Post-operative morbidity and mortality in patients with RT-PCR confirmed COVID-19 undergoing surgery – A single centre retrospective case control study

Abstract

The coronavirus pandemic continues to spike in various parts of the world. Anaesthesiologists face coronavirus positive patients for emergency and urgent procedures. Initial case series showed a high postoperative mortality for COVID-19 positive patients undergoing surgery. We aimed to find the postoperative morbidity and mortality in RTPCR positive patients undergoing urgent and emergency surgery. We retrospectively analysed all COVID-19 RTPCR positive patients undergoing surgery between May 2020 and December 2020. Selected controls were matched for age sex and type of surgery. We identified 27 patients who were COVID-19 positive prior to surgery. The average age was 43 years. 37% (10/27) of patients were males. All surgeries were either emergencies or urgent procedures. 40% of the surgeries were exploratory laparotomies, 37% were caesareans, 11% were abscess drainages, 7.4% were trauma surgeries and 3.7% were bladder clot evacuations. 48% patients received spinal anaesthesia, 51.9% patients received general anaesthesia. This was matched in the control group as well. 30 day mortality was 7.4% in COVID-19 patients compared to 3.7% in controls. The length of ICU stay and hospital stay was significantly longer in COVID-19 patients compared to controls. The median age of survivors was 34 years compared to 86 years in non-survivors (p=0.023). 30-day mortality was not significantly higher in COVID-19 positive patients undergoing surgery though they did have significantly longer ICU stay and duration of hospitalisation.