Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study: The Lancet

F.S. Almaadany, E. Samadov, I. Namazov, S. Jafarova, G.H.V. Ramshorst, P. Pattyn, L. Desender, C.A.D. Gheldere, N. Duchateau, J. Mihanovic, N. Sulen, T. Andabaka, I. Rakvin, B. Bakmaz, H.G. Smith, M.L. Jönsson, M.E. Kassas, A. Tawheed, S. Shehata, F.M. AshoushA.S. Abdelaal, M.M.A. Elfiky, S.H. Emile, A.H. Elfallal, H. Elfeki, M. Shalaby, M.M. Alrahawy, I. Sallam, G. Amira, A. Sherief, M. Sherief, Z. Lakkis, A. Doussot, C. Turco, B. Heyd, P. Mathieu, A. Chebaro, K. Lecolle, P. Zerbib, S. Truant, A. Saudemont, F.-R. Pruvot, A.P. Arnaud, D. Bergeat, A. Merdrignac, A. Scalabre, B.L. Roy, O. Perotto, S. Tzedakis, S. Gaujoux, B. Dousset, D. Moszkowicz, F. Bretagnol, E. Hervieux, E. Maisonneuve, P. Clermidi, E. Aubry, A. Thomin, A. Seguin-Givelet, F. Zadegan, C. Conso, D. Ollat, C. Kamphues, J.C. Lauscher, C. Schineis, A.A. Schnitzbauer, P. Thoenissen, H.E. Youzouri, T. Schreckenbach, T.A. Nguyen, A. Modabber, F. Hölzle, P. Winnand, A. Königsrainer, M. Quante, C. Yurttas, M.W. Löffler, S. Klimopoulos, G. Tzovaras, I. Baloyiannis, K. Perivoliotis, E. Lostoridis, P. Tourountzi, J.A.D. Marchi, T. Farrell, N.F. Davis, D. Kearney, J.O. Larkin, M. Mohan, B.J. Mehigan, B.A. Fahey, C.P. Barry, J.A. Elliott, G.A. Bass, T.M. Connelly, D.O. Kavanagh, R. Elkady, P.C. Neary, P.F. Ridgway, D.P. Joyce, S. Tierney, E. Boyle, B. Egan, A.J. Lowery, C.G. Collins, A. Hogan, K.L. McKevitt, É.J. Ryan, A.L. Fowler, T.M. Aherne, K. Nizami, S. Walsh, O. Zmora, N. Kugler, G. Falco, C.C. Ruiz, S. Mele, V. Annessi, G. Ferrari, M.T. Montella, N.M. Mariani, A.P. Ceretti, D. Lomiento, L. Taglietti, R.D. Giudice, B. Compagnoni, S. Dester, S. Granieri, C. Cotsoglou, T. Campagnaro, G. Turri, A. Guglielmi, A. Ruzzenente, C. Pedrazzani, R. Salvia, S. Paiella, S. Nobile, M.V. Marino, A. Mirabella, G. Vaccarella, E. Francone, S. Gentilli, H. Nikaj, L. Morelli, G.D. Franco, M. Palmeri, D. Tartaglia, F. Coccolini, M. Chiarugi, G. Anania, M. Chiozza, A. Urbani, M. Podda, A. Pisanu, A. Porcu, T. Perra, A. Fancellu, P. Familiari, G. D'Andrea, F. Bàmbina, M. Fiore, A. MacChi, D. Citterio, A. Mosca, F. Martinelli, L. Rolli, M. Guaglio, L.V. Comini, V. Capizzi, V. Mazzaferro, V. Cozza, L. Gordini, C.P. Lombardi, V.D. Simone, F. Marzi, A.A. Marra, E. Baldini, L. Conti, M. Ribolla, S.M. Isolani, P. Capelli, A. Spinelli, M. Carvello, F.D. Candido, H. Kurihara, E. Marrano, G. Torzilli, C. Castoro, A.D. Roit, G. Mercante, G. Spriano, F. Gaino, A. De Virgilio, L. Bonavina, E. Asti, C.V. Feo, N. Fabbri, E. Righini, S. Di Saverio, A. Scorza, D. Iovino, G. Carcano, C. Baldi, G.M. Sampietro, C. Corbellini, P. Cellerino, M.A. Zappa, A. Ardito, E. Galfrascoli, G. Iacob, N.C. Zanini, G. Palini, G. Garulli, M. Ballabio, P. Bisagni, P. Pizzini, A. Gagliano, T. Armao, M. Longhi, M. Madonini, M. Luraghi, L. Galimberti, S. Romano, M. Bastazza, F. Trotta, M. Gipponi, S. Malabarba, G. Centinaio, S. Mochet, A. Usai, M. Grivon, R. Barmasse, A.S. Sagnotta, L.M.P. Marino, R. Galleano, M. Malerba, S. Baldo, P. 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Bhangu, COVIDSurg Collaborative

Research output: Contribution to journalArticlepeer-review

Abstract

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p
Original languageEnglish
Pages (from-to)27-38
Number of pages12
JournalLancet
Volume396
Issue number10243
DOIs
Publication statusPublished - 2020

Keywords

  • adult
  • adult respiratory distress syndrome
  • age distribution
  • aged
  • anesthesiologist
  • Article
  • artificial ventilation
  • cohort analysis
  • confidence interval
  • controlled study
  • coronavirus disease 2019
  • elective surgery
  • emergency surgery
  • female
  • hospital
  • human
  • lung complication
  • major clinical study
  • major surgery
  • male
  • medical society
  • minor surgery
  • mortality
  • mortality rate
  • multicenter study
  • observational study
  • obstetric operation
  • odds ratio
  • outcome assessment
  • perioperative period
  • pneumonia
  • postoperative period
  • preoperative period
  • priority journal
  • Severe acute respiratory syndrome coronavirus 2
  • sex difference
  • surgical mortality
  • surgical patient
  • adverse event
  • Betacoronavirus
  • clinical trial
  • complication
  • Coronavirus infection
  • emergency health service
  • hospital mortality
  • middle aged
  • pandemic
  • postoperative complication
  • respiratory tract disease
  • retrospective study
  • surgery
  • virus pneumonia
  • young adult
  • Adult
  • Aged
  • Coronavirus Infections
  • Elective Surgical Procedures
  • Emergency Medical Services
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral
  • Postoperative Complications
  • Respiratory Tract Diseases
  • Retrospective Studies
  • Surgical Procedures, Operative
  • Young Adult

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