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Conceptual illustration of the coronavirus as if it were observed from a microscope.

International study highlights risks associated with recovering from surgery during COVID-19

The COVID-19 outbreak redefined how health care systems address patient safety and clinical care, especially related to emergency and elective surgeries. A new international study, locally led by Doctor of Public Health student Anna Ssentongo and trauma surgeons Joshua Hazelton, DO, and John Oh, MD, explores the impact that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has on patients’ postoperative recovery and how this can inform hospitals’ decision-making processes during a pandemic.

In the recently published report in The Lancet, Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study, researchers analyzed data from 235 hospitals in 24 countries. The study examines 1,128 patients, who underwent surgery in the midst of the pandemic during the first three months of 2020. Among this group, 74 percent had emergency surgeries, while 24.8 percent had elective surgeries.

Findings show that of patients diagnosed with SARS-COV-2 within the perioperative period, half of the patients experienced pulmonary complications, such as pneumonia or acute respiratory distress. Of those, 38 percent died within a month after their operations. Emergency surgery was completed in 74 percent of patients and elective surgery in 25 percent of patients. Emergency surgery elicited a significantly higher mortality rate, but not a higher rate of pulmonary complications compared to elective surgeries.

According to the study, certain subgroups are at a higher risk for complications and death. Findings reveal that in addition to those needing emergency or major surgery, that men, patients older than 70 years old, individuals with chronic diseases, and patients having cancer-related surgeries were most vulnerable to adverse outcomes.

The international study underscores the need for healthcare providers to prepare for public health emergencies and proceed with caution when caring for patients during a global pandemic. To further prevent disease transmission and safeguard patient health, researchers urge hospitals to explore ways to minimize in hospital SARS-COV-2 transmission and mitigate the risk of complications in emergency surgery patients with SARS-COV-2.

The study was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79).

In addition to Anna Ssentongo and Drs. Hazelton and Oh, Penn State researchers Paddy Ssentongo, MD, MPH (Epidemiology PhD student) and Niraj Gusani, MD, contributed to the study.

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