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Clinical Outcomes of 2019 COVID-19 Positive Patients Who Underwent Surgery: A New York City Experience

The coronavirus disease 2019 (COVID-19) global pandemic has led to a halt in elective surgeries throughout the United States and many other countries throughout the world. Early reports suggest that COVID-19 patients undergoing surgery have an increased risk of requiring intensive care unit (ICU) ad...

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Bibliographic Details
Published in:The Journal of surgical research 2021-05, Vol.261, p.113-122
Main Authors: Vranis, Neil M., Bekisz, Jonathan M., Daar, David A., Chiu, Ernest S., Wilson, Stelios C.
Format: Article
Language:English
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Summary:The coronavirus disease 2019 (COVID-19) global pandemic has led to a halt in elective surgeries throughout the United States and many other countries throughout the world. Early reports suggest that COVID-19 patients undergoing surgery have an increased risk of requiring intensive care unit (ICU) admission and overall mortality. A retrospective review was performed of all COVID-19, positive with polymerase chain reaction confirmation, patients who had surgery between February 17, 2020 and April 26, 2020 at a major New York City hospital. Clinical characteristics and outcomes including ICU admission, ventilator requirement, and mortality were analyzed. Thirty-nine COVID-19 surgical patients were identified. Mean age was 53.9 y, and there were more men than women in the cohort (56.4% versus 43.6%). Twenty-two patients (56.4%) had a confirmed positive COVID-19 test preoperatively, and the remainder tested positive after their procedure. The majority (59%) of patients had an American Society of Anesthesiologists (ASA) class of 3 or higher. Postoperatively, 7 patients (17.9%) required ICU level care with a mean length of stay of 7.7 d. There were 4 deaths (10.3%) in this patient population, all of which occurred in patients who were ASA class 3 or 4. This study represents the largest study to date, that objectively analyzes the outcomes of COVID-19 positive patients who underwent surgery. Overall, ICU admission rates and mortality are similar to reported rates in the literature for nonsurgical COVID-19 patients. Notably, in COVID-19 patients with ASA 1 or 2, there was a 0% mortality rate in the postoperative period. •Patients infected with COVID-19 are not necessarily at higher risk of peri-operative mortality.•Those with low ASA class status (Ex: 1 and 2) had a 0% mortality rate in our cohort.•Peri-operative ICU admission rates were similar to those reported in patients without COVID-19.•Infection with COVID-19 should not be an absolute contraindication to necessary surgery.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2020.10.032