SARS-CoV-2-related outcomes after surgical procedures on SARS-CoV-2-positive patients in a large, urban, safety net medical center

Rachel E Sargent; Stephen F Sener; Rodolfo Amaya; Elizabeth Vazquez; Michael E Bowdish; Brad Spellberg

doi:10.1016/j.sopen.2021.04.001

SARS-CoV-2-related outcomes after surgical procedures on SARS-CoV-2-positive patients in a large, urban, safety net medical center

Surg Open Sci. 2021 Jul:5:10-13. doi: 10.1016/j.sopen.2021.04.001. Epub 2021 May 3.

Authors

Rachel E Sargent^{1

2}, Stephen F Sener^{1

2}, Rodolfo Amaya^{1

3}, Elizabeth Vazquez¹, Michael E Bowdish^{1

2

4}, Brad Spellberg¹

Affiliations

¹ Los Angeles County + University of Southern California (LAC + USC) Medical Center, Los Angeles, CA.
² Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA.
³ Department of Anesthesiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA.
⁴ Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA.

Abstract

Background: Beginning on March 16, 2020, nonurgent scheduled operations at a large, urban, safety net medical center were canceled. The purpose of this study was to determine complications associated with severe acute respiratory syndrome coronavirus 2 infection for all operations done from March 16 to June 30, 2020.

Study design: This study was a single-institution, retrospective observational analysis of data for all surgical procedures and all severe acute respiratory syndrome coronavirus 2 tests done in the medical center from March 16 to June 30, 2020. The charts of all severe acute respiratory syndrome coronavirus 2-positive patients who had a surgical procedure during the study time period were retrospectively reviewed to assess the outcomes.

Results: Of 2,208 operations during that time, 29 (1.3%) patients were severe acute respiratory syndrome coronavirus 2-positive and were asymptomatic at the time of their operations. Twenty-four (82.7%) of the 29 required urgent or emergent procedures. The median time between availability of test results and operations for these patients was 0.63 + 1.94 days. With median follow-up of 89 days, none of the 29 patients died from severe acute respiratory syndrome coronavirus 2-related causes, and none developed clinically evident thromboembolism or required reintubation secondary to severe acute respiratory syndrome coronavirus 2-related pneumonia.

Conclusion: By operating on carefully screened, asymptomatic severe acute respiratory syndrome coronavirus 2-positive patients, it was possible to eliminate major complications and mortality due to severe acute respiratory syndrome coronavirus 2 infection.

Keywords: ASA, American Society of Anesthesiologists; COVID-19, coronavirus disease-19; ICU, intensive care unit; MeNTS, Medically Necessary Time-Sensitive; PPE, personal protective equipment; PUI, person under investigation; RT-PCR, real-time polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.