Comparison of COVID-19 positive and negative patients in terms of perioperative complications in urgent surgery

Background: The Covid-19 pandemic still continues to affect the world. As in many areas, the negative effects of infection on perioperative morbidity and mortality have been shown. Studies revealed that postoperative pulmonary complications and overall mortality are higher in patients with Covid-19. However, the effects of Covid-19 infection in emergency surgeries are limited in the literature. In this study, we investigated the relationship between Covid-19 infection and perioperative complications in patients undergoing urgent surgery. Materials and Methods: Adult patients who underwent emergency surgery in our center between March 2020 and December 2020 and underwent general or regional anesthesia were included in this retrospective study. Demographic data of the patients, pre-operative clinical features, laboratory results and intra-/postoperative complications were obtained from the hospital electronic database and perioperative anesthesia forms. The included patients were divided into two groups as Covid-19 positive and Covid-19 negative and statistically compared in terms of perioperative complications. Results: The mean age of 67 (51,1%) female and 64 (48,9%) male patients included in the study was 43,8±19.2 years. Thirty six (27,5%) patients were Covid-19 positive and 95 (72,5%) patients were Covid-19 negative. It was shown that the postoperative hospital stay (p<0,001), the need for intensive care (p<0,001) and the frequency of postoperative complications (p=0,001) were significantly higher in Covid-19 positive patients than in negatives. Thirty-day overall survival was 86,1% in the positive group and 95,8% in the negative group (p=0,045). In addition, it was revealed that the presence of a Covid-19 pneumonia on CT was a significant predictor of 30-day overall survival (HR: 6,36, 95% CI: 1,2-32,8, p=0,027). Conclusions: Postoperative complication rates were higher and 30-day survival was lower in Covid-19 positive patients. PCR positivity alone was not found to be effective in survival, but in addition, the presence of findings compatible with Covid-19 pneumonia on CT was revealed to be a significant predictor of 30-day overall survival. While emergency surgeries are more risky than elective surgeries on their own, the presence of Covid-19 infection also provides an additional contribution. Therefore, more attention should be paid to postoperative complications in Covid-19 -positive patients. Keywords: Covid-19, emergency surgery, perioperative complications.