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

Autori
COVIDSurg Collaborative ; GlobalSurg Collaborative

Kolaboracija
COVIDSurg Collaborative ; GlobalSurg Collaborative

Izvornik
Anaesthesia (0003-2409) 76 (2021), 6; 748-758

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
COVID-19 ; delay ; SARS-CoV-2 ; surgery ; timing

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

Napomena
Autori na kolaboraciji navedeni na kraju rada
(Appendix S2 - GlobalSurg-CovidSurg Week
Authorship)
Writing group:
Dmitri Nepogodiev* (UK), Joana FF Simoes*
(Portugal), Elizabeth Li* (UK), Maria Picciochi*
(Portugal), James C Glasbey*
(UK), Glauco Baiocchi (Brazil), Ruth Blanco-Colino
(Spain), Daoud Chaudhry (UK), Ehab AlAmeer (Saudi
Arabia), Kariem El-
Boghdadly (UK), Funmilola Wuraola (Nigeria),
Dhruva Ghosh (India), Rohan R Gujjuri (UK), Ewen M
Harrison (UK), Herman
Lule (Uganda), Haytham Kaafarani (United States),
Mohammad Khosravi (Iran), Irmgard Kronberger
(Austria), Sezai
Leventoğlu (Turkey), Harvinder Mann (UK), Kenneth
A Mclean (UK), Mengistu Gebreyohanes Mengesha
(Ethiopia), Maria Marta
Modolo (Argentina), Faustin Ntirenganya (Rwanda),
Lisa Norman (UK), Oumaima Outani (Morocco), Riinu
Pius (UK), Peter
Pockney (Australia), Ahmad Uzair Qureshi
(Pakistan), April Camilla Roslani (Malaysia),
Sohei Satoi (Japan), Catherine
Shaw (UK), Aneel Bhangu(UK).
Dissemination Committee:
Croatia: Ana Danic Hadzibegovic, Tomislav Kopjar,
Jakov Mihanovic Hospital Leads:Croatia: Jakov
Mihanovic (Zadar General
Hospital, Zadar). Local Collaborators: Croatia:
Kristina Bitunjac, Karlo Grulović, Marijana
Vučković (General and
Veterans Hospital ‘Hrvatski Ponos’ Knin, Knin);
Goran Šantak (County General Hospital Pozega,
Pozega); Emanuel Borovic,
Ana Bosak Versic, Damir Hasandić, Natasa Poldan
Grabar, Suzana Srsen Medancic (University Hospital
Center Rijeka,
Rijeka); Lucija Brkic, Sara Cokarić, Petra Pavic
Palac, Zeljka Samac, Josipa Tomić, Marija Vrdoljak
(General Hospital
Sibenik, Sibenik); Ivan Bacic, Bernarda Bakmaz,
Nikolina Bratošević Vučičić, Domagoj Brzic, Samir
Canovic, Emilio Dijan,
Maja Grgec Dragicevic, Robert Karlo, Suzana
Konjevoda, Petra Kovačević, Ivan Kovačić, Frane
Markulić, Luka Matak, Jakov
Mihanovic, Domagoj Morović, Gordan Perišić, Andrea
Simic, Neven Skitarelić, Matea Veršić, Vanja
Žufić, Matea Zuzul
(Zadar General Hospital, Zadar); Srdan Ante Anzic,
Iva Carevic, Dubravka Heli Litvic, Duska Markov-
Glavas, Tatjana Savic
Jovanovic (Children’s Hospital Srebrnjak, Zagreb);
Goran Augustin, Jerko Biloš, Bojan Biočina,
Vedrana Biosic, Dino
Bobovec, Iva Botica, Boris Bumber, Petra Čerina,
Ana Danic Hadzibegovic, Katarina Duric Vukovic,
Hrvoje Gasparovic,
Lucija Gatin, Kresimir Grsic, Ika Gugić
Radojković, Ivan Jelčić, Zeljko Kastelan, Juraj
Kolak, Tomislav Kopjar, Tomislav
Kulis, Kristian Kunjko, Marjan Maric, Marcel
Marjanović Kavanagh, Borna Milicic, Trpimir Morić,
Miram Pasini, Luka
Penezić, Drago Prgomet, Ratko Prstacic, Andreja
Prtorić, Rudolf Radojković, Ivan Romić, Tomislav
Sečan, Dora Škrljak
Šoša, Juraj Slipac, Mislav Tomic, Jurica Zedelj,
Toni Zekulić, Zoran Zimak (University Hospital
Centre Zagreb, Zagreb);
Mia Lorencin, Ivica Luksic, Matija Mamic
(University Hospital Dubrava, Zagreb)

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