학술논문

Clinical Outcomes of 2019 COVID-19 Positive Patients Who Underwent Surgery: A New York City Experience.
Document Type
Article
Source
Journal of Surgical Research. May2021, Vol. 261, p113-122. 10p.
Subject
*COVID-19
*TREATMENT effectiveness
*INTENSIVE care units
*POLYMERASE chain reaction
*COVID-19 testing
Language
ISSN
0022-4804
Abstract
The coronavirus disease 2019 (COVID-19) global pandemic has led to a halt in elective surgeries throughout the United States and many other countries throughout the world. Early reports suggest that COVID-19 patients undergoing surgery have an increased risk of requiring intensive care unit (ICU) admission and overall mortality. A retrospective review was performed of all COVID-19, positive with polymerase chain reaction confirmation, patients who had surgery between February 17, 2020 and April 26, 2020 at a major New York City hospital. Clinical characteristics and outcomes including ICU admission, ventilator requirement, and mortality were analyzed. Thirty-nine COVID-19 surgical patients were identified. Mean age was 53.9 y, and there were more men than women in the cohort (56.4% versus 43.6%). Twenty-two patients (56.4%) had a confirmed positive COVID-19 test preoperatively, and the remainder tested positive after their procedure. The majority (59%) of patients had an American Society of Anesthesiologists (ASA) class of 3 or higher. Postoperatively, 7 patients (17.9%) required ICU level care with a mean length of stay of 7.7 d. There were 4 deaths (10.3%) in this patient population, all of which occurred in patients who were ASA class 3 or 4. This study represents the largest study to date, that objectively analyzes the outcomes of COVID-19 positive patients who underwent surgery. Overall, ICU admission rates and mortality are similar to reported rates in the literature for nonsurgical COVID-19 patients. Notably, in COVID-19 patients with ASA 1 or 2, there was a 0% mortality rate in the postoperative period. • Patients infected with COVID-19 are not necessarily at higher risk of peri-operative mortality. • Those with low ASA class status (Ex: 1 and 2) had a 0% mortality rate in our cohort. • Peri-operative ICU admission rates were similar to those reported in patients without COVID-19. • Infection with COVID-19 should not be an absolute contraindication to necessary surgery. [ABSTRACT FROM AUTHOR]