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

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dc.contributor.authorCOVIDSurg Collaborative;
dc.contributor.authorGlobalSurg Collaborative
dc.date.accessioned2021-09-03T17:00:46Z
dc.date.available2021-09-03T17:00:46Z
dc.date.issued2021-06
dc.description.abstractSummary 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.en_US
dc.identifier.citationTiming of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748-758. doi: 10.1111/anae.15458. Epub 2021 Mar 9. PubMed PMID: 33690889; PubMed Central PMCID: PMC8206995.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/9554
dc.language.isoenen_US
dc.publisherEpuben_US
dc.subjectCOVID-19en_US
dc.subjectDelayen_US
dc.subjectSARS-CoV-2en_US
dc.subjectSurgeryen_US
dc.subjectTimingen_US
dc.titleTiming of surgery following SARS-CoV-2 infection: an international prospective cohort studyen_US
dc.typeArticleen_US
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