• Jonathan D Stevenson, Scott Evans, Guy Morris, Roger Tillman, Adesegun Abudu, Lee Jeys, and Michael Parry.
• Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK.
• J Surg Oncol. 2020 Nov 1; 122 (6): 1027-1030.

Background And ObjectivesShould the threshold for orthopaedic oncology surgery during the coronavirus disease-2019 (COVID-19) pandemic be higher, particularly in men aged 70 years and older? This study reports the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during, respiratory complications and 30-day mortality during the COVID-19 pandemic.MethodsThis prospective observational cohort study included 100 consecutive patients. The primary outcome measure was 14-day symptoms and/or SARS-CoV-2 test. The secondary outcome was 30-day postoperative mortality.ResultsA total of 100 patients comprising 35 females and 65 males, with a mean age of 52.4 years (range, 16-94 years) included 16 males aged greater than 70 years. The 51% of patients were tested during their admission for SARS-CoV-2; 5% were diagnosed/developed symptoms of SARS-CoV-2 during and until 14 days post-discharge; four were male and one female, mean age 41.2 years (range, 17-75 years), all had primary malignant bone or soft-tissue tumours, four of five had received immunosuppressive therapy pre-operatively. The 30-day mortality was 1% overall and 20% in those with SARS-CoV-2. The pulmonary complication rate was 3% overall.ConclusionsWith appropriate peri-operative measures to prevent viral transmission, major surgery for urgent orthopaedic oncology patients can continue during the COVID-19 pandemic. These results need validating with national data to confirm these conclusions.© 2020 Wiley Periodicals LLC.

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