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BMJ Open . Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China

tetano

Editor, Senior Moderator
BMJ Open


. 2025 May 19;15(5):e093044.
doi: 10.1136/bmjopen-2024-093044. Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China

Jia Zhan[SUP] #[/SUP][SUP] 1 [/SUP], Fei Zhong[SUP] #[/SUP][SUP] 2 [/SUP], LingYan Dai[SUP] #[/SUP][SUP] 2 [/SUP], Jue Ma[SUP] 1 [/SUP], YunFei Chai[SUP] 1 3 [/SUP], XiRui Zhao[SUP] 2 [/SUP], Lu Chang[SUP] 1 [/SUP], YiDan Zhang[SUP] 2 [/SUP], JunJiang Wang[SUP] 4 [/SUP], Yong Tang[SUP] 5 [/SUP], Wen-Zhao Zhong[SUP] 6 [/SUP], Guangyan Zhang[SUP] 1 [/SUP], Le Li[SUP] 1 [/SUP], Qiang Zhu[SUP] 1 [/SUP], ZhiHao Chen[SUP] 4 [/SUP], Xin Xia[SUP] 5 [/SUP], LiShan Peng[SUP] 6 [/SUP], Jing Wu[SUP] 1 [/SUP], RuiYun Li[SUP] 1 [/SUP], DanYang Li[SUP] 1 [/SUP], Yan Zhu[SUP] 1 [/SUP], Xin Zhou[SUP] 1 [/SUP], YiChun Wu[SUP] 1 [/SUP], RuiRong Chen[SUP] 1 [/SUP], Jie Li[SUP] 2 7 8 9 [/SUP], Yong Li[SUP] 4 [/SUP], HaiHua Shu[SUP] 10 3 8 11 [/SUP]



Affiliations
Abstract

Objective: To explore the association between perioperative SARS-CoV-2 infection and the postoperative complications during the breakout of the Omicron epidemic wave.
Design: Observational retrospective cohort study. Multivariable logistic regression was performed to explore the association between the duration from surgery to COVID-19 diagnosis and the likelihood of postoperative complications.
Setting: A general hospital in China.
Participants: 7927 patients aged 18 years and older who underwent surgical treatment between 1 December 2022 and 28 February 2023.
Primary outcome measures: The outcome was a composite of postoperative adverse events that occurred within the initial 30 postoperative days.
Results: Of all patients, 420 (11.76%) experienced postoperative complications. Compared with No COVID-19, preoperative COVID-19 within 1 week (pre-1w) exhibited a high risk of postoperative complications (adjusted OR (aOR), 2.67; 95% CI 1.50 to 4.78), followed by patients with pre-2w (aOR, 2.14; 95% CI 1.20 to 3.80). For patients with postoperative COVID-19 within 1 week (post-1w), the aOR was 2.48 (95% CI 1.48 to 4.13), followed by patients with post-2w (aOR 1.95; 95% CI 1.10 to 3.45), and those with post-3w (aOR 2.25; 95% CI 1.27 to 3.98). The risks of postoperative complications decreased roughly with the increase of the time interval between the surgery date and SARS-CoV-2 infection. Stratification analyses suggested that perioperative COVID-19 increased the risk of postoperative complications in older patients, smokers, those with comorbidities or experiencing moderate or severe COVID-19 symptoms.
Conclusions: Our findings reveal a significant time-dependent relationship between perioperative COVID-19 and postoperative complications, highlighting the importance of tailored preoperative risk evaluations, enhanced postoperative surveillance, and the implementation of effective postoperative COVID-19 prevention measures.
Trial registration number: ChiCTR2300072473.

Keywords: COVID-19; Prognosis; SURGERY.

 
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