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

[EN]Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determinethe optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. Thisinternational, multicentre, prospective cohort study included patients undergoing e...

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Detalles Bibliográficos
Autores: COVIDSurgCollaborative, GlobalSurgCollaborative
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/155372
Acceso en línea:http://hdl.handle.net/10366/155372
Access Level:acceso abierto
Palabra clave:COVID-19
delay
SARS-CoV-2
surgery
timing
General Surgery
cirugía general
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spelling Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort studyCOVIDSurgCollaborativeGlobalSurgCollaborativeCOVID-19delaySARS-CoV-2surgerytimingGeneral Surgerycirugía general[EN]Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determinethe optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. Thisinternational, multicentre, prospective cohort study included patients undergoing elective or emergencysurgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared withthose without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperativemortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by timefrom 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-2infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality wasincreased 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 ahigher 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 delayedfor at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms≥7 weeks from diagnosismay benefit from further delaTrial registration at clinicaltrials.gov (NCT04509986). Theauthors would like to thank the RCS Covid Research Groupfor their support. Funding was provided by: the NationalInstitute for Health Research (NIHR) Global Health ResearchUnit; Association of Coloproctology of Great Britain andIreland; Bowel and Cancer Research; Bowel DiseaseResearch Foundation; Association of Upper GastrointestinalSurgeons; British Association of Surgical Oncology; BritishGynaecological Cancer Society; European Society ofColoproctology; Medtronic; NIHR Academy; Sarcoma UK;the Urology Foundation; Vascular Society for Great Britainand Ireland; and Yorkshire Cancer Research. The viewsexpressed are those of the authors and not necessarily thoseof the funding partners.Wiley&Sons202420242021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/155372reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1553722026-06-07T06:28:51Z
dc.title.none.fl_str_mv Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
title Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
spellingShingle Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
COVIDSurgCollaborative
COVID-19
delay
SARS-CoV-2
surgery
timing
General Surgery
cirugía general
title_short Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
title_full Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
title_fullStr Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
title_full_unstemmed Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
title_sort Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
dc.creator.none.fl_str_mv COVIDSurgCollaborative
GlobalSurgCollaborative
author COVIDSurgCollaborative
author_facet COVIDSurgCollaborative
GlobalSurgCollaborative
author_role author
author2 GlobalSurgCollaborative
author2_role author
dc.subject.none.fl_str_mv COVID-19

delay

SARS-CoV-2

surgery

timing
General Surgery
cirugía general
topic COVID-19
delay
SARS-CoV-2
surgery
timing
General Surgery
cirugía general
description [EN]Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determinethe optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. Thisinternational, multicentre, prospective cohort study included patients undergoing elective or emergencysurgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared withthose without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperativemortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by timefrom 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-2infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality wasincreased 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 ahigher 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 delayedfor at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms≥7 weeks from diagnosismay benefit from further dela
publishDate 2021
dc.date.none.fl_str_mv 2021
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10366/155372
url http://hdl.handle.net/10366/155372
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley&Sons
publisher.none.fl_str_mv Wiley&Sons
dc.source.none.fl_str_mv reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname:Universidad de Salamanca (USAL)
instname_str Universidad de Salamanca (USAL)
reponame_str GREDOS. Repositorio Institucional de la Universidad de Salamanca
collection GREDOS. Repositorio Institucional de la Universidad de Salamanca
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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