Delaying surgery for patients with a previous SARS-CoV-2 infection

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Glasbey J. C., Nepogodiev D., Omar O., Simoes J. F. F., Ademuyiwa A., Fiore M., Minaya-Bravo A., Shaw R., Vidya R., Bhangu A., Bhangu A. A., Siaw-Acheampong K., Benson R., Bywater E., Chaudhry D., Dawson B. E., Evans J. P., Gujjuri R. R., Heritage E., Jones C. S., Kamarajah S. K., Khatri C., Khaw R. A., Keatley J. M., Knight A., Lawday S., Li E., Mann H. S., Marson E. J., McLean K. A., Mckay S. C., Mills E. C., Pellino G., Picciochi M., Taylor E. H., Tiwari A., Simoes J. F. F., Trout I. M., Venn M. L., Wilkin R. J. W., Moug S., Vimalchandran D., Vallance A., Pockney P., Griffiths E. A., Townend P., Roberts K., McKay S., Isaac J., Satoi S., Edwards J., Coonar A. S., Marchbank A., Caruana E. J., Layton G. R., Patel A., Brunelli A., Ford S., Desai A., Gronchi A., Almond M., Tirotta F., Dumitra S., Kolias A., Price S. J., Fountain D. M., Jenkinson M. D., Hutchinson P., Marcus H. J., Piper R. J., Lippa L., Servadei F., Esene I., Freyschlag C., Neville I., Rosseau G., Schaller K., Demetriades A. K., Robertson F., Alamri A., Schache A. G., Winter S. C., Ho M., Nankivell P., Biel J. R., Batstone M., Ganly I., Wilkins A., Singh J. K., Thekinkattil D., Sundar S., Fotopoulou C., Leung E., Khan T., Chiva L., Sehouli J., Fagotti A., Cohen P., Gutelkin M., Ghebre R., Konney T., Pareja R., Bristow R., Dowdy S., Rajkumar S. T. S., Ng J., Fujiwara K., Stewart G. D., Lamb B., Narahari K., McNeill A., Colquhoun A., McGrath J., Bromage S., Barod R., Kasivisvanathan V., Klatte T., Committee D., Adamina M., Ademuyiwa A. O., Agarwal A., Alameer E., Alderson D., Alakaloko F., Albertsmeiers M., Alser O., Alshaar M., Alshryda S., Arnaud A. P., Augestad K. M., Ayasra F., Azevedo J., Bankhead-Kendall B. K., Barlow E., Benson R. A., Blanco-Colino R., Brar A., Breen K. A., Buarque I. L., Chaar M., Chakrabortee S., Christensen P., Cox D., Cukier M., Cunha M. F., Davidson G. H., Di Saverio S., Drake T. M., Edwards J. G., Elhadi M., Farik S., Fitzgerald J. E., Garmanova T., Gallo G., Ghosh D., Gomes G. M. A., Grecinos G., Grundl M., Halkias C., Harrison E. M., Hisham I., Hutchinson P. J., Hwang S., Isik A., Jonker P., Lawani I., Lederhuber H., Leventoglu S., Litvin A., Loehrer A., Loffler M. W., Lorena M. A., Madolo M. M., Major P., Martin J., Mashbari H. N., Mazingi D., Metallidis S., Mohan H. M., Moore R., Moszkowicz D., Ng-Kamstra J. S., Maimbo M., Niquen M., Ntirenganya F., Olivos M., Oussama K., Outani O., Parreno-Sacdalanm M. D., Pata F., Rivera C. J. P., Pinkney T. D., Qureshi A., Radenkovic D., la Medina A. R. -D., Roslani A. C., Rutegard M., Santos I., Sayyed R., Schache A., Schnitzbauer A. A., Sharma N., Shu S., Soreide K., Spinelli A., Sund M., Tabiri S., Tsoulfas G., van Ramshorst G. H., Vimalachandran D., Warren O. J., Wedderburn D., Wright N., Allemand C., Boccalatte L., Figari M., Lamm M., Larranaga J., Marchitelli C., Noll F., Odetto D., Perrotta M., Saadi J., Zamora L., Alurralde C., Caram E. L., Eskinazi D., Mendoza J. P., Usandivaras M., Badra R., Esteban A., Garcia J. S., Garcia P. M., Gerchunoff J. I., Lucchini S. M., Vargas L., Hovhannisyan T., Stepanyan A., Gould T., Gourlay R., Griffiths B., Gananadha S., Cecire J., Joshi N., Salindera S., Sutherland A., Ahn J. H., Charlton G., Chen S., Gauri N., Hayhurst R., Jang S., Jia F., Mulligan C., Yang W., Ye G., Zhang H., Ballal M., Gibson D., Hayne D., Moss J., Richards T., Viswambaram P., Vo U. G., Bennetts J., Bright T., Brooke-Smith M., Fong R., Gricks B., Lam Y. H., Szpytma M., Watson D., Bagraith K., Caird S., Chan E., Dawson C., Ho D., Jeyarajan E., Jordan S., Lim A., Nolan G. J., Oar A., Parker D., Puhalla H., Quennell A., Rutherford L., Townend P., Von Papen M., Wullschleger M., Blatt A., Cope D., E
ISSN: 0007-1323

With at least 28 elective million operations delayed during the first three months of the COVID‐19 pandemic, the number of patients who will require surgery after a previous SARS‐CoV‐2 infection is likely to increase rapidly 1 . Operating on patients with an active perioperative SARS‐CoV‐2 infection is now known to carry a very high pulmonary complication and mortality rate 2 . Urgent information is needed to guide whether postponing surgery in patients with a previous SARS‐CoV‐2 infection leads to a clinical benefit, and the optimal length of delay.

The COVIDSurg‐Cancer study was a prospective cohort study of patients undergoing curative elective cancer surgery during the COVID‐19 pandemic up to 24 May 20203. We performed a pre‐planned subgroup analysis of patients undergoing surgery with previous SARS‐CoV‐2 positive swab that were not suspected to have active COVID‐19 at the time of surgery. Propensity score matching was used to match previous SARS‐CoV‐2 swab positive patients to patients with no a positive swab test in a 1:4 ratio. Multivariable logistic regression was used to explore associations of previous SARS‐CoV‐2 with rates of postoperative pulmonary complications and death in matched groups. Full methodology is available in the Appendix .

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