• Annals of surgery · Feb 2022

    The Risk of Postoperative Complications following Major Elective Surgery in Active or Resolved COVID-19 in the United States.

    • John Z Deng, Janine S Chan, Alexandra L Potter, Ya-Wen Chen, Harpal S Sandhu, Nikhil Panda, David C Chang, and Chi-Fu Jeffrey Yang.
    • David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA.
    • Ann. Surg. 2022 Feb 1; 275 (2): 242246242-246.

    ObjectiveTo assess the association between the timing of surgery relative to the development of Covid-19 and the risks of postoperative complications.Summary Background DataIt is unknown whether patients who recovered from Covid-19 and then underwent a major elective operation have an increased risk of developing postoperative complications.MethodsThe risk of postoperative complications for patients with Covid-19 undergoing 18 major types of elective operations in the Covid-19 Research Database was evaluated using multivariable logistic regression. Patients were grouped by time of surgery relative to SARS-CoV-2 infection; that is, surgery performed: (1) before January 1, 2020 ("pre-Covid-19"), (2) 0 to 4 weeks after SARS-CoV-2 infection ("peri-Covid-19"), (3) 4 to 8 weeks after infection ("early post-Covid-19"), and (4) ≥8 weeks after infection ("late post-Covid-19").ResultsOf the 5479 patients who met study criteria, patients with peri-Covid-19 had an elevated risk of developing postoperative pneumonia [adjusted odds ratio (aOR), 6.46; 95% confidence interval (CI): 4.06-10.27], respiratory failure (aOR, 3.36; 95% CI: 2.22-5.10), pulmonary embolism (aOR, 2.73; 95% CI: 1.35-5.53), and sepsis (aOR, 3.67; 95% CI: 2.18-6.16) when compared to pre-Covid-19 patients. Early post-Covid-19 patients had an increased risk of developing postoperative pneumonia when compared to pre-Covid-19 patients (aOR, 2.44; 95% CI: 1.20-4.96). Late post-Covid-19 patients did not have an increased risk of postoperative complications when compared to pre-Covid-19 patients.ConclusionsMajor, elective surgery 0 to 4 weeks after SARS-CoV-2 infection is associated with an increased risk of postoperative complications. Surgery performed 4 to 8 weeks after SARS-CoV-2 infection is still associated with an increased risk of postoperative pneumonia, whereas surgery 8 weeks after Covid-19 diagnosis is not associated with increased complications.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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