Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China

Objective To explore the association between perioperative SARS-CoV-2 infection and the postoperative complications during the breakout of the Omicron epidemic wave.Design Observational retrospective cohort study. Multivariable logistic regression was performed to explore the association between the...

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Main Authors: Jie Li, Jing Wu, Yong Li, Yidan Zhang, Xin Zhou, Fei Zhong, Lingyan Dai, Yunfei Chai, Wen-zhao Zhong, Zhihao Chen, Yong Tang, Yan Zhu, Le Li, Danyang Li, Xin Xia, Qiang Zhu, Guangyan Zhang, Jue Ma, HaiHua Shu, Jia Zhan, XiRui Zhao, Lu Chang, JunJiang Wang, LiShan Peng, RuiYun Li, YiChun Wu, RuiRong Chen
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/5/e093044.full
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author Jie Li
Jing Wu
Yong Li
Yidan Zhang
Xin Zhou
Fei Zhong
Lingyan Dai
Yunfei Chai
Wen-zhao Zhong
Zhihao Chen
Yong Tang
Yan Zhu
Le Li
Danyang Li
Xin Xia
Qiang Zhu
Guangyan Zhang
Jue Ma
HaiHua Shu
Jia Zhan
XiRui Zhao
Lu Chang
JunJiang Wang
LiShan Peng
RuiYun Li
YiChun Wu
RuiRong Chen
author_facet Jie Li
Jing Wu
Yong Li
Yidan Zhang
Xin Zhou
Fei Zhong
Lingyan Dai
Yunfei Chai
Wen-zhao Zhong
Zhihao Chen
Yong Tang
Yan Zhu
Le Li
Danyang Li
Xin Xia
Qiang Zhu
Guangyan Zhang
Jue Ma
HaiHua Shu
Jia Zhan
XiRui Zhao
Lu Chang
JunJiang Wang
LiShan Peng
RuiYun Li
YiChun Wu
RuiRong Chen
author_sort Jie Li
collection DOAJ
description Objective To explore the association between perioperative SARS-CoV-2 infection and the postoperative complications during the breakout of the Omicron epidemic wave.Design Observational retrospective cohort study. Multivariable logistic regression was performed to explore the association between the duration from surgery to COVID-19 diagnosis and the likelihood of postoperative complications.Setting A general hospital in China.Participants 7927 patients aged 18 years and older who underwent surgical treatment between 1 December 2022 and 28 February 2023.Primary outcome measures The outcome was a composite of postoperative adverse events that occurred within the initial 30 postoperative days.Results Of all patients, 420 (11.76%) experienced postoperative complications. Compared with No COVID-19, preoperative COVID-19 within 1 week (pre-1w) exhibited a high risk of postoperative complications (adjusted OR (aOR), 2.67; 95% CI 1.50 to 4.78), followed by patients with pre-2w (aOR, 2.14; 95% CI 1.20 to 3.80). For patients with postoperative COVID-19 within 1 week (post-1w), the aOR was 2.48 (95% CI 1.48 to 4.13), followed by patients with post-2w (aOR 1.95; 95% CI 1.10 to 3.45), and those with post-3w (aOR 2.25; 95% CI 1.27 to 3.98). The risks of postoperative complications decreased roughly with the increase of the time interval between the surgery date and SARS-CoV-2 infection. Stratification analyses suggested that perioperative COVID-19 increased the risk of postoperative complications in older patients, smokers, those with comorbidities or experiencing moderate or severe COVID-19 symptoms.Conclusions Our findings reveal a significant time-dependent relationship between perioperative COVID-19 and postoperative complications, highlighting the importance of tailored preoperative risk evaluations, enhanced postoperative surveillance, and the implementation of effective postoperative COVID-19 prevention measures.Trial registration number ChiCTR2300072473.
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spelling doaj-art-4e0ca2e9800a410788da0ebdb535bbab2025-08-20T01:52:18ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-093044Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in ChinaJie Li0Jing Wu1Yong Li2Yidan Zhang3Xin Zhou4Fei Zhong5Lingyan Dai6Yunfei Chai7Wen-zhao Zhong8Zhihao Chen9Yong Tang10Yan Zhu11Le Li12Danyang Li13Xin Xia14Qiang Zhu15Guangyan Zhang16Jue Ma17HaiHua Shu18Jia Zhan19XiRui Zhao20Lu Chang21JunJiang Wang22LiShan Peng23RuiYun Li24YiChun Wu25RuiRong Chen26School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Gastrointestinal Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGlobal Health Research Center, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGlobal Health Research Center, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGlobal Health Research Center, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGuangdong Lung Cancer Institute, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Gastrointestinal Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Thoracic Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Thoracic Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGlobal Health Research Center, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Gastrointestinal Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGuangdong Lung Cancer Institute, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaObjective To explore the association between perioperative SARS-CoV-2 infection and the postoperative complications during the breakout of the Omicron epidemic wave.Design Observational retrospective cohort study. Multivariable logistic regression was performed to explore the association between the duration from surgery to COVID-19 diagnosis and the likelihood of postoperative complications.Setting A general hospital in China.Participants 7927 patients aged 18 years and older who underwent surgical treatment between 1 December 2022 and 28 February 2023.Primary outcome measures The outcome was a composite of postoperative adverse events that occurred within the initial 30 postoperative days.Results Of all patients, 420 (11.76%) experienced postoperative complications. Compared with No COVID-19, preoperative COVID-19 within 1 week (pre-1w) exhibited a high risk of postoperative complications (adjusted OR (aOR), 2.67; 95% CI 1.50 to 4.78), followed by patients with pre-2w (aOR, 2.14; 95% CI 1.20 to 3.80). For patients with postoperative COVID-19 within 1 week (post-1w), the aOR was 2.48 (95% CI 1.48 to 4.13), followed by patients with post-2w (aOR 1.95; 95% CI 1.10 to 3.45), and those with post-3w (aOR 2.25; 95% CI 1.27 to 3.98). The risks of postoperative complications decreased roughly with the increase of the time interval between the surgery date and SARS-CoV-2 infection. Stratification analyses suggested that perioperative COVID-19 increased the risk of postoperative complications in older patients, smokers, those with comorbidities or experiencing moderate or severe COVID-19 symptoms.Conclusions Our findings reveal a significant time-dependent relationship between perioperative COVID-19 and postoperative complications, highlighting the importance of tailored preoperative risk evaluations, enhanced postoperative surveillance, and the implementation of effective postoperative COVID-19 prevention measures.Trial registration number ChiCTR2300072473.https://bmjopen.bmj.com/content/15/5/e093044.full
spellingShingle Jie Li
Jing Wu
Yong Li
Yidan Zhang
Xin Zhou
Fei Zhong
Lingyan Dai
Yunfei Chai
Wen-zhao Zhong
Zhihao Chen
Yong Tang
Yan Zhu
Le Li
Danyang Li
Xin Xia
Qiang Zhu
Guangyan Zhang
Jue Ma
HaiHua Shu
Jia Zhan
XiRui Zhao
Lu Chang
JunJiang Wang
LiShan Peng
RuiYun Li
YiChun Wu
RuiRong Chen
Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
BMJ Open
title Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
title_full Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
title_fullStr Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
title_full_unstemmed Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
title_short Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China
title_sort perioperative sars cov 2 infection and postoperative complications a single centre retrospective cohort study in china
url https://bmjopen.bmj.com/content/15/5/e093044.full
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