Mid-term postop outcomes in patients with, without COVID-19

Editor's Note

This study from the University of Maryland School of Medicine and Veterans Affairs Medical Center, Baltimore, finds that COVID-19 is associated with decreased overall and complication-free survival, primarily in the early postoperative period.

Of 153,741 surgical patients analyzed between March 2020 and 2021, 4,778 COVID-19-positive patients were matched to 14,101 COVID-19-negative patients.

Among the findings:

• COVID-19-positive status was linked to higher postoperative mortality with a 6-month survival of 94.2% vs 96.0%.
• The highest mortality was in the first 30 days after surgery.
• Hazards for mortality and postoperative complications in COVID-19-positve patients decreased with increasing time between testing positive and date of surgical procedure.
• COVID-19-positive patients having elective surgery had similar rates of mortality, thrombotic, and septic complications, but higher rates of pulmonary complications than COVID-19-negative patients.

This is the first report of mid-term postoperative outcomes in COVID-19-positive patients, the researchers say, adding that case urgency has a multiplicative effect on short-term and long-term risks of postoperative mortality and complications. Delaying surgery by 5 weeks or more reduces the risk of complications, they say.