,

title = "Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study",

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.",

keywords = "COVID-19, SARS-CoV-2, delay, surgery, timing, Prospective Studies, Humans, Middle Aged, Child, Preschool, Infant, Male, Time, Surgical Procedures, Operative/statistics & numerical data, Young Adult, Internationality, Adolescent, Aged, 80 and over, Adult, Female, Aged, Child, Cohort Studies, Practice Guidelines as Topic",

author = "{COVIDSurg Collaborative} and {GlobalSurg Collaborative} and Трофимов, {Алексей Андреевич} and Anna Zolotoukho and Павлов, {Ростислав Владимирович}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.",

year = "2021",

month = jun,

doi = "10.1111/anae.15458",

language = "English",

volume = "76",

pages = "748--758",

journal = "Anaesthesia",

issn = "0003-2409",

publisher = "Wiley-Blackwell",

number = "6",

}

RIS

TY - JOUR

T1 - Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

AU - COVIDSurg Collaborative

AU - GlobalSurg Collaborative

AU - Трофимов, Алексей Андреевич

AU - Zolotoukho, Anna

AU - Павлов, Ростислав Владимирович

PY - 2021/6

Y1 - 2021/6

N2 - 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.

AB - 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.

KW - COVID-19

KW - SARS-CoV-2

KW - delay

KW - surgery

KW - timing

KW - Prospective Studies

KW - Humans

KW - Middle Aged

KW - Child, Preschool

KW - Infant

KW - Male

KW - Time

KW - Surgical Procedures, Operative/statistics & numerical data

KW - Young Adult

KW - Internationality

KW - Adolescent

KW - Aged, 80 and over

KW - Adult

KW - Female

KW - Aged

KW - Child

KW - Cohort Studies

KW - Practice Guidelines as Topic

UR - http://www.scopus.com/inward/record.url?scp=85102236123&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/d6a71fb4-dde5-36db-9539-766d9e6da34e/

U2 - 10.1111/anae.15458

DO - 10.1111/anae.15458

M3 - Article

C2 - 33690889

VL - 76

SP - 748

EP - 758

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

IS - 6

ER -

ID: 84439753