Are surgical and non-operating room intervention safe in the COVID-19 pandemic? A retrospective study

Epidemiol Infect. 2021 Sep 16:149:e210. doi: 10.1017/S0950268821002119.

Abstract

Little is known about the impact of COVID-19 on the outcomes of patients undergoing surgery and intervention. This study was conducted between 20 March and 20 May 2020 in six hospitals in Istanbul, and aimed to investigate the effects of surgery and intervention on COVID-19 disease progression, intensive care (ICU) need, mortality and virus transmission to patients and healthcare workers. Patients were examined in three groups: group I underwent emergency surgery, group II had an emergency non-operating room intervention, and group III received inpatient COVID-19 treatment but did not have surgery or undergo intervention. Mortality rates, mechanical ventilation needs and rates of admission to the ICU were compared between the three groups. During this period, patient and healthcare worker transmissions were recorded. In total, 1273 surgical, 476 non-operating room intervention patients and 1884 COVID-19 inpatients were examined. The rate of ICU requirement among patients who had surgery was nearly twice that for inpatients and intervention patients, but there was no difference in mortality between the groups. The overall mortality rates were 2.3% in surgical patients, 3.3% in intervention patients and 3% in inpatients. COVID-19 polymerase chain reaction positivity among hospital workers was 2.4%. Only 3.3% of infected frontline healthcare workers were anaesthesiologists. No deaths occurred among infected healthcare workers. We conclude that emergency surgery and non-operating room interventions during the pandemic period do not increase postoperative mortality and can be performed with low transmission rates.

Keywords: COVID-19; COVID-19 transmission; intensive care requirement; mortality; non-operating room intervention; surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / transmission*
  • Critical Care / statistics & numerical data
  • Cross Infection / diagnosis
  • Cross Infection / epidemiology
  • Cross Infection / transmission
  • Female
  • General Surgery / statistics & numerical data*
  • Health Personnel / statistics & numerical data
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification
  • Turkey / epidemiology