Can patients with asymptomatic SARS-CoV-2 infection safely undergo elective surgery?

Glasbey, James; Dobbs, Thomas D.; Abbott, Tom

doi:10.1016/j.bja.2022.03.003

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…In the context of the evolving COVID-19 pandemic, there is insufficient evidence to determine the appropriate waiting time for surgical delay. [24] In a previous single-center retrospective cohort study, New York patients infected with SARS-CoV-2 between March 2020 and January 2022 were included, representing four waves of the COVID-19 pandemic. The fourth wave represents the one caused by the Omicron variant.…”

Section: Discussionmentioning

confidence: 99%

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study

Wang

Zheng

Zhu

et al. 2023

Chinese Medical Journal

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Background: Currently, the effect of the 2022 nationwide coronavirus disease 2019 (COVID-19) wave on the perioperative prognosis of surgical patients in China is unclear. Thus, we aimed to explore its influence on postoperative morbidity and mortality in surgical patients. Methods: An ambispective cohort study was conducted at Xijing Hospital, China. We collected 10-day time-series data from December 29 until January 7 for the 2018–2022 period. The primary outcome was major postoperative complications (Clavien–Dindo class III–V). The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient level. Results: The entire cohort consisted of 3350 patients (age: 48.5 ± 19.2 years), including 1759 females (52.5%). Overall, 961 (28.7%) underwent emergency surgery, and 553 (16.5%) had COVID-19 exposure (from the 2022 cohort). At the population level, major postoperative complications occurred in 5.9% (42/707), 5.7% (53/935), 5.1% (46/901), 9.4% (11/117), and 22.0% (152/690) patients in the 2018–2022 cohorts, respectively. After adjusting for potential confounding factors, the 2022 cohort (80% patients with COVID-19 history) had a significantly higher postoperative major complication risk than did the 2018 cohort (adjusted risk difference [aRD], 14.9% (95% confidence interval [CI], 11.5–18.4%); adjusted odds ratio [aOR], 8.19 (95% CI, 5.24–12.81)). At the patient level, the incidence of major postoperative complications was significantly greater in patients with (24.6%, 136/553) than that in patients without COVID-19 history (6.0% [168/2797]; aRD, 17.8% [95% CI, 13.6–22.1%]; aOR, 7.89 [95% CI, 5.76–10.83]). Secondary outcomes of postoperative pulmonary complications were consistent with primary findings. These findings were verified through sensitivity analyses using time-series data projections and propensity score matching. Conclusion: Based on a single-center observation, patients with recent COVID-19 exposure were likely to have a high incidence of major postoperative complications. Registration: NCT05677815 at https://clinicaltrials.gov/.

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Section: Discussionmentioning

confidence: 99%

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study

Wang

Zheng

Zhu

et al. 2023

Chinese Medical Journal

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“…A study across 116 countries or regions of COVID-19 patients receiving elective or emergency surgery from October to November 2020 indicated that postoperative mortality rate increased for those receiving surgery within 6 weeks of infection and returned to baseline for those receiving surgery after 7 weeks of infection [21] . However, COVID-19 patients with mild symptom or without symptom does not increase perioperative risks [17,20] . The number of Omicron cases increased significantly with most cases being asymptomatic or mildlt symptomatic.…”

Section: Perioperative Prognosis Of Covid-19 Patientsmentioning

confidence: 96%

“…The severe disease and mortality rates are low, but research on perioperative complications and mortality risks of Omicron remained unclear. Recent study showed that, the admission rate, pneumonia, and ICU admission rates of Omicron patients were 19.1%, 0.2%, and 1.4%, respectively, which was significantly lower than those before December 2021 [8,[16][17][18][19] . Meanwhile, the in-hospital mortality rate decreased from 18.4% before Omicron to 5.2% with Omicron dominance [16] .…”

Section: Perioperative Prognosis Of Covid-19 Patientsmentioning

confidence: 99%

Perioperative Infection Control Recommendations during the SARS-CoV-2 Omicron Variant Pandemic

Lü¹,

Wang²,

Chen³

et al. 2023

Journal of Anesthesia and Translational Medicine

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COVID-19 significantly increased perioperative risks including mortality and complications. Currently, the Omicron variant is the dominant strain worldwide. Omicron variant is highly contagious with lower incidence of severe diseases. Therefore, it is necessary to update recommendations for managing perioperative anesthesia equipment and protecting perioperative healthcare providers. This article aims to describe perioperative risks, anesthesia equipemnt management, and personelll protection when caring for Omicron patients.

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“…Intravenous intraoperative dexmedetomidine can also help to enhance the patient's tolerance of extubation to avoid or reduce choking reactions. Retaining the endotracheal tube and transferring the patient to the ICU for continued ventilator support is recommended if the patient has oxygenation index is below 150 mmHg, hemodynamically unstable, or significant metabolic disturbances at the end of the operation [12] .…”

Section: Recovery From Anesthesiamentioning

confidence: 99%

Recommendations on Perioperative Management and Emergency Intubation for Patients with Omicron

Wang¹,

Xia²,

Ma³

et al. 2023

Journal of Anesthesia and Translational Medicine

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The Chinese National Health Commission adopted the strategy of "Category B and Category B Management" for Omicron infection on January 8, 2023, which might have triggered the recent Omicron epidemic in China. This undoubtedly poses a great challenge to the medical system. For anesthesiologists, under the new trend of Omicron epidemic, perioperative anesthesia management of patients with Omicron has become the focus of attentions, which includes the whole process of preoperative visits, intraoperative management, and postoperative analgesia and ventilation monitoring. Moreover, in case of respiratory failure necessitating emergency intubation, safe, rapid, and effective emergency tracheal intubation is also a focus worthy of attention and discussion. We put forward the latest suggestions on perioperative management and emergency tracheal intubation during the Omicron pandemic.

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Can patients with asymptomatic SARS-CoV-2 infection safely undergo elective surgery?

Cited by 12 publications

References 23 publications

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study

Perioperative Infection Control Recommendations during the SARS-CoV-2 Omicron Variant Pandemic

Recommendations on Perioperative Management and Emergency Intubation for Patients with Omicron

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