Surgical mortality and complications are higher in patients with COVID-19, compared with patients without COVID-19, a matched cohort study published in JAMA Surgery concludes.
The study included 123 patients, who underwent general, vascular, thoracic, orthopaedic, or neurosurgery in a single hospital in Lombardy, Italy. Patients with a positive COVID-19 test result, either before, or within one week after surgery (n=41) were matched mainly with historical controls (n=82), with a 1:2 ratio for sex, age, comorbidities, scores of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator, and surgical pathology.
Of the 41 patients who underwent mainly emergent or urgent surgery (n=37), 33 were positive for SARS-CoV-2 preoperatively, and eight within five days of surgery.
Of the combined cohorts, 30-day mortality was significantly higher for those with COVID-19 compared with controls (odds ratio [OR] 9.5; 95% CI 1.77-96.53) and a significantly higher rate of complications (OR 4.98; 95% CI 1.81-16.07).
Pulmonary complications were the most common and were significantly higher in patients with COVID-19, but thrombotic events were also significantly associated with COVID-19, identifying COVID-19 as the main variable.
Authors suggest that surgery should be postponed in patients with COVID-19, when possible. Study limitations include the short follow-up.