Surgical outcomes inchildren with perioperative SARS-CoV-2 diagnosis

Abstract

Objective: To understand whether perioperative SARS-CoV-2 infection increases risk of pulmonary complications in children.

Methods: A retrospective cohort study of children who underwent surgery with perioperative SARS-CoV-2 infection at a children's hospital from March 1, 2020, to June 30, 2021. Uninfected, age-matched control patients who underwent the same procedure as infected patients over the past ten years were included in the study in a 3:1 ratio to infected patients. Primary outcomes were 7- and 30-day mortality. Secondary outcomes were development of pulmonary complications, readmission, length of hospital or ICU stay, and oxygen administration in post-anesthesia care unit (PACU).

Results: Our study included 73 patients who underwent surgery with perioperative diagnosis of SARS-CoV-2, and 218 control patient undergoing similar procedures. One total mortality event was observed within 7 days in an uninfected control patient, and none occurred in infected patients. Perioperative SARS-CoV-2 infection was associated with increased risk for pulmonary complications in univariate analysis. Infection was not associated with any of our other secondary outcomes. Symptomatic SARS-CoV-2 infection and timing of diagnosis was not associated with development of pulmonary complications among infected patients.

Conclusions: Children with perioperative SARS-CoV-2 infection may be at increased risk for development of pulmonary complications. Larger studies should be performed to confirm our results.

Keywords: COVID-19; Pediatric surgery; SARS-CoV-2.

Fig 1

Flow diagram demonstrating number of patient records screened and included in the study for control patients and patients infected with SARS-CoV-2.

Fig 2

Postoperative outcomes in patients testing positive for SARS-CoV-2. (A) Pulmonary complications in patients with SARS-CoV-2 infection compared to patients without infection. (B) Comparison of hospital and ICU admission, and length of stay in days for patients who tested positive for SARS-CoV-2 and patients without infection. Length of stay is presented as the average length of stay with standard deviation in parenthesis.

Fig 3

Pulmonary complications in patients who tested positive for SARS-CoV-2 by timing of diagnosis (A) and presence of symptoms of SARS-CoV-2 infection (B). Specific reported symptoms of SARS-CoV-2 infection are shown in C.