Should Local Rather than National Policy Determine our Approach to Surgery During SARS- CoV-2?

Abstract

Purpose: A major disruption of routine hospital services has occurred globally after SARS-CoV-2 pandemic. Current publications are based on large databases collected from hospitals with different characteristics which may not apply to all centres since the impact of SARS-CoV-2 varies depending on the incidence in each area. We studied the incidence of perioperative SARS-CoV-2 infection in surgical patients. Methods: We performed an observational, retrospective cohort study in patients undergoing surgery between March 16th to May 15th 2020. Results: Four patients (5.4%) tested positive with SARS-CoV-2, all positive results were obtained postoperatively. SARS-CoV-2 status was known at the time of surgery in 23 (60%) patients in emergency surgery and 20 patients (57%) in elective surgery. Mortality rate was 13% in emergency surgery with no cases due to SARS-CoV-2 related complications. Nine patients (25.7%) had changes in their management in elective surgery, no deaths were reported and one patient developed SARS-CoV-2 bilateral pneumonia. Discussion: Our results show that SARS-CoV-2 infection among surgical patients was low in our centre. Changes in policies on surgical activity during the SARS-CoV-2 pandemic should be taken at a regional or hospital level to reflect the local burden of SARS-CoV-2 and availability of resources.