Surgery w #COVID19
series in @EClinicalMed: Sx during COVID incubation & 1st manif post-op

learnings
Common post-op symptomsvigilance & low-threshold for post-op test
Outcomes, 20% death
Avoiding Sx protects patients
Test pre-op!

Details
#COVID19surgery
/1

34 pts w Sx during COVID incubation post-op symptoms
Denominator of all Sx during that time unknown
Prevalence COVID19 incubation at Sx changes w pandemic evolution
26% pts w cancer
59% w comorbidities
Majority moderate to high-risk Sx

#COVID19surgery

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Presentation w common post-op symptoms
1. Fever 91%
2. Fatigue 53%
3. SOB 44%
4. Myalgia 32%
5. Expectoration 32%
be vigilant & low-threshold for test post-op

#COVID19surgery

/3

COVID19 complications after Sx:
-100% pneumonia
-44% ICU
-33% mech ventilation
-20% death
Worse than in general population
Older, comorbid, major surgery fare worse

#COVID19surgery

/4

Timeline

Median
2 days from Sx to 1st symptoms
3 days from Sx to pneumonia
QUICK! Potentially quicker than in general population?

#COVID19surgery

/5

Sx during pandemic risk operating during incubation
Risk if COVID19 post-op
Delaying Sx not only about resourcesprotects pts
Sx only for urgent cases, prioritize
Test pre-op if consider delaying
High level suspicion post-optest quickly

#COVID19surgery
/6

Full text
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30075-4/fulltext
/7

Yes, small nb & selection bias. Better than anecdotal single reports
Thoughts? Does it change your decisions? pt counselling? #covid19surgery
@CovidSurg @AnnalsofSurgery @pan_surg @hpbsurgeon1 @ashlie_nadler @biniamkidaneMD @LiangRhea @NirajGusani @sepideh_gholami @motazqadan ...

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