TY - JOUR
T1 - Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: A Dutch, multicenter, matched-cohort clinical study
AU - Jonker, Pascal K. C.
AU - Dutch Surgical COVID-19 Research Collaborative
AU - van der Plas, Willemijn Y.
AU - Steinkamp, Pieter J.
AU - Poelstra, Ralph
AU - Emous, Marloes
AU - van der Meij, Wout
AU - Thunnissen, Floris
AU - Bierman, Wouter F. W.
AU - Struys, Michel M. R. F.
AU - de Reuver, Philip R.
AU - de Vries, Jean-Paul P. M.
AU - Kruijff, Schelto
AU - Boerma, Djamilla
AU - Gerritsen, Sarah L.
AU - van Petersen, André S.
AU - Stevens, Charles T.
AU - van Sambeek, Marc
AU - Hölscher, Marleen
AU - Pronk, Apollo
AU - Bakker, Wouter J.
AU - Vriens, Patrick Whe
AU - Houwen, Thymen
AU - Wegdam, Johannes A.
AU - de Vries Reilingh, Tammo S.
AU - Schipper, Ellis
AU - Teeuwen, Pascal H. E.
AU - van Ginhoven, Tessa M.
AU - Viëtor, Charlotte
AU - van der Oest, Mark J. W.
AU - Gans, Sarah
AU - van Duijvendijk, Peter
AU - Herklots, Tanneke
AU - de Hoop, Tom
AU - de Graaff, Michelle
AU - Sloothaak, Didi
AU - Bolster - van Eenennaam, Marieke
AU - Baaij, Jedidja
AU - Vermaas, Maarten
AU - Voigt, Kelly R.
AU - Patijn, Gijs A.
AU - Bransma, Amarins T. A.
AU - Leclercq, Wouter K. G.
AU - Sijmons, Julie M. L.
AU - Uittenbogaart, Martine
AU - Verheijen, Paul M.
AU - Burghgraef, Thijs A.
AU - Teunissen, Manon
AU - Frima, Herman
AU - Bachiri, Said
AU - Groen, Lennaert C. B.
N1 - Publisher Copyright: © 2020 The Author(s)
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background: A direct comparison of severe acute respiratory syndrome coronavirus 2 positive patients with a severe acute respiratory syndrome coronavirus 2 negative control group undergoing an operative intervention during the current pandemic is lacking, and a reliable estimate of the assumed difference in morbidity and mortality between both patient categories remains unknown. Methods: We included all consecutive patients with a confirmed pre- or postoperative severe acute respiratory syndrome coronavirus 2 positive status (operated in 27 hospitals) and negative control patients (operated in 4 hospitals) undergoing emergency or elective operations. A propensity score-matched comparison of clinical outcomes was performed between severe acute respiratory syndrome coronavirus 2 positive and negative tested patients (control group). Primary outcome was overall 30-day mortality rate between both groups. Main secondary outcomes were overall, pulmonary, and thromboembolic complications. Results: In total, 161 severe acute respiratory syndrome coronavirus 2 positive and 342 control severe acute respiratory syndrome coronavirus 2 negative patients were included in this study. The 30-day overall postoperative mortality rate was greater in the severe acute respiratory syndrome coronavirus 2 positive cohort compared with the negative control group (16% vs 4% respectively; P = .007). After propensity score matching, the severe acute respiratory syndrome coronavirus 2 positive group consisted of 123 patients (median 70 years of age [interquartile range 59–77] and 55% male) were compared with 196 patients in the matched control group (median 69 years (interquartile range 58–75] and 53% male). The 30-day mortality rate and risk were greater in the severe acute respiratory syndrome coronavirus 2 positive group compared with the matched control group (12% vs 4%; P = .009 and odds ratio 3.4 [95% confidence interval 1.5–8.5]; P = .005, respectively). Overall, pulmonary and thromboembolic complications occurred more often in severe acute respiratory syndrome coronavirus 2 positive patients (P < .01). Conclusion: Patients diagnosed with perioperative severe acute respiratory syndrome coronavirus 2 have an increased risk of 30-day mortality, pulmonary complications, and thromboembolic events. These findings serve as an evidence-based argument to postpone elective surgery and selected emergency cases.
AB - Background: A direct comparison of severe acute respiratory syndrome coronavirus 2 positive patients with a severe acute respiratory syndrome coronavirus 2 negative control group undergoing an operative intervention during the current pandemic is lacking, and a reliable estimate of the assumed difference in morbidity and mortality between both patient categories remains unknown. Methods: We included all consecutive patients with a confirmed pre- or postoperative severe acute respiratory syndrome coronavirus 2 positive status (operated in 27 hospitals) and negative control patients (operated in 4 hospitals) undergoing emergency or elective operations. A propensity score-matched comparison of clinical outcomes was performed between severe acute respiratory syndrome coronavirus 2 positive and negative tested patients (control group). Primary outcome was overall 30-day mortality rate between both groups. Main secondary outcomes were overall, pulmonary, and thromboembolic complications. Results: In total, 161 severe acute respiratory syndrome coronavirus 2 positive and 342 control severe acute respiratory syndrome coronavirus 2 negative patients were included in this study. The 30-day overall postoperative mortality rate was greater in the severe acute respiratory syndrome coronavirus 2 positive cohort compared with the negative control group (16% vs 4% respectively; P = .007). After propensity score matching, the severe acute respiratory syndrome coronavirus 2 positive group consisted of 123 patients (median 70 years of age [interquartile range 59–77] and 55% male) were compared with 196 patients in the matched control group (median 69 years (interquartile range 58–75] and 53% male). The 30-day mortality rate and risk were greater in the severe acute respiratory syndrome coronavirus 2 positive group compared with the matched control group (12% vs 4%; P = .009 and odds ratio 3.4 [95% confidence interval 1.5–8.5]; P = .005, respectively). Overall, pulmonary and thromboembolic complications occurred more often in severe acute respiratory syndrome coronavirus 2 positive patients (P < .01). Conclusion: Patients diagnosed with perioperative severe acute respiratory syndrome coronavirus 2 have an increased risk of 30-day mortality, pulmonary complications, and thromboembolic events. These findings serve as an evidence-based argument to postpone elective surgery and selected emergency cases.
UR - http://www.scopus.com/inward/record.url?scp=85095610735&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.surg.2020.09.022
DO - https://doi.org/10.1016/j.surg.2020.09.022
M3 - Article
C2 - 33158548
SN - 0039-6060
VL - 169
SP - 264
EP - 274
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -