Characteristics and outcomes of patients undergoing anesthesia while SARS-CoV-2 infected or suspected: a multicenter register of consecutive patients

Arthur James,Thomas Jeanmougin,Audrey De Jong,Flora Cipriani,Jean-Michel Constantin,Samir Jaber,Emmanuel Futier,Sébastien Campion,Mathieu Raux,Antonia Blanié ,Pierre Goffin,Samy Figueiredo,Elie Kantor,Morgan Le Guen,Null Author_Id

doi:10.1186/s12871-022-01581-0

Abstract

BackgroundThere are limited data to detail the perioperative anesthetic management and the incidence of postoperative respiratory complications among patients requiring an anesthetic procedure while being SARS-CoV-2 positive or suspected.MethodsAn observational multicenter cohort study was performed including consecutive patients who were SARS-CoV-2 confirmed or suspected and who underwent scheduled and emergency anesthesia between March 17 and May 26, 2020.ResultsA total of 187 patients underwent anesthesia with SARS-CoV-2 confirmed or suspected, with ultimately 135 (72.2%) patients positive and 52 (27.8%) negative. The median SOFA score was 2 [0; 5], and the median ARISCAT score was 49 [36; 67]. The major respiratory complications rate was 48.7% (n = 91) with 40.4% (n = 21) and 51.9% (n = 70) in the SARS-CoV-2–negative and –positive groups, respectively (p = 0.21). Among both positive and negative groups, patients with a high ARISCAT risk score (> 44) had a higher risk of presenting major respiratory complications (p < 0.01 and p = 0.1, respectively).DiscussionWhen comparing SARS-COV-2–positive and –negative patients, no significant difference was found regarding the rate of postoperative complications, while baseline characteristics strongly impact these outcomes. This finding suggests that patients should be scheduled for anesthetic procedures based on their overall risk of postoperative complication, and not just based on their SARS-CoV-2 status.

Highlights

While the SARS-CoV-2 epidemic continues spreading around the world, and some countries already face a third or fourth wave, more and more patients will require anesthesia while being SARS-CoV-2 positive for either emergency or scheduled procedures that cannot be postponed
General anesthesia, when associated with intubation and mechanical ventilation, is a situation that involves a risk of postoperative pulmonary complications [1]
The included patients were categorized into two groups: those who were confirmed as SARS-CoV-2 positive (n = 135, 72.2%) and those who were negative as SARS-CoV-2 (n = 52, 27.8%) (Supplementary material 4)

Summary

Introduction

While the SARS-CoV-2 epidemic continues spreading around the world, and some countries already face a third or fourth wave, more and more patients will require anesthesia while being SARS-CoV-2 positive for either emergency or scheduled procedures that cannot be postponed. James et al BMC Anesthesiology (2022) 22:46 involved in the perioperative management of SARSCoV-2–positive patients. General anesthesia, when associated with intubation and mechanical ventilation, is a situation that involves a risk of postoperative pulmonary complications [1]. This risk needs to be acknowledged in the current pandemic context. There are limited data to detail the perioperative anesthetic management and the incidence of postoperative respiratory complications among patients requiring an anesthetic procedure while being SARS-CoV-2 positive or suspected

Results

Discussion

Conclusion