Background A little known on early and late outcomes of abdominal surgery in patients with coronavirus disease 2019 (COVID-19). The objective of this prospective cohort study is to describe early and late complications after abdominal surgery in patients with COVID-19.
Methods The study was conducted in Yerevan, Armenia, from February 1 until October 31, 2020. The study population comprised 259 patients with COVID-19 and 245 patients without COVID-19 matched by operation type, age, sex, and comorbidities, abdominal surgery. Differences between early (1-30 postoperative days) and late (31-60 postoperative days) complications in both groups were analyzed. Patients with COVID-19 had been diagnosed based on both clinical and laboratory (RT-PCR, reverse transcriptase-polymerase chain reaction assay in nasopharyngeal swabs) criteria. The primary endpoints were postoperative complications, secondary endpoints - 60-day surgical mortality and the impact of comorbidities on postoperative complications.
Results Twenty-nine (11.2%) patients with COVID-19 and four (1.6%) patients without COVID-19 developed postoperative complications. Early and late postoperative complications in patients with COVID-19 were 21 and 8; the median age of them were 54.5 (range: 45-64) and 69.5 (range: 65-74), correspondingly. At least one comorbidity was present in 25 (86.2%) of 29 patients with COVID-19 with postoperative complications. A 60-day surgical mortality was 14.3%.
Conclusion COVID-19 is associated with high risk for postoperative complications of abdominal surgery, particularly in 45-74-year-old patients. Presence of at least one comorbidity is an additional risk factor of postoperative complications. Better designed studies are needed to find out indicators for early detection of postoperative complications in patients with COVID-19, especially in people older than 45 years and in those with comorbidities.
Keywords: COVID-19, Postoperative Complications, Surgical Mortality, Abdominal Surgery, Comorbidity.