Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study

Abstract

Objective: To analyse the clinical features of COVID-19 parturients, and to compare anaesthetic regimen and clinical outcomes in parturients with or without COVID-19 undergoing cesarean delivery.Methods: Data were extracted from the electronic medical record of 3 medical institutions in Hubei Province, China, from June 1, 2019 to March 20, 2020 according to inclusion and exclusion criteria. After propensity score matching with demographics, the clinical and laboratory characteristics of parturients with or without COVID-19 were analysed. The anaesthetic regimen and clinical outcomes of themselves and their infants were compared in these two groups of parturients.Results: A total of 1,588 patients without SARS-CoV-2 infection undergoing cesarean delivery were retrospectively included. After achieving a balanced cohort through propensity score matching, 89 patients (COVID-19 group), who were diagnosed with COVID-19 by SARS-CoV-2 nucleic acid test and CT scan matched with 173 patients without COVID-19 (Control group). The SARS-CoV-2 infected parturients in the early stages of COVID-19 outbreak was much more than during the later stage. The main clinical characteristics of parturients with COVID-19 were fever (34.8%), cough (33.7%), an increased plasma CRP (52.8%) and a decreased lymphocyte counting (33.7%). A high rate of emergency and a high incidence of anaesthesia-related complications, such as pharyngalgia, multiple puncture, intraoperative hypotension, nausea, vomiting, vertigo and chills in the COVID-19 parturients. In addition, the parturients with COVID-19 had a long duration of operation and hospital stay, and an increased intraoperative oxytocin utilization and postoperative oxygen therapy. The newborns from the SARS-CoV-2 infected mothers, who received general anaesthesia, had a high risk of Apgar score ≤ 8 at 1 and 5 minutes after delivery and a higher rate of neonatal intensive care unit (NICU) admission.Conclusions: Anaesthesia-related complications occur more frequently in the COVID-19 parturients and their newborns have a high risk of distress.

The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries

“…Full text screening then resulted in 148 included articles (Fig 1). [166,167], the USA [168,169], Singapore [170,171], Italy [172,173], Australia [174], Japan [175], Korea [176] and the Netherlands [177]. The mean age of patients was 49 years (SD 11) and where sex data were available, the ratio of males:females was 1.2:1 (10,306:8593).…”

Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

“…Evidence revealed that mortality of patients hospitalized with COVID-19 was very high which is strongly associated with the presence of comorbidities, smoking, and substance use [23,25,34,39,46,[52][53][54].…”

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high [30,32,46,[55][56][57] while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures [28,54,58,59].…”

Global Prevalence of Perioperative Outcomes of Surgical Patients with COVID-19: A Systematic Review and Meta-Analysis

“…Evidence revealed that mortality of patients hospitalized with COVID-19 was very high which is strongly associated with the presence of comorbidities, smoking, and substance use (16,18,27,32,39,(45)(46)(47).…”

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high (23,25,39,(48)(49)(50) while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures (21,47,51,52).…”