Ellison RT. Surgical complications in patients with COVID-19. NEJM Journal Watch, June 2, 2020.
“During the COVID-19 pandemic, most hospitals have suspended nonemergent surgeries. However, an increasing number of patients need urgent and semiurgent procedures, and there are economic incentives to restart elective surgery. Thus, it is critically important to know how COVID-19 affects surgical outcomes. An international observational study has assessed 30-day mortality and pulmonary complications in patients with COVID-19 undergoing surgery at 235 hospitals between January 1 and March 31, 2020. The infection was identified between 7 days before and 30 days after the procedure.
Among 1128 patients identified, 835 (74%) underwent emergency surgery, and 280, elective surgery. COVID-19 was diagnosed preoperatively in 294 (26%) and was confirmed by SARS-CoV-2 RNA detection in 969 (86%). The overall 30-day mortality rate was 24%; for elective procedures, 19%. Mortality was higher in men, patients over 70 years of age, ASA grades 3–5, malignancy, and with emergency and major surgical procedures. Pulmonary complications developed in 577 patients (51%) and were associated with a higher 30-day mortality rate.”