Timing is Everything: Surgical Outcomes for SARS-CoV-2 Positive Patients

Background A debate remains on how long to postpone surgery after testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine surgical outcomes at different time points after a positive SARS-CoV-2 test. Methods This cohort study included non-preoperative...

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Bibliographic Details
Published in:World journal of surgery 2023-02, Vol.47 (2), p.437-444
Main Authors: Codner, Jesse A., Archer, Ryan H., Lynde, Grant C., Sharma, Jyotirmay
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Cardiac Surgery
Cohort Studies
Comorbidity
Complications
Coronaviruses
COVID-19 - epidemiology
Demographic variables
General Surgery
Humans
Medicine
Medicine & Public Health
Multivariable control
Original Scientific Report
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Surgery
Surgical outcomes
Thoracic Surgery
Treatment Outcome
Vascular Surgery
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Summary:Background A debate remains on how long to postpone surgery after testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine surgical outcomes at different time points after a positive SARS-CoV-2 test. Methods This cohort study included non-preoperative critically ill adult surgical patients from 5/2020–5/2021 and a subset of SARS-CoV-2 positive patients 15–30 days before surgery from 5/2020–12/2021. Demographics, comorbidities, surgical variables, and outcomes were compared between SARS-CoV-2 positive patients within 50 days before surgery to SARS-CoV-2 negative surgical patients. Cases were stratified based on the timing of SARS-CoV-2 positivity before surgery in days ( 30). Outcomes were compared between strata and against SARS-CoV-2 negative controls. A multivariable model was built to determine the association that the timing of SARS-CoV-2 positivity has on the odds of a major complication. Results The SARS-CoV-2 positive cohort had 262 patients compared to 1,840 SARS-CoV-2 negative patients. Timing strata contained 145 ( 30 days). The SARS-CoV-2 positive group had a higher incidence of comorbidities (87.4% vs. 57.2%) and underwent more emergent surgery (45.7% vs. 9.3%). The odds of major complications in patients positive for SARS-CoV-2 before surgery were 1.88 (1.13–3.15) (
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-022-06814-4