Morbidity and Mortality in Patients with Perioperative COVID‐19 Infection: Prospective Cohort in General, Gastroesophagic, Hepatobiliary, and Colorectal Surgery

• DOI: 10.1007/s00268-021-06068-6
• Publication Date: 2021-03-21T19:02:25Z
• Authors: Martin Inzunza; Cecilia Romero; María Jesús Irarr...; Magdalena Ruiz‐Es...; Pablo Achurra; Nicolás Quezada; Fernando Crovari; Rodrigo Muñoz
• Keywords: Elective surgery; Vascular surgery; Colorectal Surgery; Cardiothoracic surgery

AbstractBackgroundSevere acute respiratory syndrome due to coronavirus 2 has rapidly spread worldwide in an unprecedented pandemic. Patients with an ongoing COVID‐19 infection requiring surgery have higher risk of mortality and complications. This study describes the mortality and morbidity in patients with perioperative COVID‐19 infection undergoing elective and emergency surgeries.MethodsProspective cohort of consecutive patients who required a general, gastroesophageal, hepatobiliary, colorectal, or emergency surgery during COVID‐19 pandemic at an academic teaching hospital. The primary outcome was 30‐day mortality and major complications. Secondary outcomes were specific respiratory mortality and complications.ResultsA total of 701 patients underwent surgery, 39 (5.6%) with a perioperative COVID‐19 infection. 30‐day mortality was 12.8% and 1.4% in patients with and without COVID‐19 infection, respectively (p < 0.001). Major surgical complications occurred in 25.6% and 6.8% in patients with and without COVID‐19 infection, respectively (p < 0.001). Respiratory complications occurred in 30.8% and 1.4% in patients with and without COVID‐19 infection, respectively (p < 0.001). Mortality due to a respiratory complication was 100% and 11.1% in patients with and without COVID‐19 infection, respectively (p < 0.006).Conclusions30‐day mortality and surgical complications are higher in patients with perioperative COVID‐19 infection. Indications for elective surgery need to be reserved for non‐deferrable procedures in order to avoid unnecessary risks of non‐urgent procedures.