Naslov
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

Autori
COVIDSurg Collaborative ; GlobalSurg Collaborative

Kolaboracija
COVIDSurg Collaborative ; GlobalSurg Collaborative

Izvornik
Anaesthesia (0003-2409) 77 (2022), 1; 28-39

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

Ključne riječi
COVID-19 ; SARS-CoV-2 ; deep vein thrombosis ; pulmonary embolism ; venous thromboembolism

Sažetak
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery) ; recent (1-6 weeks before surgery) ; previous (≥7 weeks before surgery) ; or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123, 591) in patients without SARS-CoV-2 ; 2.2% (50/2317) in patients with peri-operative SARS- CoV-2 ; 1.6% (15/953) in patients with recent SARS- CoV-2 ; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2- 3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3- 6.7)). In patients with SARS-CoV- 2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Autori na kolaboraciji navedeni na kraju rada
(Appendix S1 - GlobalSurg-CovidSurg Week
Authorship)
Writing group:
Alexis P Arnaud (France), José Moreira de Azevedo
(Portugal), Ana Maria Minaya Bravo (Spain), Daoud
Chaudhry (UK), Ehab AlAmeer (Saudi Arabia), Kariem
El-Boghdadly (UK), Muhammed Elhadi (Libya), Sameh
Emile (Egypt), Gaetano Gallo (Italy), James C
Glasbey (UK), Dhruva Ghosh (India), Arda Isik
(Turkey), Conor S Jones (UK), Sezai Leventoğlu
(Turkey), Elizabeth Li* (UK), Janet Martin
(Canada), Helen Mohan (Ireland), Dmitri
Nepogodiev* (UK), Pranay Pawar (India), Neil Smart
(UK), Peter Pockney (Australia), Joana FF Simoes
(Portugal), Stephen Tabiri (Ghana), Mary L Venn
(UK), Deborah Wright (New Zealand), 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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