Preop COVID-19 isolation precautions linked to postop lung complications

Editor's Note

This study by researchers with the University of Birmingham, England-led COVIDSurg-GlobalSurg Collaboratives (global partnerships of more than 15,000 surgeons) finds that patients who isolate before their surgical procedures to protect themselves from COVID-19 have a higher risk of postoperative pulmonary complications than those who don’t isolate.

Researchers analyzed data on 96,454 patients from 114 countries, including 26,948 who isolated before their surgical procedures. Isolation was defined as the period before an elective surgical procedure during which patients did not leave their homes or receive visitors from outside their households.

Postoperative pulmonary complications occurred in 1,947 (2%) patients. Of those, 227 (11.7%) were associated with COVID-19 infection. 

After adjusting for age, comorbidities, and type of surgery, patients who isolated preoperatively had a 20% higher risk of postoperative lung complications than those who didn’t isolate. The risk rose if patients isolated for more than 3 days—isolation for 4 to 7 days was associated with a 25% increased risk, and isolation for 8 days or longer with a 31% increased risk.

Isolation is associated with decreased physical activity, worse nutritional habits, and higher levels of anxiety and depression, and these effects in vulnerable patients may contribute to an increased risk of postoperative pulmonary complications, the researchers say.