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Mortality Up With Surgery Within Six Weeks of SARS-CoV-2 Infection

MONDAY, March 15, 2021 -- Mortality is increased for patients undergoing surgery within six weeks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, according to a study published online March 9 in Anesthesia.

Dmitri Nepogodiev, M.B.Ch.B., from the University of Birmingham in the United Kingdom, and colleagues examined the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection in an international, multicenter study. Data were included for patients undergoing elective or emergency surgery during October 2020.

The researchers found that 3,127 of the 140,231 patients (2.2 percent) from 116 countries had a preoperative SARS-CoV-2 diagnosis. In patients without SARS-CoV-2, adjusted 30-day mortality was 1.5 percent. For those with a preoperative SARS-CoV-2 diagnosis, patients having surgery within zero to two, three to four, and five to six weeks of diagnosis had increased mortality (4.1, 3.9 and 3.6 percent, respectively; odds ratios [95 percent confidence intervals], 3.22 [2.55 to 4.07], 3.03 [2.03 to 4.52], and 2.78 [1.64 to 4.71]). Mortality was similar to baseline for surgery performed at least seven weeks after SARS-CoV-2 diagnosis (1.5 percent; odds ratio, 1.02 [0.66 to 1.56]). After at least a seven-week delay in undertaking surgery following SARS-CoV-2 infection, mortality was higher for those with ongoing symptoms compared with those whose symptoms had resolved or who had been asymptomatic (6.0 percent versus 2.4 and 1.3 percent, respectively).

"We found that risks of postoperative morbidity and mortality are greatest if patients are operated within six weeks of diagnosis of SARS-CoV-2 infection," the authors write.

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