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Article: Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis
Title | Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis |
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Authors | |
Keywords | Surgery COVID-19 Mortality Medical staff safety Personal protective equipment |
Issue Date | 2020 |
Publisher | Elsevier: Creative Commons Licenses. The Journal's web site is located at https://www.journals.elsevier.com/eclinicalmedicine |
Citation | EClinicalMedicine, 2020, v. 29-30, article no. 100612 How to Cite? |
Abstract | Background:
The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking.
Methods:
We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020.
Findings:
A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality (r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality (r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected.
Interpretation:
COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE).
Funding:
Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China. |
Persistent Identifier | http://hdl.handle.net/10722/293521 |
ISSN | 2023 Impact Factor: 9.6 2023 SCImago Journal Rankings: 3.522 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wang, K | - |
dc.contributor.author | Wu, C | - |
dc.contributor.author | Xu, J | - |
dc.contributor.author | Zhang, B | - |
dc.contributor.author | Zhang, X | - |
dc.contributor.author | Gao, Z | - |
dc.contributor.author | Xia, Z | - |
dc.date.accessioned | 2020-11-23T08:17:58Z | - |
dc.date.available | 2020-11-23T08:17:58Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | EClinicalMedicine, 2020, v. 29-30, article no. 100612 | - |
dc.identifier.issn | 2589-5370 | - |
dc.identifier.uri | http://hdl.handle.net/10722/293521 | - |
dc.description.abstract | Background: The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods: We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings: A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality (r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality (r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation: COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding: Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China. | - |
dc.language | eng | - |
dc.publisher | Elsevier: Creative Commons Licenses. The Journal's web site is located at https://www.journals.elsevier.com/eclinicalmedicine | - |
dc.relation.ispartof | EClinicalMedicine | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Surgery | - |
dc.subject | COVID-19 | - |
dc.subject | Mortality | - |
dc.subject | Medical staff safety | - |
dc.subject | Personal protective equipment | - |
dc.title | Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis | - |
dc.type | Article | - |
dc.identifier.email | Xia, Z: zyxia@hkucc.hku.hk | - |
dc.identifier.authority | Xia, Z=rp00532 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1016/j.eclinm.2020.100612 | - |
dc.identifier.pmid | 33169112 | - |
dc.identifier.pmcid | PMC7641595 | - |
dc.identifier.scopus | eid_2-s2.0-85095587535 | - |
dc.identifier.hkuros | 319739 | - |
dc.identifier.volume | 29-30 | - |
dc.identifier.spage | article no. 100612 | - |
dc.identifier.epage | article no. 100612 | - |
dc.identifier.isi | WOS:000645901100006 | - |
dc.publisher.place | United Kingdom | - |