Global Prevalence of Perioperative Outcomes of Surgical Patients with COVID-19: A Systematic Review and Meta-Analysis

Abstract

Background: Surgery during the COVID-19 pandemic is too challenging globally especially for low and middle-income countries in which the limping health care system is broken with low testing capacity, sub-optimal postoperative care, lack of anesthesia machine filters, and limited personal protective equipment. Body of evidence is lacking on the prevalence of perioperative outcomes of patients with COVID-19. Therefore, this study is aimed to provide the global prevalence of perioperative outcomes of patients with COVID-19.Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 2019 to August 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting the prevalence of mortality were included.Results: A total of 515 articles were identified from different databases and 50 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The Meta-Analysis revealed that the global prevalence of perioperative mortality among COVID-19 patients was 20% (95% CI: 15 to 26). The Meta-Analysis also revealed that the rate of postoperative ICU admission was 15% (95% confidence interval (CI):10 to 21).Conclusion: There is one death for every five COVID-19 patients undergoing surgical procedures which entails mitigating strategies to decrease perioperative mortality, provide less risky anesthetic techniques, and alternative management other than surgical procedures.Registration: This systematic review and meta-analysis was registered in Prospero's international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.