Patients more likely to die after surgery if they had Covid-19 recently, study shows
Surgical patients could be at a higher risk of dying if they were infected with Covid-19 in the seven weeks before their operation.
Researchers have advised that people should not have pre-planned surgery for seven weeks after their coronavirus diagnosis.
Analysing data on thousands of patients across 116 countries, researchers in Birmingham looked at who tested positive for Covid before their surgery and also those who died in the month after their operation.
They found that death rates in people who had had operation were higher in the first few weeks after a Covid diagnosis.
After seven weeks, the proportion of people who died post-surgery were the same as people who had not been diagnosed with coronavirus.
About 4.1% of people who were infected with coronavirus up to two weeks before surgery died after surgery. The proportion was 3.9% for those who had coronavirus three to four weeks before surgery, and 3.6% for five to six weeks.
In comparison, 1.5% of people who did not have coronavirus in the weeks before surgery died within 30 days of their operation.
Patients with ongoing Covid-19 symptoms were also more likely to die 30 days after surgery - with a 6% risk of death.
This is compared with a 2.4% death rate among patients whose symptoms had resolved. For patients who were asymptomatic, the death rate was 1.3%.
The study, published in the journal Anaesthesia, looked at information on 140,231 patients – including 3,127 people who had been diagnosed with Covid-19. The study included patients from 205 hospitals in the UK.
The paper is thought to be the largest collaborate study ever taken globally, with 15,000 co-authors.
Lead author Dr Dmitri Nepogodiev of the University of Birmingham said: “We found that patients operated on 0-6 weeks after Sars-CoV-2 infection diagnosis are at increased risk of post-operative death, as were patients with ongoing symptoms at the time of surgery.
“We recommend that, whenever possible, surgery should be delayed for at least seven weeks after a positive Sars-CoV-2 test result, or until symptoms resolve if patients have ongoing symptoms for seven weeks or more after diagnosis.”
Dr Aneel Bhangu, also lead author from the same university, said: “Decisions regarding delaying surgery should be tailored for each patient, since the possible advantages of delaying surgery for at least seven weeks following Sars-CoV-2 diagnosis must be balanced against the potential risks of delay.
“For some urgent surgeries, for example for advanced tumours, surgeons and patients may decide that the risks of delay are not justified.”
Dr Mike Nathanson, president of the Association of Anaesthetists, said: “Of the millions of patients now waiting for surgery, many will have had Covid-19 and they will want to be informed about the risks.”
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