TY - JOUR
T1 - Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection
T2 - an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic
AU - De Luca, Maurizio
AU - Sartori, Alberto
AU - Vitiello, Antonio
AU - Piatto, Giacomo
AU - Noaro, Giulia
AU - Olmi, Stefano
AU - Foschi, Diego
AU - De Re, Luca
AU - Zappa, Marco
AU - Sarro, Giuliano
AU - Rivolta, Umberto
AU - Giraudo, Giorgio
AU - Borghi, Felice
AU - Pozzo, Gabriele
AU - Sorisio, Vincenzo
AU - Pignata, Giusto
AU - Greco, Paola Antonella
AU - Sisti, Valerio
AU - Campagnaro, Tommaso
AU - Guglielmi, Alfredo
AU - Andreuccetti, Jacopo
AU - Di Leo, Alberto
AU - Lauro, Enrico
AU - Ricci, Francesco
AU - Musella, Mario
AU - Zizzo, Maurizio
AU - Bonacini, Stefano
AU - Podda, Mauro
AU - Pisanu, Adolfo
AU - Coletta, Pietro
AU - Guerrieri, Mario
AU - Caracino, Valerio
AU - Basti, Massimo
AU - Pilone, Vincenzo
AU - Raffaelli, Marco
AU - Oragano, Luigi
N1 - Publisher Copyright:
© 2021, Italian Society of Surgery (SIC).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Since the beginning of the pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), several articles reported negative outcomes in surgery of infected patients. Aim of this study is to report results of patients with COVID-19-positive swab, in the perioperative period after surgery. Data of COVID-19-positive patients undergoing emergent or oncological surgery, were collected in a retrospective, multicenter study, which involved 20 Italian institutions. Collected parameters were age, sex, body mass index, COVID-19-related symptoms, patients’ comorbidities, surgical procedure, personal protection equipment (PPE) used in operating rooms, rate of postoperative infection among healthcare staff and complications, within 30-postoperative days. 68 patients, who underwent surgery, resulted COVID-19-positive in the perioperative period. Symptomatic patients were 63 (92.5%). Fever was the main symptom in 36 (52.9%) patients, followed by dyspnoea (26.5%) and cough (13.2%). We recorded 22 (32%) intensive care unit admissions, 23 (33.8%) postoperative pulmonary complications and 15 (22%) acute respiratory distress syndromes. As regards the ten postoperative deaths (14.7%), 6 cases were related to surgical complications. One surgeon, one scrub nurse and two circulating nurses were infected after surgery due to the lack of specific PPE. We reported less surgery-related pulmonary complications and mortality in Sars-CoV-2-infected patients, than in literature. Emergent and oncological surgery should not be postponed, but it is mandatory to use full PPE, and to adopt preoperative screenings and strategies that mitigate the detrimental effect of pulmonary complications, mostly responsible for mortality.
AB - Since the beginning of the pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), several articles reported negative outcomes in surgery of infected patients. Aim of this study is to report results of patients with COVID-19-positive swab, in the perioperative period after surgery. Data of COVID-19-positive patients undergoing emergent or oncological surgery, were collected in a retrospective, multicenter study, which involved 20 Italian institutions. Collected parameters were age, sex, body mass index, COVID-19-related symptoms, patients’ comorbidities, surgical procedure, personal protection equipment (PPE) used in operating rooms, rate of postoperative infection among healthcare staff and complications, within 30-postoperative days. 68 patients, who underwent surgery, resulted COVID-19-positive in the perioperative period. Symptomatic patients were 63 (92.5%). Fever was the main symptom in 36 (52.9%) patients, followed by dyspnoea (26.5%) and cough (13.2%). We recorded 22 (32%) intensive care unit admissions, 23 (33.8%) postoperative pulmonary complications and 15 (22%) acute respiratory distress syndromes. As regards the ten postoperative deaths (14.7%), 6 cases were related to surgical complications. One surgeon, one scrub nurse and two circulating nurses were infected after surgery due to the lack of specific PPE. We reported less surgery-related pulmonary complications and mortality in Sars-CoV-2-infected patients, than in literature. Emergent and oncological surgery should not be postponed, but it is mandatory to use full PPE, and to adopt preoperative screenings and strategies that mitigate the detrimental effect of pulmonary complications, mostly responsible for mortality.
KW - COVID-19
KW - Mortality
KW - Pulmonary complications
KW - SARS-CoV-2
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U2 - 10.1007/s13304-020-00909-0
DO - 10.1007/s13304-020-00909-0
M3 - Article
AN - SCOPUS:85098536448
JO - Updates in Surgery
JF - Updates in Surgery
SN - 2038-131X
ER -