Undergoing surgery with COVID-19 can lead to serious lung complicationsby Brian P. Dunleavy
May 29 (UPI) -- More than half of those who undergo surgery with COVID-19 develop lung complications like pneumonia and serious breathing problems, according to a study published Friday by the journal The Lancet.
In addition, nearly 40 percent of those patients died within 30 days, the authors found.
"Although the risks associated with COVID-19 need to be carefully balanced against the risks of delaying surgery for every individual patient, our study suggests that the thresholds for surgery should be raised, compared to normal practice," co-author Dr. Aneel Bhangu said in a statement.
"Medical teams should consider postponing noncritical procedures and promoting other treatment options, which may delay the need for surgery or sometimes avoid it altogether," said Bhangu, a surgeon at the University of Birmingham in England.
Exposure to SARS-CoV-2, the coronavirus that causes COVID-19, in the hospital has been linked with pulmonary complications, due to the increased inflammation and immune responses to surgery and mechanical ventilation, Bhangu and his colleagues said.
A number of guidelines exist for managing surgical patients during the pandemic, but they said there has not been much research on the impact of SARS-CoV-2 infection on pulmonary complications and death.
For the research, Bhangu and his team analyzed outcomes data for 1,128 patients from 235 hospitals in 24 countries, in the United States and primarily Europe. Most of the patients, 74 percent, underwent emergency surgery, while the remainder had elective procedures, the researchers reported.
All of those included in the study had tested positive for SARS-CoV-2 within seven days leading up to their operation, or 30 days following surgery, they said.
In all, pulmonary complications occurred in 51.2 percent, the researchers observed. Of these, 38 percent died within 30 days of their operation.
Overall, 24 percent of patients with SARS-CoV-2 infection who underwent surgery died within 30 days, according to the findings.
Being male or older than 70, having underlying conditions -- including heart disease, high blood pressure and diabetes -- and undergoing cancer, emergency or major surgery were linked to potentially fatal pulmonary complications, the researchers said.
"When hospitals resume routine surgery, it's likely it will take place in environments that remain exposed to SARS-CoV-2," co-author Dr. Ana Minaya-Bravo, a surgeon and researcher at Henares University Hospital in Spain, said in a statement.
"Hospital-acquired infection will remain a challenge, but strategies are urgently required to minimize it, as well as to minimize the risk of pulmonary complications for infected patients whose surgery cannot be delayed," she said.
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