Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients

• Published in: Frontiers in medicine Vol. 9; p. 1065625
• Main Authors: Clancy, Paul W, Knio, Ziyad O, Zuo, Zhiyi
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 21.12.2022
• Subjects: COVID-19; intraoperative; length of stay; Medicine; SARS-CoV-2; surgery; COVID-19; intraoperative; length of stay; SARS-CoV-2; surgery
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2022.1065625

It has been demonstrated that surgical patients with COVID-19 are at increased risk for postoperative complications. However, this association has not been tested in asymptomatic elective surgical patients. A retrospective cohort study among elective gynecological and spine surgery patients at a single tertiary medical center from July 2020 through April 2022 ( = 1,130) was performed. The primary endpoint was prolonged (>75th percentile for the corresponding surgical service) length of stay. Secondary endpoints included postoperative respiratory complications, duration of supplemental oxygen therapy, and other major adverse events. The association between SARS-CoV-2 detection and the above outcomes was investigated with univariate and multivariable analyses. Of 1,130 patients who met inclusion criteria, 30 (2.7%) experienced intraoperative detection of SARS-CoV-2. Those with intraoperative viral detection did not experience an increased incidence of prolonged length of stay [16.7% vs. 23.2%; RR, 0.72 (95% CI, 0.32-1.61); = 0.531] nor did they have a longer mean length of stay (4.1 vs. 3.9 days; = 0.441). Rates of respiratory complications [3.3% vs. 2.9%; RR, 1.15 (95% CI, 0.16-8.11); = 0.594] and mean duration of supplemental oxygen therapy (9.7 vs. 9.3 h; = 0.552) were similar as well. All other outcomes were similar in those with and without intraoperative detection of SARS-CoV-2 (all > 0.05). Asymptomatic patients with incidental detection of SARS-CoV-2 on intraoperative testing do not experience disproportionately worse outcomes in the elective spine and gynecologic surgical population.