Outcomes of surgical patients in a tertiary ICU with incidental COVID-19 in comparison with COVID-19 naïve patients.

Background: COVID-19 was first identified in Wuhan, China, in December 2019, where it spread over a wide geographic area until it reached the status of a pandemic in 2020. We postulated that patients who were diagnosed with incidental COVID-19, and underwent surgery, did not have a worse outcome due to the COVID-19 virus compared to their counterparts who did not have the virus.

Methods: This retrospective study included surgical patients (COVID-19 incidentals and COVID-19 negatives) who were admitted to the surgical intensive care unit (SICU) at Tygerberg Academic Hospital between 1 May 2020 and 31 December 2021.

Results: The sample consisted of 578 patients. Forty-one (41) patients had incidental COVID-19 infection, and 537 patients were COVID-19 naïve. The mean age was 43.9 years (SD = 16.7 years; range = 13.0-82.0 years) and 181 (31.3%) were female. The rates of complications in patients with COVID-19 infection (7.3%) and those without (5.0%) were similar (p = 0.64). Grades of complications, as measured using the Clavien-Dindo classification were also similar between patients with and without COVID-19 infection (p = 0.19). The mortality rates of patients with COVID-19 infection (17.1%) and those without (13.6%) were similar (p = 0.53).

Conclusion: This study demonstrates that surgery among asymptomatic PCR-positive patients was not associated with increased mortality or morbidity in the SICU. This also adds a valuable contribution to the growing body of literature regarding COVID-19 infections. Further prospective and multicentred studies are required to provide more robust results.