tetano
Editor, Senior Moderator
Ann Surg
. 2020 Nov 4.
doi: 10.1097/SLA.0000000000004586. Online ahead of print.
Risk of Acquiring Perioperative COVID-19 During the Initial Pandemic Peak: A Retrospective Cohort Study
Lucas G Axiotakis Jr[SUP] 1 [/SUP], Brett E Youngerman[SUP] 1 2 3 [/SUP], Randy K Casals[SUP] 3 [/SUP], Tyler S Cooke[SUP] 3 [/SUP], Graham M Winston[SUP] 3 [/SUP], Cory L Chang[SUP] 1 [/SUP], Deborah M Boyett[SUP] 2 3 [/SUP], Anil K Lalwani[SUP] 1 3 4 5 [/SUP], Guy M McKhann[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Objective: To determine the risk of acquiring perioperative coronavirus disease 2019 (COVID-19) infection in previously COVID-19 negative patients.
Summary background data: During the initial peak of the COVID-19 pandemic, there was significant concern of hospital acquired COVID-19 infections. Medical centers rapidly implemented systems to minimize perioperative transmission, including routine preoperative testing, patient isolation, and enhanced cleaning.
Methods: In this retrospective cohort study, medical records of all adult patients who underwent surgery at our quaternary, acute care hospital between March 15 and May 15, 2020 were reviewed. The risk of preoperatively negative patients developing symptomatic COVID-19 within 2-14 days postoperatively was determined. Surgical characteristics, outcomes, and complications were compared between those with and without acquired perioperative COVID-19 infection.
Results: Among 501 negative patients undergoing index surgeries, 9 (1.8%) developed symptomatic COVID-19 in the postoperative period; all occurred before implementation of routine preoperative testing (9/243, 3.7% vs. 0/258, 0%, OR: 0.048, p = 0.036). No patient who was PCR negative on the day of surgery (n = 170) developed postoperative infection. Perioperative infection was associated with preoperative diabetes (OR: 3.70, p = 0.042), cardiovascular disease (OR: 3.69, p = 0.043), angiotensin receptor blocker use (OR: 6.58, p = 0.004), and transplant surgery (OR: 11.00, p = 0.002), as well as multiple complications, readmission (OR: 5.50, p = 0.029) and death (OR: 12.81, p = 0.001).
Conclusions: During the initial peak of the COVID-19 pandemic, there was minimal risk of acquiring symptomatic perioperative COVID-19 infection, especially after the implementation of routine preoperative testing. However, perioperative COVID-19 infection was associated with poor postoperative outcome.
. 2020 Nov 4.
doi: 10.1097/SLA.0000000000004586. Online ahead of print.
Risk of Acquiring Perioperative COVID-19 During the Initial Pandemic Peak: A Retrospective Cohort Study
Lucas G Axiotakis Jr[SUP] 1 [/SUP], Brett E Youngerman[SUP] 1 2 3 [/SUP], Randy K Casals[SUP] 3 [/SUP], Tyler S Cooke[SUP] 3 [/SUP], Graham M Winston[SUP] 3 [/SUP], Cory L Chang[SUP] 1 [/SUP], Deborah M Boyett[SUP] 2 3 [/SUP], Anil K Lalwani[SUP] 1 3 4 5 [/SUP], Guy M McKhann[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 33156061
- DOI: 10.1097/SLA.0000000000004586
Abstract
Objective: To determine the risk of acquiring perioperative coronavirus disease 2019 (COVID-19) infection in previously COVID-19 negative patients.
Summary background data: During the initial peak of the COVID-19 pandemic, there was significant concern of hospital acquired COVID-19 infections. Medical centers rapidly implemented systems to minimize perioperative transmission, including routine preoperative testing, patient isolation, and enhanced cleaning.
Methods: In this retrospective cohort study, medical records of all adult patients who underwent surgery at our quaternary, acute care hospital between March 15 and May 15, 2020 were reviewed. The risk of preoperatively negative patients developing symptomatic COVID-19 within 2-14 days postoperatively was determined. Surgical characteristics, outcomes, and complications were compared between those with and without acquired perioperative COVID-19 infection.
Results: Among 501 negative patients undergoing index surgeries, 9 (1.8%) developed symptomatic COVID-19 in the postoperative period; all occurred before implementation of routine preoperative testing (9/243, 3.7% vs. 0/258, 0%, OR: 0.048, p = 0.036). No patient who was PCR negative on the day of surgery (n = 170) developed postoperative infection. Perioperative infection was associated with preoperative diabetes (OR: 3.70, p = 0.042), cardiovascular disease (OR: 3.69, p = 0.043), angiotensin receptor blocker use (OR: 6.58, p = 0.004), and transplant surgery (OR: 11.00, p = 0.002), as well as multiple complications, readmission (OR: 5.50, p = 0.029) and death (OR: 12.81, p = 0.001).
Conclusions: During the initial peak of the COVID-19 pandemic, there was minimal risk of acquiring symptomatic perioperative COVID-19 infection, especially after the implementation of routine preoperative testing. However, perioperative COVID-19 infection was associated with poor postoperative outcome.