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.

Hartmann's reversal was performed in a small percentage of patients, mostly including those with benign disease. It had a significant morbidity.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

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Introducción: La igualdad de género hay sido una preocupación introducida en los últimos años por instituciones tanto internacionales como nacionales. La cuestión de igualdad afecta también al ámbito laboral tanto en lo que se refiere a la distribución del trabajo como a la exposición a riesgos psicosociales, principalmente en economías basadas en la información y conocimiento. Los objetivos de este estudio se dirigen a identificar, entre la población trabajadora española, situaciones de desigualdad entre géneros en lo que se refiere a los diferentes componentes de la carga mental y estimar su prevalencia. Material y métodos: Se realizó un estudio observacional de tipo transversal a partir de los datos recogidos de la « VII Encuesta Nacional de Condiciones del Trabajo» con una muestra de 8.892 trabajadores. Los datos se analizaron de forma bivariante utilizándose el test de Chi-Cuadrado para las variables cualitativas y el t-test para muestras independientes en el caso de variables cuantitativas. La significación se consideró con p < 0,05. Con el objeto de analizar la influencia de distintos factores potencialmente relacionados con componentes de la carga mental y su interacción, se realizó un análisis de regresión logística binaria con el método de inclusión retroceder por paso (Wald). Resultados: Los hombres manifiestan sufrir una menor carga mental que la mujer en relación con el ritmo de trabajo, OR = 0,89 (0,8-0.9), la prevalencia de un «Alto ritmo de trabajo» fue de (0,65‰) en mujeres con respecto a un 0,63‰ en hombres. Los hombres refirieron una menor carga mental por «exceso de trabajo» con respecto a las mujeres OR = 0,9 (0,8-1,0). Las mujeres con mayor frecuencia que el hombre se encuentran fatigadas por una sobrecarga de trabajo (0,37‰); 0,35‰) respectivamente. Conclusiones: Estos resultados no corroboran nuestra hipótesis inicial de que la mujer está expuesta a una mayor carga mental que el hombre. Analizando diferentes componentes de la carga mental, la mujer está expuesta a un mayor ritmo de trabajo y a una mayor fatiga como consecuencia del a cantidad de trabajo.