Patients should get COVID-19 vaccine before surgery to reduce death risk: study

Thursday, 25 March 2021

An international research study has found that surgery dramatically increases the risk of death from COVID-19, recommending that all non-emergency surgery patients be vaccinated while awaiting procedures.

COVID-19 and surgery

The research group estimates that global prioritisation of pre-operative vaccination for surgery patients could prevent an additional 58,687 COVID-19-related deaths in one year.

Australian project lead, Associate Professor Amanda Dawson, a Royal Australasian College of Surgeons (RACS) Fellow and general surgeon from the University of Newcastle, said elective surgery patients were vulnerable.

“People undergoing surgery are at greater risk of getting COVID-19 and if they do, they are at greater risk of dying than other people,” Associate Professor Dawson said.

Between 0.6 per cent and 1.6 per cent of patients develop COVID-19 infection after elective surgery – which is categorised as all non-emergency surgery, including for cancer, hip replacement and hernia surgery.

This small percentage of patients are four to eight times more likely to die in the month following surgery, than those who don’t contract the virus.”

Based on the high risks that surgical patients face, scientists calculate that vaccinating this group would be more likely to prevent COVID-19 related deaths than vaccines given to the population at large – particularly among the over-70s and those undergoing surgery for cancer, which is classed elective.

“Patients aged over 70 who undergo cancer surgery would usually have a 2.8 per cent mortality rate, yet the risk increases to 18.6 per cent if they develop COVID-19 infection,” she said.

The COVIDSurg Collaborative international team of researchers, led by the University of Birmingham, published its findings after studying data for 141,582 patients from across 1,667 hospitals in 116 countries - including Australia, Brazil, China, India, UAE, UK and USA, creating the world’s largest ever international study on surgery.

Associate Professor Dawson said preoperative vaccination could support a safer continuation of elective surgery.

“Many countries, particularly low and middle-income countries, will not have widespread access to COVID vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at highest risk of COVID-19 mortality. Our work can help to inform these decisions.”

Vaccination is also likely to decrease post-operative pulmonary complications, reducing intensive care use and overall healthcare costs.

Australian co-lead author Dr Jess Vo, from the University of Western Australia said restarting elective surgery was a global priority.

“More than 15,000 surgeons and anaesthetists from across 116 countries came together to contribute to this study, making it the largest ever scientific collaboration. It’s crucial that policy makers use the data we have collected to support a safe continuation of elective surgery; COVID vaccination should be prioritised for elective surgery patients ahead of the general population,” Dr Vo said.

The research was published in the British Journal of Surgery, incorporating the European Journal of Surgery.


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