"As an exception during this period of health crisis, some of the publications mentioned are at the time of writing still in pre-publication, undergoing peer review and subject to change. The results of this pre-print study should be interpreted with utmost caution."
A 'COVID-19-free cold site' set up to carry out non-emergency oncology surgeries reported no coronavirus-related deaths in 500 consecutive patients, reports a cohort study led by University College London (UCL) and UCL Hospitals (UCLH).
The pre-print study, published on medRxiv, was carried out during the peak of the pandemic in the UK.
A hub-and-spoke surgical network was created among 14 NHS institutions to determine whether it was feasible and safe to continue non-emergency surgery in the COVID-19 pandemic.
The hub was a cancer centre, converted into a COVID-19 cold site, performing urological, thoracic, gynaecological and general surgical operations. Strict COVID-19 infection control and patient triage measures were undertaken and full personal protective equipment was worn in theatre for every case.
Between 5 March 2020 and 22 April 2020, 500 patients underwent surgery with median age 62.5 (IQR 51-71); 65 per cent were male and 60 per cent had a known diagnosis of cancer.
Of these operations, 44 per cent were performed with robotic or laparoscopic assistance, and 61 per cent were considered complex or major operations. None of the 500 patients who underwent surgery died from COVID-19 at 30 days.
Thirty-day all-cause mortality was seen in three out of 500 patients (
Ten (2%) patients were diagnosed with COVID-19, four (1%) with confirmed laboratory diagnosis and six (1%) with probable COVID-19. A total of 33 (7%) patients developed Clavien-Dindo grade 3 or higher complications, with one out of 33 (3%) occurring in a patient with COVID-19.
The findings show it is safe to continue non-emergency surgery during the COVID-19 pandemic with appropriate service reconfiguration, said the study authors.
In addition to the completed study, UCL/UCLH confirmed that more than 1000 patients have been operated on at the three 'COVID-19-free cold sites' coordinated by the North Central London and North East London Cancer Hub.