Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. What are the implications for the commencement of elective surgery?
Gary Ross
Abstract
Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. What are the implications for the commencement of elective surgery? As we make plans to recommence elective surgery following the devastating consequences of the pandemic we look for advice from institutions that have performed elective surgery during the pandemic. This study [[1]Lei S. Jiang F. Su W. et al.Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection.EClinicalMedicine. 2020; ([Epub ahead of print])100331https://doi.org/10.1016/j.eclinm.2020.100331Summary Full Text Full Text PDF Scopus (832) Google Scholar] suggests potential risk factors for the poor outcomes of operative patients with COVID-19 infection concluding that the rate of asymptomatic COVID 19 patients undergoing elective surgery requiring ITU was >44% and mortality 20.5%. Although the article does state that this is a retrospective study analysing 34 patients who were unintentionally scheduled for elective surgery within the incubation period, further information is required to be able to provide a perspective to all those institutions wishing to recommence elective surgery. I would like the authors to clarify how many patients underwent elective surgery between 1st January to 5th Feb 2020. What percentage of patients were COVID negative before/after surgery and what were the outcomes in these patients as compared to the 34 patients discussed in this study? For all patients deemed COVID negative at the time of elective surgery how do these outcomes compare to the institutions normal standard outcomes? As we recommence elective surgery although patients need to be consented for the potential additional risk, that the authors elude to, it is imperative that the authors clarify what this potential additional risk is for the COVID negative patient. There are no conflict of interests to declare. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infectionIn this retrospective cohort study of 34 operative patients with confirmed COVID-19, 15 (44·1%) patients needed ICU care, and the mortality rate was 20·5%. Full-Text PDF Open AccessAuthor's replyWe thank Tuech et al. and Dr. Ross for their letters in response to our recent study [1]. At the very beginning of the epidemic, we encountered some patients who had no symptoms before surgery but quickly developed COVID-19 pneumonia after surgery. During the period of the research, the participating hospitals performed approximately 15,000 elective surgeries. Our focus was to report those we believe and confident that the surgeries were performed during incubation period. Thus, any infection long after surgery (say, 10 to 14 days after surgery) or those who contacted with confirmed cases of COVID-19 after surgery (such as the 3 excluded patients) were excluded. Full-Text PDF Open Access