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Multicenter Study
. 2021 Apr;73(2):745-752.
doi: 10.1007/s13304-020-00909-0. Epub 2021 Jan 3.

Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection: an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic

Maurizio De Luca  1 , Alberto Sartori  2 , Antonio Vitiello  3 , Giacomo Piatto  2 , Giulia Noaro  2 , Stefano Olmi  4 , Diego Foschi  5 , Luca De Re  5 , Marco Zappa  6 , Giuliano Sarro  7 , Umberto Rivolta  7 , Giorgio Giraudo  8 , Felice Borghi  8 , Gabriele Pozzo  9 , Vincenzo Sorisio  9 , Giusto Pignata  10 , Paola Antonella Greco  11 , Valerio Sisti  11 , Tommaso Campagnaro  12 , Alfredo Guglielmi  12 , Jacopo Andreuccetti  13 , Alberto Di Leo  13 , Enrico Lauro  14 , Francesco Ricci  14 , Mario Musella  3 , Maurizio Zizzo  15 , Stefano Bonacini  15 , Mauro Podda  16 , Adolfo Pisanu  16 , Pietro Coletta  17 , Mario Guerrieri  17 , Valerio Caracino  18 , Massimo Basti  18 , Vincenzo Pilone  19 , Marco Raffaelli  20 , Luigi Oragano  21
Affiliations
Multicenter Study

Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection: an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic

Maurizio De Luca et al. Updates Surg. 2021 Apr.

Abstract

Since the beginning of the pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), several articles reported negative outcomes in surgery of infected patients. Aim of this study is to report results of patients with COVID-19-positive swab, in the perioperative period after surgery. Data of COVID-19-positive patients undergoing emergent or oncological surgery, were collected in a retrospective, multicenter study, which involved 20 Italian institutions. Collected parameters were age, sex, body mass index, COVID-19-related symptoms, patients' comorbidities, surgical procedure, personal protection equipment (PPE) used in operating rooms, rate of postoperative infection among healthcare staff and complications, within 30-postoperative days. 68 patients, who underwent surgery, resulted COVID-19-positive in the perioperative period. Symptomatic patients were 63 (92.5%). Fever was the main symptom in 36 (52.9%) patients, followed by dyspnoea (26.5%) and cough (13.2%). We recorded 22 (32%) intensive care unit admissions, 23 (33.8%) postoperative pulmonary complications and 15 (22%) acute respiratory distress syndromes. As regards the ten postoperative deaths (14.7%), 6 cases were related to surgical complications. One surgeon, one scrub nurse and two circulating nurses were infected after surgery due to the lack of specific PPE. We reported less surgery-related pulmonary complications and mortality in Sars-CoV-2-infected patients, than in literature. Emergent and oncological surgery should not be postponed, but it is mandatory to use full PPE, and to adopt preoperative screenings and strategies that mitigate the detrimental effect of pulmonary complications, mostly responsible for mortality.

Keywords: COVID-19; Mortality; Pulmonary complications; SARS-CoV-2.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

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