Severity of Prior Coronavirus Disease 2019 is Associated With Postoperative Outcomes After Major Inpatient Surgery
Year: 2023
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To determine how the severity of prior history (Hx) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection influences postoperative outcomes after major elective inpatient surgery. BACKGROUND: Surgical guidelines instituted early in the coronavirus disease 2019 (COVID-19) pandemic recommended a delay in surgery of up to 8 weeks after an acute SARS-CoV-2 infection. This was based on the observation of elevated surgical risk after recovery from COVID-19 early in the pandemic. As the pandemic shifts to an endemic phase, it is unclear whether this association remains, especially for those recovering from asymptomatic or mildly symptomatic COVID-19. METHODS: Utilizing the National COVID Cohort Collaborative, we assessed postoperative outcomes for adults with and without a Hx of COVID-19 who underwent major elective inpatient surgery between January 2020 and February 2023. COVID-19 severity and time from infection to surgery were each used as independent variables in multivariable logistic regression models. RESULTS: This study included 387,030 patients, of whom 37,354 (9.7%) were diagnosed with preoperative COVID-19. Hx of COVID-19 was found to be an independent risk factor for adverse postoperative outcomes even after a 12-week delay for patients with moderate and severe SARS-CoV-2 infection. Patients with mild COVID-19 did not have an increased risk of adverse postoperative outcomes at any time point. Vaccination decreased the odds of respiratory failure. CONCLUSIONS: Impact of COVID-19 on postoperative outcomes is dependent on the severity of illness, with only moderate and severe disease leading to a higher risk of adverse outcomes. Existing perioperative policies should be updated to include consideration of COVID-19 disease severity and vaccination status.
Source: Annals of Surgery
Authors: Nathaniel B. Verhagen, Gopika SenthilKumar, Taylor Jaraczewski, Nicolas K. Koerber, Jennifer R. Merrill, Madelyn A. Flitcroft, Aniko Szabo, Anjishnu Banerjee, Xin Yang, Bradley W. Taylor, Carlos E. Figueroa Castro, Tina W.F. Yen, Callisia N. Clarke, Kathryn Lauer, Kurt J. Pfeifer, Jon C. Gould, Anai N. Kothari
Institution: Medical College of Wisconsin
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Bill and Melinda Gates Foundation, Yale University, University of Southern California, Children's Hospital of Philadelphia, University of Nebraska Medical Center, Vanderbilt University, University of Miami, University of Pennsylvania, Ohio State University, Emory University, Tufts Medical Center, NYU Langone Medical Center, University of Wisconsin-Madison, Northwestern University, George Washington University, Wake Forest University, Cincinnati Children's Hospital Medical Center, Children's Hospital Colorado, Vanderbilt Institute for Clinical and Translational Research, University of Chicago, University of Minnesota, Washington University in St. Louis, University of Michigan, Harvard Catalyst, Loyola University Chicago, University of Utah, University of Washington, University of Texas Medical Branch, Tulane University, Johns Hopkins University, University of Oklahoma, Institute for Translational Medicine and Therapeutics, Institute of Clinical and Translational Sciences, University of Rochester, University of Cincinnati, Pennsylvania State University, University of Arkansas for Medical Sciences, Rush University, University of South Carolina, Virginia Commonwealth University, Southern California Clinical and Translational Science Institute, West Virginia University, Montana State University, Rutgers, The State University of New Jersey, Children’s Hospital of Wisconsin Research Institute, MedStar Health Research Institute, Georgetown-Howard Universities Center for Clinical and Translational Science, University of Texas Health Science Center at Houston, NorthShore University HealthSystem, Vanderbilt University Medical Center, Institute of Translational Health Sciences, Georgia Clinical and Translational Science Alliance, Penn State Clinical and Translational Science Institute, Children's National Hospital, Louisiana Clinical and Translational Science Center, Ochsner Health, West Virginia Clinical and Translational Science Institute, Stony Brook University, National Institutes of Health, University of Illinois at Urbana-Champaign, Institute for Clinical and Translational Research, University of Wisconsin, Madison, University of California, Los Angeles, Weill Cornell Medical College, University of California, Davis, Oregon Clinical and Translational Research Institute, University of North Carolina at Chapel Hill, University of California, San Diego, University of Oklahoma Health Sciences Center, University of California, San Francisco, University at Buffalo, Michigan Institute for Clinical and Health Research, University of California, Irvine, Leonard M. Miller School of Medicine, Center for Clinical and Translational Research, School of Medicine, Indiana University, University of Colorado Denver, Center for Clinical and Translational Science, University of Massachusetts, Center for Clinical and Translational Science, Mayo Clinic, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Irving Medical Center, Columbia University, Translational Research Institute, University of Arkansas for Medical Sciences, South Carolina Clinical and Translational Research Institute, Medical University of South Carolina, Clinical and Translational Science Institute, University of Florida, Frontiers Clinical and Translational Science Institute, University of Kansas, Clinical and Translational Science Center, University of New Mexico, National Institute of General Medical Sciences, National Center for Advancing Translational Sciences, Institute for Integration of Medicine and Science, Colorado Clinical and Translational Sciences Institute, Institute for Clinical and Translational Science, University of California, Irvine, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Accelerated Innovation Research Initiative Turning Top Science and Ideas into High-Impact Values
Awards: G1003362385, G1034546755, G1074397124, G1110702752, G112449207, G1133842343, G1172658771, Center for Clinical and Translational Sciences (CCTS), G1198907661, G1252910802, The OSU Center for Clinical and Translational Science: Advancing Today's Discoveries to Improve Health, G1426198371, G1576582908, G1599055349, University of Massachusetts Center for Clinical and Translational Science, G1699415014, G171052541, G1717162763, G1756254663, G1843193268, G1843992630, Wake Forest Clinical and Translational Science Award, G1862468807, Together: Transforming and Translating Discovery to Improve Health, Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS), G2008237588, Duke CTSA, G2049072053, G2101559773, G210617772, G2118698080, G213118816, G2152875133, G216896791, G2190116832, G2191929784, G2202983096, G2228636686, G2285413653, G235420648, G237123860, G2507118478, G2508192175, G2529322290, G2592540264, G2610614086, G2615776415, G2635992203, G2714998049, G2740763107, G2761940466, Center for Clinical and Translational Science, G2922236389, The Harvard Clinical and Translational Science Center, Stanford Center for Clinical & Translational Education and Research (Spectrum), G3015141988, G3075846822, G3125251562, G3137464953, G3187757946, UNM HSC Clinical and Translational Science Center, University of Minnesota Clinical and TranslationalmScience Institute (UMN CTSI), G3455473179, G3534013791, G3573251375, G3667826151, Institute for Clinical and Translational Science, Tufts Clinical and Translational Science Institute, G4045563614, G4091522973, G4159580532, G4169670960, G4186163313, G432001851, G4410787187, G4688203610, The integrated Translational Health Research Institute of Virginia (iTHRIV): Using Data to Improve Health, MSHS Translational Science Hub, A National Center for Digital Health Informatics Innovation, G476308836, Northwestern University Clinical and Translational Science Institute (NUCATS), G4811095511, G4823677270, G4851974581, G4852991764, G4900725235, G4924162002, G4925418384, G4950870472, G5031973872, Center for Clinical and Translational Research, G5049613280, G5059334661, G5086723997, G5159529264, G5258278944, Center for Clinical and Translational Science and Training, G5286663980, G5352274017, G536197267, G5385890486, G5409860367, G5430408733, G5555614831, G55941084, G5619247364, Miami Clinical and Translational Science Institute, G572024221, G584478153, G5849810213, Expanding Translational Research in Arkansas, Utah Center for Clinical and Translational Science, G6036981074, G6090519289, G611660658, G614564937, G625544220, G6292001676, American Indian - Alaska Native Clinical and Translational Research Center (AI-AN CTRC), G6523867696, G6576913434, Clinical and Translational Science Award, North Carolina Translational and Clinical Science Institute (NC TraCS), Sage Bionetworks - to evaluate the signs and symptoms of COVID-19 in a data-consortium approach to inform better clinical decision making for diagnosis, G6720719670, G6831857590, G687203789, G6979210571, Michigan Institute for Clinical and Health Research (MICHR), G707880362, G7157803174, G7199445640, G7406577712, G7473568262, Scripps Translational Science Institute, New Jersey Alliance for Clinical Translational Science: NJ ACTS, G7594186269, G761346317, Clinical and Translational Science Institute at Childrens National, G7672581523, G7695494419, G7707125228, The University of Rochester Clinical and Translational Science Award Hub, G7758172473, Indiana Clinical and Translational Sciences Institute, G7768549844, G7818101325, Clinical and Translational Science Award, Clinical and Translational Science Award, Johns Hopkins Institute for Clinical and Translational Research, The University of Iowa Clinical and Translational Science Award, University of Buffalo Clinical and Translational Science Institute, Institute for Integration of Medicine & Science: A Partnership to Improve Health, G7971701139, G8013765, G8021374757, Colorado Clinical and Transational Sciences Institute, G8241404708, South Carolina Clinical & Translational Research Institute (SCTR), Boston University Clinical and Translational Science Institute, G8536079613, UC San Diego Clinical and Translational Research Institute, G8908676624, Frontiers Clinical and Translational Science Institute at the University of Kansas, Advance Clinical and Translational Research (Advance-CTR), Clinical and Translational Science Award, UC Davis Clinical and Translational Science Center, Northern New England Clinical and Translational Research Network, University of Wisconsin Institute for Clinical and Translational Research, Clinical and Translational Science Center, Mayo Clinic Center for Clinical and Translational Science (CCaTS), West Virginia Clinical and Translational Science Institute: A Statewide Organization Building Research Excellence and Engaging Communities to Improve Health, Vanderbilt Institute for Clinical and Translational Research (VICTR), Oregon Clinical and Translational Research Institute, Clinical and Translational Science Award, Oklahoma Shared Clinical and Translational Resources, Great Plains IDeA-CTR, Delaware Clinical and Translational Research ACCEL Program, Penn State Clinical and Translational Science Institute, Southern California Clinical and Translational Science Institute, Institutional Clinical and Translational Science Award, Washington University Institute of Clinical and Translational Sciences, Mississippi Center for Clinical and Translational Research, The Institute for Translational Medicine, Michigan Institute for Clinical and Health Research (MICHR), Georgia Clinical & Translational Science Alliance (Georgia CTSA), Institute of Translational Health Sciences, Louisiana Clinical and Translational Science Center, Yale Clinical and Translational Science Award, Miami Clinical and Translational Science Institute, Kentucky Center for Clinical and Translational Science, Developing, Demonstrating, and Disseminating Innovative Programs to Achieve Translational Success, Colorado Clinical and Translational Sciences Institute (CCTSI), UCLA Clinical and Translational Science Institute, Clinical and Translational Science Institute, G927150221, UTMB Clinical and Translational Science Award
OpenAlex ID: W4384922313