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.

e13056 Background: Cervical cancer (CC) is the second most frequent cancer of women after breast cancer. Prophylactic vaccines for human papillomavirus (HPV) are being introduced in many countries more than 10 years ago. The standardized incidence of СС in Kazakhstan (KZ) in 2017 was 17.1 per 100,000 women. From 2013 to 2016, there was a pilot project of school-based HPV vaccination of adolescent girls in four districts of KZ. Vaccination was carried out with two vaccines (Gardasil and Cervarix) on the choice of parents in a three-dose regimen. Due to the high rejection of vaccination, this program was completed in 2016. Aim of study was to analyze the results of HPV vaccination in KZ. Methods: The results of vaccination of adolescent girls from 9 to 15 years old were evaluated. We analyzed database registry of Kazakhstani vaccinated girls to evaluate vaccine coverage in four district of KZ. Results: A total 11,648 adolescent girls were fully vaccinated during the pilot program for 2013-2016. The average age of the vaccinated is 12.67 ± 1.04. In 2013, immunization was performed for 1,816 girls aged 11–13 years. In 2014, the age range of the target group was expanded to 15 years. The number of vaccinated girls increased to 5,699 adolescent girls. 7,136 girls were fully vaccinated in 2015. 10,004 girls have not received full doses of vaccine. Overall coverage rates of fully vaccinated were 14.8%. The majority of coverage results was stastically similar except for Almaty, where coverage was higher than the average coverage (17.9% vs. 14.8%, p < 0.05). Conclusions: Pilot project of vaccination in Kazakhstan was declared unsuccessful. This situation is associated with a lack of information campaigns on vaccination. This findings highlights the need for phased implementation of vaccination through an educational campaign of parents.

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randomised 2:1 to receive FSD of niraparib 300 mg orally once daily (QD) or placebo. The trial was amended to incorporate an ISD of 200 mg orally QD for patients with a body weight <77 kg or platelet count <150,000/mL, and 300 mg QD in patients with a body weight 77 kg and platelet count 150,000/mL. Patients were stratified by best response to firstline chemotherapy (complete/partial response), receipt of neoadjuvant chemotherapy (yes/no), and homologous recombination status (deficient/proficient and not determined). BRCA status was determined in tumour samples at screening via the myChoice test (Myriad ® ). The post hoc BRCAm subgroup PFS analysis was performed using a stratified Cox proportional hazards model and Kaplan-Meier methodology. Safety and patient-reported outcome analyses were also performed. Results The intention-to-treat population comprised 733 randomised patients, of which 223 (30%) had BRCAm tumours. Of those, 144 (65%) received FSD and 79 (35%) received ISD. Niraparib provided a comparable PFS benefit over placebo in patients receiving both FSD (hazard ratio, 0.44; 95% CI 0.26-0.73) and ISD (hazard ratio 0.29; 95% CI 0.13-0.67). A PFS subgroup analysis by patient characteristics is shown in table 1. A summary of grade 3 selected adverse events is shown in table 2. Conclusion Niraparib significantly improved PFS when utilised as maintenance treatment after front-line therapy in patients with BRCAm aOC. Patients receiving FSD or ISD derived similar PFS benefit, while the ISD group showed an improved safety profile. Disclosures Dr.