@article {202027,
	title = {Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study},
	journal = {The Lancet},
	volume = {396},
	number = {10243},
	year = {2020},
	note = {n/a},
	pages = {27-38},
	abstract = {<p>{Summary Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74{\textperiodcentered}0\%) had emergency surgery and 280 (24{\textperiodcentered}8\%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26{\textperiodcentered}1\%) patients. 30-day mortality was 23{\textperiodcentered}8\% (268 of 1128). Pulmonary complications occurred in 577 (51{\textperiodcentered}2\%) of 1128 patients; 30-day mortality in these patients was 38{\textperiodcentered}0\% (219 of 577), accounting for 81{\textperiodcentered}7\% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1{\textperiodcentered}75 [95\% CI 1{\textperiodcentered}28{\textendash}2{\textperiodcentered}40], p\&lt;0{\textperiodcentered}0001), age 70 years or older versus younger than 70 years (2{\textperiodcentered}30 [1{\textperiodcentered}65{\textendash}3{\textperiodcentered}22], p\&lt;0{\textperiodcentered}0001), American Society of Anesthesiologists grades 3{\textendash}5 versus grades 1{\textendash}2 (2{\textperiodcentered}35 [1{\textperiodcentered}57{\textendash}3{\textperiodcentered}53], p\&lt;0{\textperiodcentered}0001), malignant versus benign or obstetric diagnosis (1{\textperiodcentered}55 [1{\textperiodcentered}01{\textendash}2{\textperiodcentered}39]</p>
},
	issn = {0140-6736},
	doi = {https://doi.org/10.1016/S0140-6736(20)31182-X},
	url = {https://www.sciencedirect.com/science/article/pii/S014067362031182X},
	author = {Nepogodiev, Dmitri and Bhangu, Aneel and James C Glasbey and Elizabeth Li and Omar M Omar and Joana FF Simoes and Tom EF Abbott and Osaid Alser and Alexis P Arnaud and Brittany K Bankhead-Kendall and Kerry A Breen and Miguel F Cunha and Giana H Davidson and Di Saverio, Salomone and Gallo, Gaetano and Ewen A Griffiths and Rohan R Gujjuri and Peter J. Hutchinson and Haytham MA Kaafarani and Hans Lederhuber and Markus W L{\"o}ffler and Hassan N Mashbari and Ana Minaya-Bravo and Dion G Morton and David Moszkowicz and Pata, Francesco and George Tsoulfas and Mary L Venn and Cox, Daniel and April C Roslani and Alakaloko, Felix and Jean-Paul PM {de Vries} and Mahmoud A Aaraj and Tom EF Abbott and Sarah J Abbott and Mutwakil OM Abdalla and Ahmed S Abdelaal and Ademuyiwa, Adesoji O and Thomas M Aherne and Osman M Ali and Ghadah Z Alkadeeki and Ana C Almeida and Mahmoud M Alrahawy and Graeme K Ambler and Ehab Alameer and Stefano M Andreani and Beatriz {De Andr{\'e}s-Asenjo} and Leyre Lopez Antonanzas and Salah G Aoun and Fouad M Ashoush and Augestad, Knut Magne and Rocio B Avellana and Funbi A Ayeni and John OO Ayorinde and Bheemanakone H Babu and Mirza MAS Baig and Oreoluwa M Bajomo and Olivia J Baker and Markus P Baker and Alexander J Baldwin and Vin Shen Ban and Ryan D Baron and Alberto G Barranquero and Conor P Barry and Alessandro {DI Bartolomeo} and Gary A Bass and Michael F Bath and H Hunt Batjer and Andrew J Beamish and Ajay P Belgaumkar and Matthew N Bence and Ruth A Benson and Juan Carlos Bernal-Sprekelsen and Anuradha R Bhama and Avi V Bhavaraju and Walter L Biffl and Chris M Blundell and Alexander P Boddy and Alexander BJ Borgstein and David C Bosanquet and Karen D Bosch and Ahmad EM Bouhuwaish and Mehmet A Bozkurt and Collin EM Brathwaite and Benjamin C Brown and Oliver D Brown and Allison K Brown and Igor Lima Buarque and Alejandro D Bueno-Ca{\~n}ones and Mustafa R Bulugma and Joshua R Burke and Matthew HV Byrne and Elima P Cagigal-Ortega and Rachael A Callcut and Francesca {DI Candido} and Michaela E Canova and William J Carlos and Edward J Caruana and Liam D Cato and Andrew B Catton and Andrea Pisani Ceretti and Thomas JG Chase and Francesco Di Chiara and Abeed H Chowdhury and Eric A Chung and Pierfranco M Cicerchia and Ethan CS Clough and Natasha L Coleman and Chris G Collins and Michelle L Collins and Emily T Colonna and Lara V Comini and Patrick A Coughlin and Laura Fern{\'a}ndez-Gomez Cruzado and Brian R Davidson and Richard J Davies and Emma J Davies and Niall F Davis and Brett E Dawson and Benjamin JF Dean and Maria Garcia-Conde Delgado and Jose J Diaz and Kathryn E Dickson and Manuel M Diez-Alonso and Jan R Dixon and Matthew J Doe and Thomas D Drake and Frederick T Drake and John P Duffy and Declan FJ Dunne and Naomi JM Dunne and Virginia M Dur{\'a}n-Mu{\~n}oz-Cruzado and Alexander ZE Durst and Nicola J Eardley and John G Edwards and Ahmed H Elfallal and ElFiky, Mahmoud MA and Jessie A Elliott and Sameh H Emile and Katy M Emslie and Frederick W Endorf and Jamie L Engel and Diego T Enjuto and Eric W Etchill and Jonathan P Evans and Brian A Fahey and Carlos S Faria and Carlo V Feo and Henry JM Ferguson and Beatriz Dieguez Fernandez and Andres Garcia Fernandez and Antonio J Fern{\'a}ndez and Borja Camacho Fern{\'a}ndez-Pacheco and Fitzgerald, J Edward and Giovanni B Fonsi and Roser Farr{\'e} Font and Amy L Fowler and Kenneth R Fretwell and Lorena Sanchon Fructuoso and Giuseppe K Fusai and Miguel Hernandez Garcia and Miguel Angel Garcia-Ure{\~n}a and Charn K Gill and Suzanne S Gisbertz and Roberto {Del Giudice} and Maria Carmela Giuffrida and Matteo {Di Giuseppe} and Mar{\'\i}a Fanjul G{\'o}mez and Ewen A Griffiths and Claudio A Guariglia and Alison J Hainsworth and Bria J Hall and James RW Hall and John S Hammond and Maha H Haqqani and Harrison, Ewen M and Joshua P Hazelton and Maarten {van Heinsbergen} and Arnold DK Hill and Caroline B Hing and Sameer A Hirji and Michael WS Ho and Charlotte M Holbrook and Thomas J Holme and James C Hopkins and David N Hopkinson and Fahad S Hossain and Victoria E Hudson and Jane L Hughes and E. Shelley Hwang and Mohamed AH Ibrahim and Simone M Isolani and Michael D Jenkinson and Hillary E Jenny and Deva S Jeyaretna and Robert P Jones and Andrew P Jones and Pascal KC Jonker and Maria L J{\"o}nsson and Doireann P Joyce and Kyle J Kalkwarf and Kamarajah, Sivesh K and El Kassas, Mohamed and Dara O Kavanagh and James M Keatley and Mohamed A Khalefa and Jim S Khan and Bilal H Kirmani and Aaron P Kisiel and Spyros Marinos Kouris and Mikolaj R Kowal and Peter L Labib and John O Larkin and Johannes C Lauscher and Wouter KG Leclercq and Frances SJ Ledesma and Andr{\'e} M Leite-Moreira and Elaine YL Leung and Sophia E Lewis and Maria Jo{\~a}o Lima and Daniel J Lin and Helen H Liu and Aoife J Lowery and Saida Martel Lozano and Catriona R Luney and Mariana Magalh{\~a}es Maia and Nicol{\`o} M Mariani and Marco V Marino and Angelo A Marra and Christopher L Marsh and Robert CG Martin and Simon J McCluney and Robert C McIntyre and Siobhan C Mckay and Kevin L McKevitt and Ashley D Meagher and Mohammad Q Mehdi and Brian J Mehigan and Melania {Gonzalez-De Miguel} and Maria-Carmen {De Miguel-Ardevines} and Sarah J Mills and Helen M Mohan and John AG Moir and John RT Monson and Joana M Monteiro and Maria T Montella and Cristina Soto Montesinos and Marwa M Morgom and Francisco S Moura and Jose M Muguerza and Suzanne H Murphy and Paola {De Nardi} and David N Naumann and Paul C Neary and David TA Neely and Joshua S Ng-Kamstra and Albert WT Ngu and Truong A Nguyen and George E Nita and Quentin M Nunes and Rachel M Nygaard and Lindsay B O{\textquoteright}Meara and John R O{\textquoteright}Neill and Barbara U Okafor and Steven A Olson and Aung Y Oo and Pablo Collera Ormazabal and Alexander L Osorio and Max J Pachl and James T Parry and Panna K Patel and Luis E P{\'e}rez-S{\'a}nchez and Ana Nogues Pevidal and Anna P Pezzuto and Matthew M Philp and Thomas D Pinkney and Joerg M Pollok and Meical G Povey and Alfredo Alonso Poza and Amarkumar D Rajgor and Jagan N Rao and Dimitri A Raptis and Henry E Rice and Paul F Ridgway and Ana Munoz Rivas and Juan C Rodriguez-Sanjuan and Luke J Rogers and Anna {Da Roit} and Rebecca A Rollett and Jose L Romera and Siobhan M Rooney and Vanessa I Roxo and Bertrand {Le Roy} and Eduardo E Rubio and Carolina Castro Ruiz and Manuel Losada Ruiz and {\'E}anna J Ryan and Abdel Rahman Saad and Samerah A Saeed and Hiba A Salama and Abdulrauf A Salamah and Gianluca M Sampietro and Diwakar R Sarma and Kathryn B Schaffer and Andreas A Schnitzbauer and Rachel J Scurrah and Olivia L Serevina and Pedro A Serralheiro and Joseph M Sewards and Michael J Shackcloth and Abigail V Shaw and Andrea RG Sheel and Giuseppe S Sica and Veronica {De Simone} and Aminder A Singh and Rabindra P Singh and Brendan L Skelly and Henry G Smith and Amir H Sohail and Duncan R Spalding and Laurie R Springford and Anna E Ssentongo and Pieter J Steinkamp and Kent A Stevens and Grant D Stewart and Nicholas A Stylianides and Tom BB Sullivan and Ahmed SA Taher and Muhammad S Tamimy and Alethea M Tang and Giovanni D Tebala and Francisco J Tejero-Pintor and Mohamed A Thaha and Amy J Thomas and Giorgio {De Toma} and Filippo {La Torre} and Antonio J Torres and David N Townshend and Isobel M Trout and Sarah C Tucker and Harmony K Ubhi and Viviana A Vega and George C Velmahos and Catherine G Velopulos and Yirupaiahgari KS Viswanath and Alfredo A Vivas and Ryckie G Wade and Martin S Wadley and Joshua JS Wall and Andrew M Walters and Oliver J Warren and Chamindri K Weerasinghe and Richard JW Wilkin and Katherine J Williams and Stuart C Winter and Justin CR Wormald and Franklin L Wright and Souzana E Xyda and Alastair L Young and Youssef, Mina M G and Farhat B Yousuf and Hanan {El Youzouri} and Marco A Zappa and Emmanuele Abate and Hossam Abdalaziz and Mostafa Abdelkarim and Abdou, Hossam and Ahmad Aboelkassem-Ibrahim and Ala Abuown and Fernando Acebes-Garcia and Metesh Acharya}
}
