Surgical Practices and Patient Outcomes During the COVID-19 Pandemic
Summary
The COVID-19 pandemic precipitated a rapid reorganisation of surgical services worldwide, with the deferral of non-urgent procedures and the reallocation of personnel and resources to critical care. Surgeons established triage protocols to balance the risks of disease progression against perioperative complications associated with SARS-CoV-2 infection. Preoperative screening strategies evolved from universal testing to risk-based approaches, informed by emerging evidence on variant virulence and vaccine effectiveness. Concurrently, perioperative pathways were modified to include enhanced infection-control measures, dedicated operating rooms with airflow management, and updated personal protective equipment guidelines. Outcomes studies have documented heightened 30-day mortality and pulmonary and thromboembolic complications among patients undergoing surgery with peri-operative or recent SARS-CoV-2 infection. Over time, vaccination campaigns and the predominance of less virulent variants have attenuated these risks, prompting revisions to recommended intervals between infection and elective surgery. Collectively, these changes underscore a dynamic interplay between pandemic control measures and the maintenance of essential surgical care, with global implications for patient safety and healthcare resilience.
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Surgical Practices and Patient Outcomes During the COVID-19 Pandemic publication trend
The graph below shows the total number of articles in surgical practices and patient outcomes during the covid-19 pandemic across all publications each year (not limited to Nature Index journals).
Technical terms
Preoperative: Period before surgery during which patients are evaluated and optimised for operative intervention.
Postoperative respiratory morbidity: Composite outcome of pulmonary complications such as pneumonia, acute respiratory failure or need for mechanical ventilation occurring after surgery.
Venous thromboembolism: Formation of blood clots in the veins, including deep vein thrombosis and pulmonary embolism, as a known surgical complication.
Elective surgery: Non-urgent operative procedures that can be scheduled in advance without immediate threat to life or organ function.
References
- Association of preoperative COVID-19 and postoperative respiratory morbidity during the Omicron epidemic wave: the DROMIS-22 multicentre prospective observational cohort study. EClinicalMedicine (2023).
- Cost-Effectiveness of Universal Asymptomatic Preoperative SARS-CoV-2 Polymerase Chain Reaction Screening: A Cost-Utility Analysis. Clinical Infectious Diseases (2023).
- Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study. Anaesthesia (2021).
- Surgery in COVID-19 patients: operational directives. World Journal of Emergency Surgery (2020).
- Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: A Dutch, multicenter, matched-cohort clinical study. Surgery (2020).
- SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study. Anaesthesia (2021).
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