COVID-19 Cross-Infection Rate After Surgical Procedures: Incidence and Outcome

Laryngoscope. 2021 Nov;131(11):E2749-E2754. doi: 10.1002/lary.29667. Epub 2021 Jun 5.

Abstract

Objectives/hypothesis: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is transmitted by droplet as well as airborne infection. Surgical patients are vulnerable to the infection during their hospital admission. Some surgical procedures are classified as aerosol generating (AGP).

Study design: Retrospective observational study of four specialties associates with known AGP's during the 4 months of the first wave of UK COVID-19 epidermic to identify post-surgical cross-infection with SARSCoV-2 within 14 days of a procedure.

Methods: Retrospective observational study in a tertiary healthcare center of four specialties associates with known AGP's during the 4 months of the first wave of UK COVID-19 epidermic to identify post-surgical cross-infection with SARSCoV-2 within 14 days of a procedure.

Results: There were 3,410 procedures reported during this period. The overall cross-infection rate from tested patients was 1.3% (4 patients), that is, 0.11% of all operations over 4 months. Ear, nose, and throat carried slightly higher rate of infection (0.4%) than gastroenterology (0.08%). The mortality rate was 0.3% (one gastroenterology patient from 304 positive cases) compared to 0% if surgery performed after recovery from SARSCoV-2 and 37.5% when surgery was conducted during the incubation period of the disease. Routine preoperative rapid screening tests and self-isolation are crucial to avoid the risk of cross-infection. Patients with underlying malignancy or receiving chemotherapy were more prone to pulmonary complications and mortality.

Conclusion: The risk of SARS-COV-2 cross-infection after surgical procedure is very low. Preoperative screening and self-isolation together with personal protective measures should be in place to minimize the cross-infection.

Level of evidence: 4 Laryngoscope, 131:E2749-E2754, 2021.

Keywords: SARSCoV-2; mortality; outcome; surgery.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aerosols
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / transmission*
  • COVID-19 / virology
  • Cross Infection / epidemiology*
  • Cross Infection / prevention & control
  • Disease Transmission, Infectious / prevention & control*
  • Disease Transmission, Infectious / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Mortality / trends
  • Outcome Assessment, Health Care
  • Particulate Matter / adverse effects
  • Patient Isolation / methods
  • Personal Protective Equipment / standards
  • Preoperative Period
  • Retrospective Studies
  • Risk Assessment / methods
  • SARS-CoV-2 / genetics
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / classification
  • Surgical Procedures, Operative / statistics & numerical data
  • United Kingdom / epidemiology

Substances

  • Aerosols
  • Particulate Matter