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Postoperative Morbidity and Mortality in Patients with Perioperative SARS-CoV-2 Infection – a Cohort Study

By Boris

Volume 9, Issue 1

Original Article / Published: November 2021

DOI: https://www.doi.org/10.57045/jemis/911121.pp59-66

Ts. Lukanova (1), I. Takorov (1), D. Vylcheva (1), S. Arnaudov (1), S. Simeonovski (1), D. Dimitrov (1), Ts. Stanimirov (1), M. Abrasheva (2)

  1. First Clinic of Abdominal Surgery, 2. Department of Anesthesiology and Intensive CareMilitary Medical Academy, Sofia

Abstract

Introduction: Concerning SARS-CoV-2 pandemic strict restrictions were introduced in Bulgaria comparable to other countries worldwide in terms of elective surgical care with a cancellation of all but emergency surgery. The aim of this study is to report the results of COVID-19-positive patients in terms of postoperative morbidity and mortality following elective and emergency surgery. Material and methods: We performed a prospective cohort study of patients who underwent elective or emergency surgery at First Clinic of Abdominal Surgery, Military Medical Academy, Sofia between November 11, 2020, and January 11, 2021. For the same period, the clinic was remodelled into a combined surgical and therapeutic unit for the treatment of COVID-19 patients. Results: Twenty-five patients with SARS-CoV-2 underwent surgery or were postoperatively treated between November 11, 2020, and January 11, 2021, at First Clinic of Abdominal Surgery, Military Medical Academy, Sofia – 15 males and 10 females, the median age of 66.2 years (43-95). There were 5 (20%) elective oncological operations and 20 (80%) emergency procedures. Pulmonary complications were registered in 18/25 (72%) of the patients and cardio-vascular – at 3/25 (12%). Postoperative morbidity was 16% – postoperative haemorrhage (n=2), surgical site infection (n=1) and postoperative pancreatic fistula type B (n=1). Eleven patients were admitted to the intensive care unit. Early postoperative mortality was 24%. The median age of the deceased was 69.5 years (55-82), 83.33 % males. There was comorbidity in 100 % of lethal cases. The main cause of mortality was COVID-19 associated. Conclusion: A SARS-CoV-2 positive status increases postoperative morbidity and mortality rates in patients undergoing general and oncological operative care. If possible, elective abdominal surgery in COVID-19 patients should be postponed for 4-7 weeks in order to optimize postoperative outcomes.

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Article [pdf]

Keywords:

COVID-19 surgery, morbidity, mortality

How to cite this article:

Ts. Lukanova, I. Takorov , D. Vylcheva, S. Arnaudov , S. Simeonovski , D. Dimitrov , Ts. Stanimirov, M. Abrasheva . Postoperative Morbidity and Mortality in Patients with Perioperative SARS-CoV-2 Infection – a Cohort Study. Journal of Endourology and Minimally Invasive Surgery 2021; 9 (1): 59-66

Corresponding author:

Assoc. prof. Tsonka Lukanova. MD, PhD

First Clinic of Abdominal Surgery Military Medical Academy

Sofia 1606, 3 “Georgi Sofiiski” blvd., Bulgaria

E-mail: priluki@abv.bg; Тel.: +359 2 9225711