Perioperative Mortality and Complications in Patients with COVID-19 Undergoing Surgery: A Meta-Regression and Meta-Analysis of 8 Cohort Studies (preprint)

ABSTRACT

Objectives: The novel coronavirus pneumonia (COVID-19)，spread rapidly world wide, was first reported in December 2019. Meanwhile, there are still a large number of patients who need to undergo various surgical treatments. However, the consensus on whether patients with COVID-19 receive emergency or elective surgery will influence their perioperative mortality and complications still cannot be reached. Therefore, we used meta-analysis to explore the impact of patients with COVID-19 perioperative mortality and complications, aiming to provide evidence for clinical decision-making.Methods: We searched PubMed, Embase, Web of Science, Wan Fang database, date from December 2019 to July 2020 for collecting clinical trail on the impact of patients with COVID-19 perioperative mortality and complications. According to the Cochrane system evaluation method, the data is meta-analyzed with RevMan5.3 software.Results: Eight studies involving 2037 patients, 261 (12.81%) patients with COVID-19 and 1776(87.19%) without COVID-19, were included. The results of meta-analysis showed the COVID-19 group vs Non-COVID-19 group , perioperative mortality and postoperative pneumonia syndrome increased in COVID-19 group（OR3.84，95%CI：2.10-7.02，I2 =46%， P <0.0001）, (OR 33.42，95%CI：15.49-72.07，I 2 =0%， P <0.00001), The number of postoperative fever were significantly higher in COVID-19 , There were no significant difference in postoperative complications and ICU admission between the two groups.Conclusions: In our study, The risk of perioperative death and postoperative pulmonary is significantly increased in patients with COVID-19. These data suggested that consideration should be taken for postponing non-critical procedures and promoting nonoperative treatment to delay or avoid the need for surgery during the pandemic of COVID-19.Funding Statement Natural Science Foundation of China, Grant number 31760327/ 81760191Declaration of Interests The authors declare no competing interests.