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Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection: an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic.
De Luca, Maurizio; Sartori, Alberto; Vitiello, Antonio; Piatto, Giacomo; Noaro, Giulia; Olmi, Stefano; Foschi, Diego; De Re, Luca; Zappa, Marco; Sarro, Giuliano; Rivolta, Umberto; Giraudo, Giorgio; Borghi, Felice; Pozzo, Gabriele; Sorisio, Vincenzo; Pignata, Giusto; Greco, Paola Antonella; Sisti, Valerio; Campagnaro, Tommaso; Guglielmi, Alfredo; Andreuccetti, Jacopo; Di Leo, Alberto; Lauro, Enrico; Ricci, Francesco; Musella, Mario; Zizzo, Maurizio; Bonacini, Stefano; Podda, Mauro; Pisanu, Adolfo; Coletta, Pietro; Guerrieri, Mario; Caracino, Valerio; Basti, Massimo; Pilone, Vincenzo; Raffaelli, Marco; Oragano, Luigi.
  • De Luca M; Department of General, Oncological and Metabolic Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy. nnwdel@tin.it.
  • Sartori A; Department of General, Oncological and Metabolic Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy.
  • Vitiello A; University Federico II of Naples, Naples, Italy.
  • Piatto G; Department of General, Oncological and Metabolic Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy.
  • Noaro G; Department of General, Oncological and Metabolic Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy.
  • Olmi S; Policlinico San Marco, Bergamo, Italy.
  • Foschi D; San Giuseppe Hospital, University of the Study, Milan, Italy.
  • De Re L; San Giuseppe Hospital, University of the Study, Milan, Italy.
  • Zappa M; Fatebenefratelli-Sacco Hospital, Milan, Italy.
  • Sarro G; Magenta Hospital, Milan, Italy.
  • Rivolta U; Magenta Hospital, Milan, Italy.
  • Giraudo G; Santa Croce and Carle Hospital, Cuneo, Italy.
  • Borghi F; Santa Croce and Carle Hospital, Cuneo, Italy.
  • Pozzo G; San Lazzaro Hospital, Asti, Italy.
  • Sorisio V; San Lazzaro Hospital, Asti, Italy.
  • Pignata G; Spedali Civili, Brescia, Italy.
  • Greco PA; San Salvatore Centrale Hospital, Pesaro, Italy.
  • Sisti V; San Salvatore Centrale Hospital, Pesaro, Italy.
  • Campagnaro T; University Borgo Roma, Verona, Italy.
  • Guglielmi A; University Borgo Roma, Verona, Italy.
  • Andreuccetti J; San Camillo Hospital, Trento, Italy.
  • Di Leo A; San Camillo Hospital, Trento, Italy.
  • Lauro E; Santa Maria del Carmine Hospital, Rovereto Trento, Italy.
  • Ricci F; Santa Maria del Carmine Hospital, Rovereto Trento, Italy.
  • Musella M; University Federico II of Naples, Naples, Italy.
  • Zizzo M; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
  • Bonacini S; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
  • Podda M; University of Cagliari, Cagliari, Italy.
  • Pisanu A; University of Cagliari, Cagliari, Italy.
  • Coletta P; Ospedali Riuniti, Ancona, Italy.
  • Guerrieri M; Ospedali Riuniti, Ancona, Italy.
  • Caracino V; Santo Spirito Hospital, Pescara, Italy.
  • Basti M; Santo Spirito Hospital, Pescara, Italy.
  • Pilone V; University of Salerno, Salerno, Italy.
  • Raffaelli M; Policlinico Universitario Gemelli, Rome, Italy.
  • Oragano L; San Biagio Hospital, Domodossola, Italy.
Updates Surg ; 73(2): 745-752, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1002181
Semantic information from SemMedBD (by NLM)
1. Complication PROCESS_OF Cohort
Subject
Complication
Predicate
PROCESS_OF
Object
Cohort
2. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
3. Patients USES Swab
Subject
Patients
Predicate
USES
Object
Swab
4. Operating Room LOCATION_OF Body mass index procedure
Subject
Operating Room
Predicate
LOCATION_OF
Object
Body mass index procedure
5. Postoperative infection PROCESS_OF Staff
Subject
Postoperative infection
Predicate
PROCESS_OF
Object
Staff
6. Lung LOCATION_OF Postoperative Complications
Subject
Lung
Predicate
LOCATION_OF
Object
Postoperative Complications
7. Postoperative death COEXISTS_WITH Surgical Complication
Subject
Postoperative death
Predicate
COEXISTS_WITH
Object
Surgical Complication
8. Surgery--Complications PROCESS_OF Patients
Subject
Surgery--Complications
Predicate
PROCESS_OF
Object
Patients
9. Complication PROCESS_OF Cohort
Subject
Complication
Predicate
PROCESS_OF
Object
Cohort
10. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
11. Patients USES Swab
Subject
Patients
Predicate
USES
Object
Swab
12. Operating Room LOCATION_OF Body mass index procedure
Subject
Operating Room
Predicate
LOCATION_OF
Object
Body mass index procedure
13. Postoperative infection PROCESS_OF Staff
Subject
Postoperative infection
Predicate
PROCESS_OF
Object
Staff
14. Lung LOCATION_OF Postoperative Complications
Subject
Lung
Predicate
LOCATION_OF
Object
Postoperative Complications
15. Postoperative death COEXISTS_WITH Surgical Complication
Subject
Postoperative death
Predicate
COEXISTS_WITH
Object
Surgical Complication
16. Surgery--Complications PROCESS_OF Patients
Subject
Surgery--Complications
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Since the beginning of the pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), several articles reported negative outcomes in surgery of infected patients. Aim of this study is to report results of patients with COVID-19-positive swab, in the perioperative period after surgery. Data of COVID-19-positive patients undergoing emergent or oncological surgery, were collected in a retrospective, multicenter study, which involved 20 Italian institutions. Collected parameters were age, sex, body mass index, COVID-19-related symptoms, patients' comorbidities, surgical procedure, personal protection equipment (PPE) used in operating rooms, rate of postoperative infection among healthcare staff and complications, within 30-postoperative days. 68 patients, who underwent surgery, resulted COVID-19-positive in the perioperative period. Symptomatic patients were 63 (92.5%). Fever was the main symptom in 36 (52.9%) patients, followed by dyspnoea (26.5%) and cough (13.2%). We recorded 22 (32%) intensive care unit admissions, 23 (33.8%) postoperative pulmonary complications and 15 (22%) acute respiratory distress syndromes. As regards the ten postoperative deaths (14.7%), 6 cases were related to surgical complications. One surgeon, one scrub nurse and two circulating nurses were infected after surgery due to the lack of specific PPE. We reported less surgery-related pulmonary complications and mortality in Sars-CoV-2-infected patients, than in literature. Emergent and oncological surgery should not be postponed, but it is mandatory to use full PPE, and to adopt preoperative screenings and strategies that mitigate the detrimental effect of pulmonary complications, mostly responsible for mortality.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Postoperative Complications / Elective Surgical Procedures / COVID-19 Subject: Pneumonia, Viral / Postoperative Complications / Elective Surgical Procedures / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Risk factors Language: English Journal: Updates Surg Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Postoperative Complications / Elective Surgical Procedures / COVID-19 Subject: Pneumonia, Viral / Postoperative Complications / Elective Surgical Procedures / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Risk factors Language: English Journal: Updates Surg Clinical aspect: Etiology Year: 2021
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