Low incidence and high COVID-19 mortality in a general surgery during the first wave of the pandemia

The impact of coronavirus disease (COVID-19) in intervened patients seems to cause large postoperative mortality, although its incidence varies among centres. Primary aim was to evaluate the incidence of COVID-19 on the patients intervened in our General and Digestive Surgery Department, during the maximum impact of the pandemia in Spain. Secondary outcomes were evaluating perioperative mortality, and determining the risk factors for COVID-19 infection. Materials and Method: Retrospective single centre study of consecutive patients undergoing general and gastrointestinal surgical procedures with more than 24 hours of in-hospital stay, from February 1, 2020 to April 30, 2020 in a tertiary referral centre in Madrid, Spain. Results: A total of 441 patients were analysed: 423 were non-COVID-19 patients while 18 of them had COVID-19. Preoperative and operative characteristics were similar for both groups, unless for the American Society of Anesthesiologists grade. The incidence of COVID-19 in our intervened patients was 4.1%. Postoperative mortality was high among surgical patients with COVID-19, with a mortality rate of 22.2% compared to a 2.8% in non COVID-19 patients. The risk factors for COVID-19 infection were a prolonged postoperative stay (OR: 1.035 [95% CI: 1.007-1.065]) and the need of a reintervention (OR: 5.025 [95% CI: 1.650-15.311]). Conclusion: Surgical interventions during the COVID-19 pandemia resulted in a low infection rate but a high postoperative COVID-19 mortality. The decision to intervene must be carefully balanced against the additional risk for patients in a high transmission setting. © 2021, Sociedad de Cirujanos de Chile. All rights reserved.