Postoperative outcomes in surgical COVID-19 patients: a multicenter cohort study

François Martin Carrier, Éva Amzallag, Vincent Lecluyse, Geneviève Côté, Étienne J Couture, Frédérick D'Aragon, Stanislas Kandelman, Alexis F Turgeon, Alain Deschamps, Roy Nitulescu, Codjo Djignefa Djade, Martin Girard, Pierre Beaulieu, Philippe Richebé, François Martin Carrier, Éva Amzallag, Vincent Lecluyse, Geneviève Côté, Étienne J Couture, Frédérick D'Aragon, Stanislas Kandelman, Alexis F Turgeon, Alain Deschamps, Roy Nitulescu, Codjo Djignefa Djade, Martin Girard, Pierre Beaulieu, Philippe Richebé

Abstract

Background: Data on postoperative outcomes of the COVID-19 patient population is limited. We described COVID-19 patients who underwent a surgery and the pandemic impact on surgical activities.

Methods: We conducted a multicenter cohort study between March 13 and June 192,020. We included all COVID-19 patients who underwent surgery in nine centres of the Province of Québec, the Canadian province most afflicted by the pandemic. We also included concomitant suspected COVID-19 (subsequently confirmed not to have COVID-19) patients and patients who had recovered from it. We collected data on baseline characteristics, postoperative complications and postoperative mortality. Our primary outcome was 30-day mortality. We also collected data on overall surgical activities during this first wave and during the same period in 2019.

Results: We included 44 COVID-19 patients, 18 suspected patients, and 18 patients who had recovered from COVID-19 at time of surgery. Among the 44 COVID-19 patients, 31 surgeries (71%) were urgent and 16 (36%) were major. In these patients, pulmonary complications were frequent (25%) and 30-day mortality was high (15.9%). This mortality was higher in patients with symptoms (23.1%) compared to those without symptoms (5.6%), although not statistically significant (p = 0.118). Of the total 22,616 cases performed among participating centres during the study period, only 0.19% had COVID-19 at the time of surgery. Fewer procedures were performed during the study period compared to the same period in 2019 (44,486 cases).

Conclusion: In this Canadian cohort study, postoperative 30-day mortality in COVID-19 patients undergoing surgery was high (15.9%). Although few surgeries were performed on COVID-19 patients, the pandemic impact on surgical activity volume was important.

Trial registration: ClinicalTrials.gov Identifier: NCT04458337 .

Keywords: COVID-19; Health system impact; Pandemic; Postoperative mortality; Postoperative outcomes; Surgery.

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Kaplan-Meir curves for 30 -day postoperative survival in COVID-19 patients. P = 0.118 by log-rank test

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