Heightened 30-Day Postoperative Complication Risk Persists After COVID-19 Infection.

BACKGROUND: Current literature describing the riskiness of operating on actively infected COVID-19 patients far outnumbers that on the risk of operating on recovered patients. The purpose of this study was to analyze a single, tertiary referral center experience regarding postoperative complications and readmissions in COVID-19-recovered patients versus COVID-19-naïve (never previously infected) patients undergoing elective and emergency surgery across all surgical subspecialties. METHODS: All PCR positive COVID-19 patients that underwent a surgical procedure between February 1, 2020, and November 1, 2020, were included in the COVID-positive cohort. These patients were then matched to COVID-naïve controls that underwent similar procedures within the same time frame. Primary outcomes included 30-day postoperative complications as well as 90-day readmissions. Multivariable analyses were also performed. RESULTS: 112 COVID-positive patients met inclusion criteria and were all matched to COVID-naïve controls. 76 patients (68%) underwent surgery > 30 days from their COVID diagnosis. COVID-positive patients were at significantly higher risk of 30-day complications compared to the COVID-naïve cohort (22% versus 8%, respectively; p < 0.01). Multivariable analyses found ambulatory/asymptomatic infections, undergoing surgery between 30 and 120 days from diagnosis, initial presentation to the emergency department and elevated ASA scores to be significantly associated with 30-day complications. No differences were found for 90-day readmissions. CONCLUSION: Patients with previous COVID-19 infections carry a higher perioperative risk profile for 30-day complications compared to COVID-naïve counterparts in unvaccinated populations.

Early Postoperative Pneumonia After Elective Primary Total Hip Arthroplasty in "COVID-19 Survivor": A Case Report.

CASE: A 57-year-old woman with a history of COVID-19 pneumonia, myelodysplastic syndrome, type II diabetes mellitus, and nonalcoholic steatohepatitis underwent elective total hip arthroplasty 3 months after her COVID-19 infection had clinically resolved. Her postoperative course was complicated by COVID-19-negative pneumonia within 24 hours postoperatively requiring ICU admission. CONCLUSION: Patients who have previously recovered from COVID-19 infection may have long-lasting cardiopulmonary effects that may be asymptomatic. Further assessment of postoperative risk and guidance on preoperative evaluation of COVID-19 "survivors" is needed.