Safety of elective paediatric surgery during the coronavirus disease 2019 pandemic

Abstract

Introduction Corona-virus Disease 2019 (COVID-19) has had a huge impact on the delivery of healthcare worldwide, particularly elective surgery. There is a lack of data regarding risk of postoperative COVID-19 infection in children undergoing elective surgery, and regarding the utility of pre-operative COVID-19 testing, and preoperative “cocooning” or restriction of movements. The purpose of this present study was to examine the safety of elective paediatric Otolaryngology surgery during the COVID-19 pandemic with respect to incidence of postoperative symptomatic COVID-19 infection or major respiratory complications. Materials and methods Prospective cohort study of paediatric patients undergoing elective Otolaryngology surgery between September and December 2020. Primary outcome measure was incidence of symptomatic COVID-19 or major respiratory complications within the 14 days after surgery. Parents of prospectively enrolled patients were contacted 14 days after surgery and enquiry made regarding development of postoperative symptoms, COVID-19 testing, or diagnosis of COVID-19. Results 302 patients were recruited. 125 (41.4%) underwent preoperative COVID-19 RTPCR testing. 66 (21.8%) restricted movements prior to surgery. The peak 14-day COVID-19 incidence during the study was 302.9 cases per 100,000 population. No COVID-19 infections or major respiratory complications were reported in the 14 day follow up period. Conclusion The results of our study support the safety of elective paediatric Otolaryngology surgery during the pandemic, in the setting of community incidence not exceeding that observed during the study period.

Surgical outcomes inchildren with perioperative SARS-CoV-2 diagnosis

“…These two studies did not include matched controls and were based solely on observed post-operative complication rates among infected children. Kavanagh et al did not identify any pulmonary complications in infected children who underwent surgery in a two-month time frame 16 . However, Saynhalath et al concluded increased risk for pulmonary complications in infected children in a study which included matched controls 11 .…”