Are surgical and non-operating room intervention safe in the COVID-19 pandemic? A retrospective study

Abstract

Little is known about the impact of COVID-19 on the outcomes of patients undergoing surgery and intervention. This study was conducted between 20 March and 20 May 2020 in six hospitals in Istanbul, and aimed to investigate the effects of surgery and intervention on COVID-19 disease progression, intensive care (ICU) need, mortality and virus transmission to patients and healthcare workers. Patients were examined in three groups: group I underwent emergency surgery, group II had an emergency non-operating room intervention, and group III received inpatient COVID-19 treatment but did not have surgery or undergo intervention. Mortality rates, mechanical ventilation needs and rates of admission to the ICU were compared between the three groups. During this period, patient and healthcare worker transmissions were recorded. In total, 1273 surgical, 476 non-operating room intervention patients and 1884 COVID-19 inpatients were examined. The rate of ICU requirement among patients who had surgery was nearly twice that for inpatients and intervention patients, but there was no difference in mortality between the groups. The overall mortality rates were 2.3% in surgical patients, 3.3% in intervention patients and 3% in inpatients. COVID-19 polymerase chain reaction positivity among hospital workers was 2.4%. Only 3.3% of infected frontline healthcare workers were anaesthesiologists. No deaths occurred among infected healthcare workers. We conclude that emergency surgery and non-operating room interventions during the pandemic period do not increase postoperative mortality and can be performed with low transmission rates.

The Impact of the COVID-19 Pandemic on Anesthesia Management and Clinical Outcomes in Cesarean Section Surgery

“…Although many changes in anesthesia practice, such as postponing elective cases, reconsidering urgency, have emerged with the COVID-19 pandemic, pregnancy-related procedures such as C/S surgery have not been interrupted 7 . Therefore, the best opportunity to observe the effects of the pandemic was obtained in these cases.…”

“…Particularly in this period, there was a decrease in elective cases and a divergency from general anesthesia to limit airway interventions. 7,18 For that reason, regional anesthesia practices have arisen significantly in all procedures, as well as in C/S surgery 16,19 . In our study, it was shown that general anesthesia rates in C/S surgery decreased from 43% to 35% in the early pandemic period, consistent with the evidences.…”