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oai:recercat.cat:20.500.12328/34632025-05-16T12:55:28Zcom_2072_67741col_2072_484352

2025-05-16T12:55:28Z urn:hdl:20.500.12328/3463 Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study RUBIO-PALAU, JOSEP COVIDSurg Collaborative GlobalSurg Collaborative Sars-cov-2 COVID-19 Cirurgia Mortalitat Sars-cov-2 COVID-19 Cirugía Mortalidad Sars-cov-2 COVID-19 Surgery Mortality Trial registration at clinicaltrials.gov (NCT04509986). The authors would like to thank the RCS Covid Research Group for their support. Funding was provided by: the National Institute for Health Research (NIHR) Global Health Research Unit; Association of Coloproctology of Great Britain and Ireland; Bowel and Cancer Research; Bowel Disease Research Foundation; Association of Upper Gastrointestinal Surgeons; British Association of Surgical Oncology; British Gynaecological Cancer Society; European Society of Coloproctology; Medtronic; NIHR Academy; Sarcoma UK; the Urology Foundation; Vascular Society for Great Britain and Ireland; and Yorkshire Cancer Research. The views expressed are those of the authors and not necessarily those of the funding partners. No other competing interests. Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3–4.8), 3.9 (2.6–5.1) and 3.6 (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9–2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. 2025-05-16T12:55:28Z 2025-05-16T12:55:28Z 2021 info:eu-repo/semantics/article COVIDSurg Collaborative; GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia, 2021, 76, p. 748-758. Disponible en: <https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15458>. Fecha de acceso: 21 oct. 2022. DOI: 10.1111/anae.15458 1365-2044 http://hdl.handle.net/20.500.12328/3463 https://dx.doi.org/10.1111/anae.15458 eng Anaesthesia 76;6 https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15458 https://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess ©2021 The Authors.Anaesthesiapublished by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use,distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. John Wiley & Sons