Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

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Background : Gradual bone loss around the implants is an ongoing concern. More recently peri-implant mucosal tissue thickness (MTT) is considered as a contributing factor which influences bone remodelling. It has been suggested that tissue thickness thinner than 2.5 mm may contribute to more peri-implant bone loss eventually affecting implant bone stability. Measuring of MTT prior to surgery may be a predictor of the bone changes and could modify the surgical methods. Aim/Hypothesis : The aim of this radiographic retrospective study was undertaken to test the relationship of peri-implant MTT on long-term (3-5 yrs) bone changes. The null hypothesis tested that MTT influences bone stability. Materials and Methods : This retrospective radiographic study evaluated proximal peri-implant bone changes around in the maxillary premolar area. Patients were selected from "Adenta Dental Clinic" database (included if radiographs were acquired prior to surgery, 1st year after surgery, 3-5 years after surgery). Patients were divided in to two groups based on Linkevicius et. al. (2009) study. Each measurement was done three times by three experts with initials: IA, RL, AG. Peri-implant bone levels were measured at proximal sites two times: one year and 3 to 5 years after implant placement. The differences in bone thickness at proximal sites (DM, DD) and relationship between MTT and peri-implant bone stability were evaluated in both groups (Group 1 = MTT < 2.5 mm and Group 2 = MTT ≥ 2.5 mm). Additionally, patient smoking status (yes/no) and implant diameters (small implant group: 3-3.9 mm; large implant group 4-5 mm) were compared to MTT and peri-implant bone changes. Results : Total of 450 measurements of MTT and 150 measurements of proximal sites were taken in 50 patients (22 M, 28 F) with the average age of 57 years (12 patients with smoking of at least 10 cigarettes a day. Radiographs were divided into two groups: group 1-(61 measurements of proximal sites, 183 measurements of MTT); group 2-(89 measurements of proximal sites, 267 measurements of MTT). Average MTT in group 1 was 1.88 ± 0.05 mm and for group 2 was 3.12 ± 0.06 mm (P < 0.001). There were no differences between groups in 1st and 2nd follow up at proximal sites (1st follow-up mesial site: P = 0.168 and distal site P = 0.125), (2nd follow-up mesial site: P = 0.230 and distal site P = 0.325). There were no correlations with MTT and peri-implant bone changes in Group 1