Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic

Abstract

Quick implementation of specific protocols and protective measures in a tertiary hospital in Spain allowed for the early diagnosis and optimal management of patients with SARS-CoV-2 infection and proper protection of staff and inpatients. From the COVID-19 outbreak in this country until the time of writing, 14 patients in our hospital underwent surgery with COVID-19, or COVID-19 developed postoperatively. Their postoperative outcomes did not differ from those in our routine clinical practice, with a 0% respiratory failure rate and a 7.14% mortality rate, in contrast with other published series. COVID-19 did not develop in any of the healthcare workers present in the operating room during these procedures or in those who cared for these patients on the ward.

Mortality of patients with COVID‐19 who undergo an elective or emergency surgical procedure: a systematic review and meta‐analysis

“…Studies were excluded if they reported tracheostomy outcomes only; did not involve a surgical intervention; the diagnosis of COVID-19 was based on symptoms or X-ray findings only; did not 16 Paris Urology All Yes Di Martino 17 Spain Gen Surg All Yes Alvarez Gallego 18 Spain Gen Surg All Yes Kayani 19 UK Ortho Emergency Yes Egol 20 USA Ortho Emergency Yes Cai 21 China Gen Surg Emergency Yes Javanmard-Emamghissi 22 UK Gen Surg Emergency Yes Barkhordari 23 Iran Cardiac Emergency Yes Sobti 24 UK Trauma/Orthopaedics Emergency Yes COVIDSurg Collaborative 8 Global All All No Dai 25 China Cancer Elective No Lei 26 China All Elective No Shrikhande 27 India Cancers Elective No Aminian 28 Iran Gen Surg Elective No Zhong 29 China Ortho/Gynae Emergency No Munoz Vives 30 Spain Ortho Emergency No Bellosta 31 Italy Vascular Emergency No Chen 32 China Caesarean Section Emergency No Senent-Boza 33 Spain All Emergency No Barret 34 Spain Burns Emergency No Hussain 35 London Cardiac Emergency No Li 36 China Thoracic Not stated No Case reports Gou, SM 37 China Pancreas Emergency Garcia-Portabella 38 Spain Ortho Emergency Davis-Sandfoss 39 USA Breast Cancer Elective Han 40 China Thoracic Emergency Lepre 41 Italy General Surgery Emergency Lyra 42 Portugal Obstetrics Elective Powezka 43 UK Vascular Emergency Qin 44 China Liver Transplant Emergency Rinaldi 45 Italy Vascular Emergency Stevenson 46 UK Ortho cancers Elective Sunkin 47 USA Orthopaedics Emergency Wen 48 China Neurosurgery Emergency Xuan 49 China Lung Transplant Emergency report on surgical outcomes; were incidence only studies, practice guidelines, consensus stateme...…”

Evaluating the Efficacy of a Screening Protocol for Severe Acute Respiratory Syndrome Coronavirus 2 Virus in Asymptomatic Preoperative/Preprocedural Patients at a Military Hospital

“…However, we considered available data on surgical outcomes in infected patients to provide justification for delaying procedures in patients who tested positive. 7 , 10–12 We also do not know how much risk these patients posed in transmitting infection to health care workers or other patients, as such risk in this population remains to be determined. The rates of asymptomatic positivity in our population are similar to those observed by Jou et al.…”