Does Coronavirus Disease 2019 History Alone Increase the Risk of Postoperative Pulmonary Complications After Surgery? Prospective Observational Study Using Serology Assessment

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 May 21

PMID 38771760

Authors

Ah Ran Oh

Eun-Suk Kang

Jungchan Park

Sangmin Maria Lee

Mijeong Jeong

Jong-Hwan Lee

Affiliations

Soon will be listed here.

Abstract

Background: Concern exists about the increasing risk of postoperative pulmonary complications in patients with a history of coronavirus disease 2019 (COVID-19).

Objective: We conducted a prospective observational study that compared the incidence of postoperative pulmonary complications in patients with and without a history of COVID-19.

Methods: From August 2022 to November 2022, 244 adult patients undergoing major non-cardiac surgery were enrolled and allocated either to history or no history of COVID-19 groups. For patients without a history of confirming COVID-19 diagnosis, we tested immunoglobulin G to nucleocapsid antigen of SARS-CoV-2 for serology assessment to identify undetected infection. We compared the incidence of postoperative pulmonary complications, defined as a composite of atelectasis, pleural effusion, pulmonary edema, pneumonia, aspiration pneumonitis, and the need for additional oxygen therapy according to a COVID-19 history.

Results: After excluding 44 patients without a COVID-19 history who were detected as seropositive, 200 patients were finally enrolled in this study, 100 in each group. All subjects with a COVID-19 history experienced no or mild symptoms during infection. The risk of postoperative pulmonary complications was not significantly different between the groups according to the history of COVID-19 (24.0% vs. 26.0%; odds ratio, 0.99; 95% confidence interval, 0.71-1.37; P-value, 0.92). The incidence of postoperative pulmonary complications was also similar (27.3%) in excluded patients owing to being seropositive.

Conclusion: Our study showed patients with a history of no or mild symptomatic COVID-19 did not show an increased risk of PPCs compared to those without a COVID-19 history. Additional precautions may not be needed to prevent PPCs in those patients.

References

Abate S, Mantefardo B, Basu B . Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Saf Surg. 2020; 14:37. PMC: 7549731. DOI: 10.1186/s13037-020-00262-6. View

Hou H, Wang T, Zhang B, Luo Y, Mao L, Wang F . Detection of IgM and IgG antibodies in patients with coronavirus disease 2019. Clin Transl Immunology. 2020; 9(5):e01136. PMC: 7202656. DOI: 10.1002/cti2.1136. View

Sykes D, Holdsworth L, Jawad N, Gunasekera P, Morice A, Crooks M . Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?. Lung. 2021; 199(2):113-119. PMC: 7875681. DOI: 10.1007/s00408-021-00423-z. View

Brindle M, Gawande A . Managing COVID-19 in Surgical Systems. Ann Surg. 2020; 272(1):e1-e2. PMC: 7188040. DOI: 10.1097/SLA.0000000000003923. View

. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020; 396(10243):27-38. PMC: 7259900. DOI: 10.1016/S0140-6736(20)31182-X. View

Haffner M, Le H, Saiz Jr A, Han G, Fine J, Wolinsky P . Postoperative In-Hospital Morbidity and Mortality of Patients With COVID-19 Infection Compared With Patients Without COVID-19 Infection. JAMA Netw Open. 2021; 4(4):e215697. PMC: 8042521. DOI: 10.1001/jamanetworkopen.2021.5697. View

Haines K, Agarwal S . Postoperative Pulmonary Complications-A Multifactorial Outcome. JAMA Surg. 2016; 152(2):166-167. DOI: 10.1001/jamasurg.2016.4102. View

Dong E, Du H, Gardner L . An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20(5):533-534. PMC: 7159018. DOI: 10.1016/S1473-3099(20)30120-1. View

Oh A, Park J, Lee J, Choi D, Yang K, Choi J . Association between Mortality and Sequential Organ Failure Assessment Score during a Short Stay in the Intensive Care Unit after Non-Cardiac Surgery. J Clin Med. 2022; 11(19). PMC: 9573186. DOI: 10.3390/jcm11195865. View

10.

Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z . SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382(12):1177-1179. PMC: 7121626. DOI: 10.1056/NEJMc2001737. View

11.

Nahshon C, Bitterman A, Haddad R, Hazzan D, Lavie O . Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling all Asymptomatic Patients Before Surgical Treatment. World J Surg. 2020; 44(8):2477-2481. PMC: 7229873. DOI: 10.1007/s00268-020-05575-2. View

12.

Byambasuren O, Dobler C, Bell K, Rojas D, Clark J, McLaws M . Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: Systematic review. PLoS One. 2021; 16(4):e0248946. PMC: 8018669. DOI: 10.1371/journal.pone.0248946. View

13.

Lai C, Wang J, Hsueh P . Population-based seroprevalence surveys of anti-SARS-CoV-2 antibody: An up-to-date review. Int J Infect Dis. 2020; 101:314-322. PMC: 7546669. DOI: 10.1016/j.ijid.2020.10.011. View

14.

Carrier F, Amzallag E, Lecluyse V, Cote G, Couture E, DAragon F . Postoperative outcomes in surgical COVID-19 patients: a multicenter cohort study. BMC Anesthesiol. 2021; 21(1):15. PMC: 7801565. DOI: 10.1186/s12871-021-01233-9. View

15.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C . Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4):420-422. PMC: 7164771. DOI: 10.1016/S2213-2600(20)30076-X. View

16.

Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney C . COVID-19 Outbreak and Surgical Practice: Unexpected Fatality in Perioperative Period. Ann Surg. 2020; 272(1):e27-e29. PMC: 7188030. DOI: 10.1097/SLA.0000000000003925. View

17.

Deng J, Chan J, Potter A, Chen Y, Sandhu H, Panda N . The Risk of Postoperative Complications After Major Elective Surgery in Active or Resolved COVID-19 in the United States. Ann Surg. 2021; 275(2):242-246. PMC: 8745943. DOI: 10.1097/SLA.0000000000005308. View

18.

Miskovic A, Lumb A . Postoperative pulmonary complications. Br J Anaesth. 2017; 118(3):317-334. DOI: 10.1093/bja/aex002. View

19.

. Global guidance for surgical care during the COVID-19 pandemic. Br J Surg. 2020; 107(9):1097-1103. PMC: 7262310. DOI: 10.1002/bjs.11646. View

20.

Jungwirth-Weinberger A, Boettner F, Kapadia M, Diane A, Chiu Y, Lyman S . History of COVID-19 Was Not Associated With Length of Stay or In-Hospital Complications After Elective Lower Extremity Joint Replacement. Arthroplast Today. 2021; 13:109-115. PMC: 8660178. DOI: 10.1016/j.artd.2021.11.021. View