Evaluation of Perioperative Complications and Mortality in Covid-19 Patients Who Had Emergency Surgery

Objective: The risk for adverse outcomes in COVID-19 patients necessitates further scrutiny in Covid 19 patients in providing appropriate surgical indications and perioperative surgical safety precautions. In this study, we aimed to contribute to elective surgery resumption about infection with early and late postoperative complications and mortality in patients with RT-PCR (+) and clinically suspicious COVID-19 who underwent emergency surgery in our hospital. Methods: A total of 86 patients who have been operated on in our institution for emergency surgery over the age of 18 who were diagnosed with SARS-CoV-2 infection seven days before or 30 days after surgery were enrolled in the study. In this retrospective study, the primary outcome has been established as mortality factors and survival within postoperative 30 days. Results: Regarding the primary outcome as 30-day survival, every 1-year increase in age increased the risk of death by two folds. Patients with one or more comorbidities have an increased risk of death 13 times and those with two or more have an increased risk of death 23 times. Patients in intensive care units increase the risk of death by 8.5 times compared to those who are not hospitalized. On the contrary, an increase in hemoglobin level was shown to reduce the risk of death by 0.8 times. Conclusion: The need for intensive care and mortality is high, especially after emergency surgery, in patients with COVID19 symptoms and more than one comorbidity. Surgical indications of such patients should be well investigated.

Eye care in intensive care in COVID-19 era: a prospective observational study from Turkey.

OBJECTIVE: There has been an increase in intensive care applications due to respiratory failure of COVID-19 infection. Management of respiratory failure includes a range of additional interventions, including high-flow nasal oxygen, noninvasive and invasive ventilation and prone position. These interventions contain risk factors for the development of ocular complications. This study aimed to elucidate the ocular pathologies that occurred in COVID-19 patients hospitalized in the intensive care unit. PATIENTS AND METHODS: Patients who completed 24 hours in the intensive care unit were included in the study. Age, gender, duration of hospitalization before intensive care unit, comorbid diseases and APACHE 2 scores of COVID-19 patients admitted to intensive care unit were recorded. SOFA scores, presence of sedation and muscle relaxant, oxygen therapy (conventional oxygen therapy, high flow nasal oxygen therapy, noninvasive ventilation, invasive ventilation) and presence of prone position were recorded. All patients were evaluated daily for ocular findings. Routine eye care protocol was applied to all patients. RESULTS: Seventy patients were followed for a total of 596 days in the intensive care unit. Pathological ocular findings were observed during hospitalization in 59 of the patients followed. The incidence of chemosis in patients who underwent IMV was significantly higher compared to other methods (p<0.001). CONCLUSIONS: In this study, we observed that despite our routine eye care protocols, invasive mechanical ventilation applications predispose corneal surface damage in patients followed up in the intensive care unit with COVID-19 infection.