Coronavirus patients at higher risk of post-operative death, study finds

COVID-19 patients who undergo surgery are at increased risk of post-operative death, a global study has shown.

Among coronavirus-infected patients who underwent surgery for a number of other conditions, mortality rates approach those of the sickest patients admitted to intensive care after contracting the virus in the community, research by medical journal The Lancet found.

Experts at the University of Birmingham-led NIHR Global Research Health Unit on Global Surgery have also published findings that show SARS-CoV-2 (Covid-19) infected patients who undergo surgery experience substantially worse post-operative outcomes than would be expected for similar patients who do not have the infection.

The study, which was published last week, identified that mortality rates were higher in men (28.4 per cent) versus women (18.2 per cent). It was also higher in patients aged 70 years or over (33.7 per cent) versus those aged under 70 years (13.9 per cent).

In addition to age and sex, risk factors for post-operative death included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

The report’s co-author, Aneel Bhangu, who is senior lecturer in surgery at the University of Birmingham, commented: “We would normally expect mortality for patients having minor or elective surgery to be under one per cent, but our study suggests that in SARS-CoV-2 (coronavirus) patients, these mortality rates are much higher in both minor surgery (16.3 per cent) and elective surgery (18.9 per cent). We recommend that thresholds for surgery during the pandemic should be raised compared to normal practice.

“For example, men aged 70 years and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed.”