ABSTRACT
Hundreds of surgeries are postponed every day during the global COVID -19 pandemic. The hospital and clinicians are in dilemma scheduling elective procedures during the pandemic. The current study was designed to evaluate postoperative pulmonary complications and mortality in COVID-19 patients in a systematic review and meta-analysis of globally published peer-reviewed literatures. A systematic literature search was conducted using the selection criteria in five databases. A quality assessment was made with a validated Newcastle-Ottawa Scale. The meta-analysis worked as a generic inverse variance meta-analysis. A total of 308 articles were identified from different databases and 5 articles with a total 1408 participants were selected for evaluation after successive screenings. The meta-analysis revealed a high global rate of postoperative mortality among COVID-19 patients, as high as 23% (95% CI: 15 to 26), and high postoperative pulmonary complications including pneumonia and acute respiratory distress syndrome. The 30-days mortality rate and prevalence of pulmonary complications were high. There was one death for every five COVID-19 patients undergoing surgical procedures, indicating the need for mitigating strategies to decrease perioperative mortality, transmission to healthcare workers, and non-COVID-19 patients. Larger samples and/or multicenter trials are needed to explore the perioperative mortality dan morbidity rate of patients with COVID-19 undergoing surgeries, and in particular, factors with the highest impact on perioperative mortality. There should be a clinical guideline to determine when to operate or not to operate on patients with COVID-19 for elective and emergency surgeries. © 2022 National Journal of Clinical Anatomy ;Published by Wolters Kluwer - Medknow.
ABSTRACT
Coronaviruses have caused several global challenges for health-care providers all over the world. The notorious SARS-CoV-2 could attack the lower respiratory tract and trigger the immune systems to release massive number of immune cells and pro-inflammatory cytokines and cause immunopathology consequences called cytokine release syndrome. These pro-inflammatory cytokines and other immune cells caused lung injury and severe acute respiratory distress syndrome in COVID-19 (CARDS) and multiple organ failure. There are still many intertwined immune responses that not yet been discovered in SARS-CoV-2 infections. Targeted and specific cell therapy would be reasonable and considered safer to be employed in patients who present with comorbidities and at risk of complications. © 2020 Bali Journal of Anesthesiology ;Published by Wolters Kluwer-Medknow.