COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

O’Glasser, Avital Y.; Schenning, Katie J.

doi:10.1016/j.pcorm.2022.100272

Cited by 6 publications

(5 citation statements)

References 71 publications

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“…In order to evaluate postoperative outcomes in vaccinated patients, according to the elapsed time between infection and surgery, we identified among Group2022, those patients with past SARS‐CoV‐2 infection, and subdivided them into two groups according to the elapsed time to surgery of more or less than 7 weeks. On analyzing the results, we found no differences between the two groups in terms of postoperative morbidity and mortality, postoperative hospital length of stay or ICU admission, contrary to what has been reported in the literature [5, 20–24]. Although we were unable to validate the statistical significance due to the low number of patients in both subgroups, we believe that these results may be derived from a careful selection of patients, permitting the identification of the optimal candidates for surgical intervention.…”

Section: Discussioncontrasting

confidence: 97%

“…Subsequent studies have demonstrated an elevated postoperative risk that persists for at least four weeks after the index infection, including increased mortality, pulmonary complications and venous thromboembolic events [5,[22][23][24][25][26][27]. This elevated risk of postoperative complications is also observed with the postoperative acquisition of SARS-CoV-2 infection [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

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Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

García‐Botella,

De la Serna Esteban,

López‐Antoñanzas

et al. 2023

World j. surg.

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Background The reported high surgical morbidity and mortality in patients with SARS-CoV-2 prompted preoperative screening and modification of surgical protocols. Although vaccination and treatment of COVID-19 have resulted in lower hospitalization rates and infection severity, publications on postoperative results have not been updated. The aim of the study was to analyze the outcomes of patients undergoing surgery in two periods with high incidence of SARS-CoV-2 infection, before and after vaccination. Materials and Methods This is a prospective cohort study of patients undergoing surgery in two periods: March-June 2020 (Group2020) and December 2021-February 2022 (Group2022) (after massive vaccination). Results In total, 618 patients who underwent surgery were included in the analysis (Group2020: 343 vs. Group2022: 275). Significantly more oncological procedures were performed in Group2020, and there were no differences in postoperative complications. Nosocomial SARS-CoV-2 infection occurred in 4 patients in Group2020 and 1 patient in Group2022. In Group 2022, 70 patients (25.4%) had COVID-19 prior to surgery, and 68 (97.1%) were vaccinated. Comparative analysis between patients with past COVID-19 and those without showed no difference in postoperative morbidity and mortality. According to the time elapsed between SARS-CoV-2 infection and surgery (B 7 or [ 7 weeks), comparative analysis showed no significant differences. Conclusion The establishment of preoperative screening protocols for SARS-CoV-2 infection results in a low incidence of nosocomial infection and optimal postoperative outcomes. Preoperative SARS-CoV-2 infection in vaccinated patients was not associated with increased postoperative complications, even in shorter periods after infection. In surgical patients, individualized preoperative evaluation after SARS-CoV-2 infection may be more important than strict time limitation.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

García‐Botella,

De la Serna Esteban,

López‐Antoñanzas

et al. 2023

World j. surg.

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“…For example, the need to rapidly implement infection prevention protocols with limited evidence and organizational support in a system with depleted resources can result in a deteriorating working environment. 39 Despite efforts, as the pandemic eased, there were large surgical backlogs, heavy staff losses, and unpredictable supply chain disruptions. This further increased physicians’ workloads and complexity that additional personal sacrifices could not easily overcome.…”

Section: The Development Of Perioperative Physician Burnoutmentioning

confidence: 99%

Time Out: The Impact of Physician Burnout on Patient Care Quality and Safety in Perioperative Medicine

Shin¹,

Desai²,

Conte³

et al. 2023

TPJ

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Perioperative care delivery is a patient-centered, multidisciplinary process. It relies heavily on synchronized teamwork from a well-coordinated team. Perioperative physicians—surgeons and anesthesiologists—face enormous challenges in surgical care delivery due to changing work environments, post-COVID consequences, shift work disorder, value conflict, escalating demands, regulatory complexity, and financial uncertainties. Physician burnout in this working environment has become increasingly prevalent. It is not only harmful to physicians’ health and well-being, but it also affects the quality and safety of patient care. Additionally, the economic costs associated with physician burnout are untenable due to the high turnover rate, high recruitment expenses, and potential early permanent exit from medical practice. In this deteriorating environment of unbalanced physician supply/demand, recognizing, managing, and preventing physician burnout may help preserve the system’s most valuable asset and contribute to higher quality and safety of patient care. Leaders in government agencies, health care systems, and organizations must work together to re-engineer the health care system for better physicians and patient care.

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“…Although cerebral blood flow improves with time, it remains abnormal ( 44 , 45 ). Many uncertainties persist regarding the perioperative risk of COVID-19 survivors ( 111 ).…”

Section: Prognosismentioning

confidence: 99%

Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination

Gómez-Moyano,

Rodríguez-Capitán,

Gaitán Román

et al. 2023

Front. Neurol.

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The COVID-19 pandemic has caused a challenge for our society due to the post-acute sequelae of the disease. Persistent symptoms and long-term multiorgan complications, known as post-acute COVID-19 syndrome, can occur beyond 4 weeks from the onset of the COVID-19 infection. Postural orthostatic tachycardia syndrome (POTS) is considered a variety of dysautonomia, which is characterized by chronic symptoms that occur with standing and a sustained increase in heart rate, without orthostatic hypotension. POTS can lead to debilitating symptoms, significant disability, and impaired quality of life. In this narrative review, the etiopathogenic basis, epidemiology, clinical manifestations, diagnosis, treatment, prognosis, and socioeconomic impact of POTS, as well as other related dysautonomic disorders, after COVID-19 infection and SARS-CoV-2 postvaccination, were discussed. After a search conducted in March 2023, a total of 89 relevant articles were selected from the PubMed, Google Scholar, and Web of Science databases. The review highlights the importance of recognizing and managing POTS after COVID-19 infection and vaccination, and the approach to autonomic disorders should be known by all specialists in different medical areas. The diagnosis of POTS requires a comprehensive clinical assessment, including a detailed medical history, physical examination, orthostatic vital signs, and autonomic function tests. The treatment of POTS after COVID-19 infection or vaccination is mainly focused on lifestyle modifications, such as increased fluid and salt intake, exercise, and graduated compression stockings. Pharmacotherapy, such as beta-blockers, fludrocortisone, midodrine, and ivabradine, may also be used in selected cases. Further research is needed to understand the underlying mechanisms, risk factors, and optimal treatment strategies for this complication.

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COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

Cited by 6 publications

References 71 publications

Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

Time Out: The Impact of Physician Burnout on Patient Care Quality and Safety in Perioperative Medicine

Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination

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