• Aiman Suleiman, Ricardo Munoz-Acuna, Simone Redaelli, Elena Ahrens, Tim M Tartler, Sarah Ashrafian, May M Hashish, Abeer Santarisi, Guanqing Chen, Stefan Riedel, Daniel Talmor, Elias N Baedorf Kassis, Maximilian S Schaefer, and Valerie Goodspeed.
• From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts.
• Anesth. Analg. 2024 Jul 26.

BackgroundLong-term pulmonary complications have been reported after a coronavirus disease-2019 (COVID-19). We hypothesized that a history of COVID-19 is associated with a measurable decrease in baseline respiratory system compliance in patients undergoing general anesthesia.MethodsIn this hospital registry study, we included adult patients undergoing general anesthesia between January 2020 and March 2022 at a tertiary health care network in Massachusetts. We excluded patients with an American Society of Anesthesiologists physical status >IV, laryngoscopic surgeries, and patients who arrived intubated. The primary exposure was a history of COVID-19. The primary outcome was baseline respiratory system compliance (mL/cmH2O). Effects of severity of infection, surges (Alpha1, Alpha2, Delta, and Omicron), patient demographics, and time between infection and assessment of compliance were investigated.ResultsA total of 19,921 patients were included. Approximately 1386 (7.0%) patients had a history of COVID-19. A history of COVID-19 at any time before surgery was associated with a measurably lower baseline respiratory system compliance (ratio of meansadj = 0.96; 95% confidence interval [CI], 0.94-0.97; P < .001; adjusted compliance difference: -1.6 mL/cmH2O). The association was more pronounced in patients with a severe form of COVID-19 (ratio of meansadj = 0.95; 95% CI, 0.90-0.99; P = .02, adjusted compliance difference: -2 mL/cmH2O). Alpha1, Alpha2, and Delta surges, but not Omicron, led to a lower baseline respiratory system compliance (P < .001, P = .02, and P < .001). The Delta surge effect was magnified in Hispanic ethnicity (P-for-interaction = 0.003; ratio of meansadj = 0.83; 95% CI, 0.74-0.93; P = .001; adjusted compliance difference: -4.6 mL/cmH2O).ConclusionsA history of COVID-19 infection during Alpha1, Alpha2, and Delta surges was associated with a measurably lower baseline respiratory system compliance.Copyright © 2024 International Anesthesia Research Society.

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