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

Publication ,  Journal Article
COVIDSurg Collaborative, ; GlobalSurg Collaborative,
Published in: Anaesthesia
June 2021

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.

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Published In

Anaesthesia

DOI

EISSN

1365-2044

Publication Date

June 2021

Volume

76

Issue

6

Start / End Page

748 / 758

Location

England

Related Subject Headings

  • Young Adult
  • Time
  • Surgical Procedures, Operative
  • SARS-CoV-2
  • Prospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Internationality
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
NLM
COVIDSurg Collaborative, ., & GlobalSurg Collaborative, . (2021). Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia, 76(6), 748–758. https://doi.org/10.1111/anae.15458
COVIDSurg Collaborative, Francesco, and Francesco GlobalSurg Collaborative. “Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.Anaesthesia 76, no. 6 (June 2021): 748–58. https://doi.org/10.1111/anae.15458.
COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748–58.
COVIDSurg Collaborative, Francesco, and Francesco GlobalSurg Collaborative. “Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.Anaesthesia, vol. 76, no. 6, June 2021, pp. 748–58. Pubmed, doi:10.1111/anae.15458.
COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748–758.
Journal cover image

Published In

Anaesthesia

DOI

EISSN

1365-2044

Publication Date

June 2021

Volume

76

Issue

6

Start / End Page

748 / 758

Location

England

Related Subject Headings

  • Young Adult
  • Time
  • Surgical Procedures, Operative
  • SARS-CoV-2
  • Prospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Internationality
  • Infant