Abstract
Background: Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission.
Methods: This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days.
Results: A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%. The length of stay (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.04-1.11; p < 0.001), surgical time (OR 1.004; 95% CI 1.001-1.008; p = 0.023), intensive care unit admission (OR 7.7; 95% CI 2.03-29.28; p = 0.003), and hospital readmissions (OR 9.56; 95% CI 2.50-36.56; p = 0.001) were associated with postoperative coronavirus disease (COVID-19). Using unadjusted and adjusted logistic regression, length of stay (OR 1.08; 95% CI 1.04-1.11; p < 0.001), and readmission (OR 9.02; 95% CI 2.30-35.48; p = 0.002) were independent factors of postoperative COVID-19.
Conclusions: Screening patients preoperatively may reduce in-hospital SARS-CoV-2 transmission. Length of stay and readmission were independently correlated with postoperative COVID-19.
【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, coronavirus, intensive care, SARS-COV-2 infection, hospital, surgical, RT-PCR, cohort study, Nasopharyngeal swab, SARS-CoV-2 transmission, Logistic regression, incidence, Admission, patients, asymptomatic patient, readmission, RT-PCR test, Odds ratio, Elective surgery, In-hospital, Patients with cancer, acute respiratory syndrome, Factor, Endpoint, 95% CI, 95% confidence interval, routine, positive, Surgical Procedure, independent, analyzed, performed, was performed, adjusted, postoperative, correlated, reduce, Length, Screening patient, 【제목키워드】 COVID-19, SARS-CoV-2, surgery, Screening, Factor, preoperative,