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Coronavirus: increased risk of death after surgery in corona infected people


Study: COVID-19 increased risk of death after surgery

In mid-March it was decided that all planned operations in German hospitals, as far as this is medically justifiable, should be postponed indefinitely. This should ensure that there is sufficient capacity to treat coronavirus diseases. This measure could have saved lives. According to a new study, COVID-19 sufferers have an increased risk of dying in connection with an operation.

According to a recent announcement from the University Hospital Tübingen, patients who develop COVID-19 are at an increased risk of dying in connection with an operation. Infection with the novel coronavirus SARS-CoV-2 should therefore be ruled out as far as possible before plannable surgeries. This is the conclusion of a worldwide study, the results of which were recently published by the research network CovidSurg Collaborative in the specialist journal "The Lancet".

Further evaluations should clarify the situation in Germany

Professor Dr. Alfred Königsrainer, clinical director of the study in Tübingen and medical director of the university clinic for general, visceral and transplant surgery, sees the university hospital in Tübingen as well equipped.

“We have learned from the past few weeks and are well prepared. In case of emergency interventions and before planned operations, we do everything possible to exclude a SARS-CoV-2 infection in advance. So far we have succeeded in doing this, ”said the doctor.

Further evaluations should as soon as possible clarify whether the situation in Germany is as dramatic as the study data suggest. All surgical clinics in Germany are currently urged to participate in the CovidSurg cohort study.

Data from two dozen countries

To get their results, the researchers examined data from 1,128 patients from 235 hospitals in 24 countries. These mainly represent the situation in Europe, and some clinics in Africa, Asia and North America were also involved.

According to the now published results, which were evaluated under the leadership of the NIHR Global Research Health Unit on Global Surgery at the University of Birmingham, SARS-CoV-2-infected people who undergo surgery have significantly worse postoperative results than without the infection .

The overall mortality rate during the first 30 days after the operation was 23.8 percent. According to the authors, the mortality rate was disproportionately high in all subgroups.

According to the information, this affected both elective surgery (18.9 percent), emergency surgery (25.6 percent), minor surgery (16.3 percent) and major surgery (26.9 percent).

Older people and men are more at risk

Furthermore, the study found that the mortality rate of men (28.4 percent) compared to that of women (18.2 percent) but also in older patients over 70 years (33.7 percent) compared to younger patients (13 , 9 percent) was greatly increased.

In addition to age and gender, the risk factors for postoperative mortality also include pre-existing serious illnesses such as cancer, major interventions and emergency operations.

Mortality rate increased significantly even during routine operations

The Tübingen co-author of the study, Prof. Dr. Alfred Königsrainer commented on the report: "We normally expect the mortality rate of patients undergoing elective surgery to be less than one percent," said the expert.

“However, this study now shows that the mortality rate in patients infected with the SARS-CoV-2 coronavirus is significantly increased even during routine operations. In fact, the mortality rate is so high that it is comparable to the mortality risk of high-risk patients before the pandemic. ”

Additional data is currently being used to analyze whether these figures can also be transferred to German hospitals. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • University Hospital Tübingen: Risk of death of patients who become infected with SARS-CoV-2 before or immediately after an operation is increased (accessed: June 2, 2020), University Hospital Tübingen
  • CovidSurg Collaborative: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study; in: The Lancet, (published: 29.05.2020), The Lancet


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