COVID-19 Vaccination and the Timing of Surgery Following COVID-19 Infection.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
pubmed:
16
7
2022
medline:
12
10
2022
entrez:
15
7
2022
Statut:
ppublish
Résumé
To evaluate whether COVID-19 vaccination status or mode of anesthesia modified the temporal harms associated with surgery following coronavirus disease-2019 (COVID-19) infection. Surgery shortly after COVID-19 infection is associated with higher rates of complications, leading to recommendations to delay surgery following COVID-19 infection when possible. However, prior studies were based on populations with low or no prevalence of vaccination. A retrospective cohort study of patients who underwent scheduled surgery in a health system from January 1, 2018 to February 28, 2022 (N=228,913) was performed. Patients were grouped by time of surgery relative to COVID-19 test positivity: 0 to 4 weeks after COVID-19 ("early post-COVID-19"), 4 to 8 weeks after COVID-19 ("mid post-COVID-19"), >8 weeks after COVID-19 ("late post-COVID-19"), surgery at least 30 days before subsequent COVID-19 ("pre-COVID-19"), and surgery with no prior or subsequent test positivity for COVID-19. Among patients who were not fully vaccinated at the time of COVID-19 infection, the adjusted rate of perioperative complications for the early post-COVID-19 group was significantly higher than for the pre-COVID-19 group (relative risk: 1.55; P =0.05). No significantly higher risk was identified between these groups for patients who were fully vaccinated (0.66; P =1.00), or for patients who were not fully vaccinated and underwent surgery without general anesthesia (0.52; P =0.83). Surgery shortly following COVID-19 infection was not associated with higher risks among fully vaccinated patients or among patients who underwent surgery without general anesthesia. Further research will be valuable to understand additional factors that modify perioperative risks associated with prior COVID-19 infection.
Sections du résumé
OBJECTIVE
To evaluate whether COVID-19 vaccination status or mode of anesthesia modified the temporal harms associated with surgery following coronavirus disease-2019 (COVID-19) infection.
BACKGROUND
Surgery shortly after COVID-19 infection is associated with higher rates of complications, leading to recommendations to delay surgery following COVID-19 infection when possible. However, prior studies were based on populations with low or no prevalence of vaccination.
METHODS
A retrospective cohort study of patients who underwent scheduled surgery in a health system from January 1, 2018 to February 28, 2022 (N=228,913) was performed. Patients were grouped by time of surgery relative to COVID-19 test positivity: 0 to 4 weeks after COVID-19 ("early post-COVID-19"), 4 to 8 weeks after COVID-19 ("mid post-COVID-19"), >8 weeks after COVID-19 ("late post-COVID-19"), surgery at least 30 days before subsequent COVID-19 ("pre-COVID-19"), and surgery with no prior or subsequent test positivity for COVID-19.
RESULTS
Among patients who were not fully vaccinated at the time of COVID-19 infection, the adjusted rate of perioperative complications for the early post-COVID-19 group was significantly higher than for the pre-COVID-19 group (relative risk: 1.55; P =0.05). No significantly higher risk was identified between these groups for patients who were fully vaccinated (0.66; P =1.00), or for patients who were not fully vaccinated and underwent surgery without general anesthesia (0.52; P =0.83).
CONCLUSIONS
Surgery shortly following COVID-19 infection was not associated with higher risks among fully vaccinated patients or among patients who underwent surgery without general anesthesia. Further research will be valuable to understand additional factors that modify perioperative risks associated with prior COVID-19 infection.
Identifiants
pubmed: 35837898
doi: 10.1097/SLA.0000000000005597
pii: 00000658-202211000-00028
pmc: PMC9533764
mid: NIHMS1819307
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e265-e272Subventions
Organisme : NIGMS NIH HHS
ID : R35 GM128672
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20:533–534.
LeBrun DG, Konnaris MA, Ghahramani GC, et al. Hip fracture outcomes during the COVID-19 pandemic: early results from New York. J Orthop Trauma. 2020;34:403–410.
Doglietto F, Vezzoli M, Gheza F, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg. 2020;155:691–702.
Jonker PKC, van der Plas WY, Steinkamp PJ, et al. Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: a Dutch, multicenter, matched-cohort clinical study. Surgery. 2021;169:264–274.
COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396:27–38.
Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg. 2022;275:242–246.
Collaborative C, Collaborative G. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021;76:748–758.
El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: a multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia. 2021;76:940–946.
Anesthesia Patient Safety Foundation. American Society of Anesthesiologists and Anesthesia Patient Safety Foundation Joint Statement on Elective Surgery and Anesthesia for Patients After COVID-19 Infection. 2022. Available at: https://www.apsf.org/news-updates/asa-and-apsf-joint-statement-on-elective-surgery-and-anesthesia-for-patients-after-covid-19-infection/ . Accessed March 3, 2022.
Rouillard S, Liu VX, Corley DA. COVID-19 and long-term planning for procedure-based specialties during extended mitigation and suppression strategies. Gastroenterology. 2021;160:4–9.
Collaborative ISR, Surgery ISoC, Training AoSi. Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study. Lancet Oncol. 2021;22:1507–1517.
Jain A, Dai T BK, Myers C. Covid-19 created an elective surgery backlog: how can hospitals get back on track. Harv Bus Rev. 2020;10:2–7.
AbuRahma AF, Campbell J, Stone PA, et al. The correlation of aortic neck length to early and late outcomes in endovascular aneurysm repair patients. J Vasc Surg. 2009;50:738–748.
Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. Lancet. 2021;397:1819–1829.
Bernal JL, Andrews N, Gower C, et al. Effectiveness of COVID-19 vaccines against the B. 1.617. 2 (Delta) variant. N Engl J Med. 2021;385:585–594.
Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. Lancet. 2021;398:1407–1416.
Collie S, Champion J, Moultrie H, et al. Effectiveness of BNT162b2 vaccine against omicron variant in South Africa. N Engl J Med. 2022;386:494–496.
Prasad NK, Lake R, Englum BR, et al. COVID-19 vaccination associated with reduced postoperative SARS-CoV-2 infection and morbidity. Ann Surg. 2022;275:31–36.
Warren J, Sundaram K, Anis H, et al. Spinal anesthesia is associated with decreased complications after total knee and hip arthroplasty. J Am Acad Orthop Surg. 2020;28:e213–e221.
Uppal V, Sondekoppam RV, Lobo CA, et al. Practice recommendations on neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic. ASRA/ESRA COVID-19 Guidance for Regional Anesthesia. Anesthesia. 2020;31:1350–1363.
National Center for Immunization and Respiratory Diseases. Science Brief: background rationale and evidence for public health recommendations for fully vaccinated people. CDC COVID-19 Science Briefs. Centers for Disease Control and Prevention (US); 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html .
Escobar GJ, Gardner MN, Greene JD, et al. Risk-adjusting hospital mortality using a comprehensive electronic record in an integrated health care delivery system. Med Care. 2013;51:446–453.
Escobar GJ, Greene JD, Scheirer P, et al. Risk-adjusting hospital inpatient mortality using automated inpatient, outpatient, and laboratory databases. Med Care. 2008;46:232–239.
Le ST, Corbin D, Myers LC, et al. Development and validation of an electronic health record-based score for triage to perioperative medicine [published online November 9, 2021]. Ann Surg . doi:10.1097/SLA.0000000000005284.
Sample NI. Healthcare Cost and Utilization in Project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality; 2003.
Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 2007;85:867–872.
Hsu J. Multiple Comparisons: Theory and Methods. Boca Raton, Florida: CRC Press; 1996.
Demographic characteristics of people receiving COVID-19 vaccinations in the United States: percent of people receiving COVID-19 by race/ethnicity and date administered, December 14, 2020-May, 2021. Centers for Disease Control and Prevention, eds. Altanta, GA, 2021 Available at: https://www.cdc.gov/mmwr/volumes/70/wr/mm7005e1.htm .
Parums DV. Revised World Health Organization (WHO) terminology for variants of concern and variants of interest of SARS-CoV-2. Med Sci Monit. 2021;27:e933622.
Maslo C, Friedland R, Toubkin M, et al. Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 Omicron wave compared with previous waves. JAMA. 2022;327:583–584.
Ulloa AC, Buchan SA, Daneman N, et al. Estimates of SARS-CoV-2 Omicron variant severity in Ontario, Canada. JAMA. 2022;327:1286–8.
COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. J Br Surg. 2020;107:1440–1449.
Control CfD, Prevention. Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic. 2020.
Control CfD, Prevention. Ending isolation and precautions for people with COVID-19: Interim guidance. 2021.
Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March–June 2020. Morbid Mortal Wkly Rep. 2020;69:993.
Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324:603–605.
Karter AJ, Ferrara A, Liu JY, et al. Ethnic disparities in diabetic complications in an insured population. JAMA. 2002;287:2519–2527.
Koebnick C, Langer-Gould AM, Gould MK, et al. Sociodemographic characteristics of members of a large, integrated health care system: comparison with US Census Bureau data. Perm J. 2012;16:37–41.