Escolha do momento cirúrgico pós-infecção por Sars-Cov-2 no Hospital Naval Marcílio Dias: um estudo de coorte prospectivo

Abstract

Introduction: Perioperative SARS-CoV-2 infection increases postoperative morbidity and mortality. Objective: The aim of the study was to determine the optimal timing for an elective surgical approach post-infection with SARS-CoV-2. Methodology: This prospective observational cohort study from Hospital Naval Marcílio Dias included patients found in elective surgery between October 19 and 25, 2020. Patients with preoperative SARS-CoV-2 infection were compared with those without prior infection. The primary outcome was 30-day postoperative mortality. Secondary outcomes were to assess pulmonary complications within 30 days postoperatively and institutional performance compared to international standards. Results/ Discussion: Among 62 patients, 5 patients (8.06%) had a preoperative diagnosis of SARS-CoV-2. Mortality in patients without infection and in patients with a preoperative diagnosis of SARS-CoV-2 was equally null (0%), but increased the rate of pulmonary complications within 30 days after surgery (1.75% vs 20% ) and the rate of postoperative complications in patients undergoing surgery within 5-6 weeks (20%), 7-8 weeks (20%) and 3-4 months (40%) after preoperative diagnosis of infection by SARS-CoV-2, based on the Clavien-Dindo classification (26.31% vs 80%) when comparing with the rates of patients without infection. Our patients fit the benefit profile of delays ≥7 weeks in surgery after infection due to ongoing symptoms and higher prior cardiac risks. Conclusion: Surgery should be delayed ≥7 weeks after SARS-CoV-2 infection. Patients with ongoing symptoms or at increased perioperative cardiovascular risk may benefit from delays ≥7 weeks from diagnosis.