Surgery a bad idea with corona in the air
● If you are not sure of your exposure to Covid-19 and are due to have surgery, you may want to rethink.
A study in Wuhan, China’s Covid-19 epicentre, suggests that having surgery during the coronavirus incubation period is likely to complicate or prolong your hospital stay.
Researchers behind the first study of the effects of surgery on Covid-19 progression said in the Lancet medical journal this week that surgery might accelerate and worsen the disease.
Their findings were supported by Guy Richards, emeritus professor of critical care at Wits University, who said surgical patients are particularly at risk of complications and death due to the inflammatory response caused by any virus.
“If one has any viral infection at the time of surgery this can increase the potential for bacterial pneumonia,” said Richards.
“In the setting of this virus, however, what kills patients is a hyper-inflammatory response along with hypercoagulability [increased risk of blood clots] induced by the virus. Surgery also induces an inflammatory response and this would compound that of the virus. Finally, following surgery one mounts a compensatory anti-inflammatory response, which can cause relative immunosuppression and enhance the virus’s ability to invade.”
Researchers from Renmin Hospital at Wuhan University and the University of Hong Kong found that 34 surgical patients who were later treated for Covid-19 complications had a 21% mortality rate, versus 2% for nonsurgical Covid-19 patients.
Surgical patients also developed symptoms within two days of surgery compared to between five and eight days for the others.
“Surgery may not only cause immediate impairment of immune function but also induce an early systemic inflammatory response,” said lead researcher Shaoqing Lei.
Many hospitals in SA have postponed elective surgery, but authorities showed mixed reactions to the Chinese study.
Mark van der Heever, spokesperson for the Western Cape health department, said the study sample was small and the patients involved had serious cancer procedures and even kidney transplants. “It is not relevant to our population or to any routine elective surgery,” he said.
However, “the department issued a public notice informing clients that … elective surgery will be cancelled”.
Netcare group medical director Anchen Laubscher said the hospital group is postponing all elective surgery, “provided that this will not result in the patient’s outcome or quality of life being significantly altered”.