Evaluation of Clinical Characteristics and Outcomes in Patients Undergoing Surgery During the COVID-19 Incubation Period

Kachoei, A; Eshraghi, M; A, Salimi; Vahedian, M; Atarod, MH; Heidary, Z; Jafari, Z; Eshraghi, F

Evaluation of Clinical Characteristics and Outcomes in Patients Undergoing Surgery During the COVID-19 Incubation Period

Authors

A Kachoei ¹

M Eshraghi ²

Salimi A ³

M Vahedian ⁴

MH Atarod ⁵

Z Heidary ⁶

Z Jafari ⁷

F Eshraghi ⁸

¹ Associate Professor, Department of General Surgery, Faculty of Medicine, Qom University of Medical Sciences, Shahid Beheshti Hospital, Qom

² Associate Professor, Department of Thoracic Surgery, Faculty of Medicine, Qom University of Medical Sciences, Shahid Beheshti Hospital, Qom

³ Assistant Professor, Department of Pediatric Surgery, Faculty of Medicine, Qom University of Medical Sciences, Shahid Beheshti Hospital, Qom

⁴ Associate Professor, Department of Epidemiology, Qom University of Medical Sciences, Shahid Beheshti Hospital, Qom

⁵ Medical Student, Student Research Committee, Faculty of Medicine, Qom University of Medical Sciences

⁶ General Physician, Clinical Development Research Center, Faculty of Medicine, Qom University of Medical Sciences

⁷ Cardiology Resident, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

⁸ Medical Student, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran

Abstract

Background and Objective: The COVID-19 pandemic has profoundly impacted healthcare systems and treatment protocols, particularly surgical procedures. This study examines the clinical characteristics and outcomes of patients undergoing surgery during the incubation period of COVID-19 infection. Materials & Methods: In this analytical cross-sectional study conducted in 2019, clinical data from surgical patients in the COVID-19 incubation period were collected and analyzed. Clinical characteristics included age, sex, type of surgery, and postoperative outcomes such as length of hospital stay and mortality. All data were entered into SPSS version 22, and statistical analysis was performed using t-tests and chi-square tests, with a significance level set at p < 0.05. Results: The mean operative time for elective surgeries was 3.87 ± 1.12 hours in PCR-positive patients and 2.7 ± 0.98 hours in PCR-negative patients. For minor surgeries, the mean operative time was 4.11 ± 2.12 hours in PCR-positive patients and 3.5 ± 1.14 hours in PCR-negative patients. Major surgeries lasted 12.3 ± 3.3 hours in PCR-positive patients and 11.8 ± 2.5 hours in PCR-negative patients. The results revealed a statistically significant difference in recovery time between the two groups (p < 0.001), with COVID-19 patients experiencing longer recovery periods and higher mortality rates compared to non-COVID-19 patients. Conclusion: This study demonstrates that patients with COVID-19 undergoing surgery during the incubation period had prolonged recovery times and higher mortality rates than non-infected patients. These findings underscore the importance of thorough preoperative screening for COVID-19 infection before elective and non-urgent surgeries and highlight the need for precautionary measures to mitigate surgical risks in COVID-19 patients.

Keywords

COVID-19

Surgery

RT PCR

1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine. 2020; 382(8): 727-33.

2. Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. COVID-19 outbreak and surgical practice: unexpected fatality in perioperative period. Annals of surgery. 2020; 272(1): e27-e9.

3. Noori E, Vahedian M, Rezvan S, Minaei N, Tabaraii R. The proposed scoring system for hospitalization or discharge of patients with COVID-19. Journal of Emergency Practice and Trauma. 2022; 8(1): 60-3.

4. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of 2019 novel coronavirus infection in China. MedRxiv. 2020.

5. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. jama. 2020; 323(11): 1061-9.

6. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020; 395(10223): 507-13.

7. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020; 395(10223): 497-506.

8. Bai Y, Yao L, Wei T, Tian F, Jin D-Y, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. Jama. 2020; 323(14): 1406-7.

9. François M, Carrier., Éva, Amzallag., Vincent, Lecluyse., Geneviève, Côté., Geneviève, Côté., Etienne, J., Couture., Frédérick, D’Aragon., Stanislas, Kandelman., Alexis, F., Turgeon., Alain, Deschamps., Alain, Deschamps., Roy, Nitulescu., Codjo, Djignefa, Djade., Martin, Girard., Pierre, Beaulieu., Philippe, Richebé., Philippe, Richebé. 1. Postoperative outcomes in surgical COVID-19 patients: a multicenter cohort study. BMC Anesthesiology, (2021). doi: 10.1186/
S12871-021-01233-9.

10. Martin I, Cecilia, Romero., Irarrázaval, Mj., Magdalena, Ruiz-Esquide., Pablo, Achurra., Nicolás, Quezada., Fernando, Crovari., Rodrigo, Muñoz. 4. Morbidity and Mortality in Patients with Perioperative COVID-19 Infection: Prospective Cohort in General, Gastroesophagic, Hepatobiliary, and Colorectal Surgery. World Journal of Surgery, (2021). doi: 10/1007./S00268-021-06068-6.

11. Sevil ÇIcipwtC-paesaifpaps AJoS, (2022). doi: 10.1016/j.amjsurg.2021.04.005.

12. Maurizio D, Luca., Alberto, Sartori., Antonio, Vitiello., Giacomo, Piatto., Giulia, Noaro., Stefano, Olmi., Diego, Foschi., Luca, De, Re., Marco, Zappa., Giuliano, Sarro., Umberto, Rivolta., Giorgio, Giraudo., Felice, Borghi., Gabriele, Pozzo., Vincenzo, Sorisio., Giusto, Pignata., Paola, Antonella, Greco., Valerio, Sisti., Tommaso, Campagnaro., Alfredo, Guglielmi., Jacopo, Andreuccetti., Alberto, Di, Leo., Enrico, Lauro., Francesco, Ricci., Mario, Musella., Maurizio, Zizzo., Stefano, Bonacini., Mauro, Podda., Adolfo, Pisanu., Pietro, Coletta., Mario, Guerrieri., Valerio, Caracino., Massimo, Basti., Vincenzo, Pilone., Marco, Raffaelli., Luigi, Oragano. (2021). 5. Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection: an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic.. Updates in Surgery, doi: 10.1007/
S13304-020-00909-0.