Clinical characteristics and risk factors for perioperative lung surgery patients with SARS‐CoV‐2 infection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XU Chenzhen ¹ , HUANG Zhixin ² , WANG Wenjie ¹ , LIU Bohao ¹ , ZUO Yifan ¹ , GAO Minglang ¹ , DENG Yu ¹ , LI Ning ¹ ,  GENG Qing ¹

1. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, P. R. China;
2. Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, 430060, P. R. China;

Corresponding author：

GENG Qing, Email: gengqingwhu@whu.edu.cn

Keywords：

SARS-CoV-2; Omicron variant; lung surgery; postoperative complications; prognosis

DOI：

10.7507/1007-4848.202301043

Video：

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Objective To investigate the clinical characteristics and risk factors for perioperative lung surgery patients with SARS‐CoV‐2 Omicron variant infection. Methods The clinical data of patients who underwent lung surgery at the Department of Thoracic Surgery, Renmin Hospital of Wuhan University from December 1, 2022 to January 9, 2023 were retrospectively analyzed. The patients were divided into an infection group and a non-infection group according to whether they were infected with SARS-CoV-2. And the clinical data of two groups were collected and compared. Multiple linear regression analysis was used to explore the risk factors affecting the time of hospitalization. Results A total of 70 patients were enrolled in this study, including 36 (51.4%) males and 34 (48.6%) females at a median age of 61.0 (49.0, 66.8) years. There were 28 patients in the infection group and 42 patients in the non-infection group. The proportion of preoperative abnormal coagulation function and the risk of postoperative pulmonary infection in perioperative patients infected with SARS-CoV-2 were higher than those in the non-infection group (P<0.05). Subgroup analysis found that patients with preoperative SARS-CoV-2 infection were more likely to have pulmonary infection after surgery, but did not prolong the time of hospitalization or increase the risk of severe disease rate. The patients with postoperative SARS-CoV-2 infection had worse clinical prognosis, including longer time of hospitalization (P=0.004), higher ICU admission rate (P=0.000), higher lung infection rate (P=0.003) and respiratory failure rate (P=0.000). Multiple linear regression analysis showed that gender and extent of surgery were independent risk factors for prolonged hospitalization time. Conclusion Preoperative infection with SARS-CoV-2 Omicron variant will increase the risk of pulmonary infection, but it will not affect the clinical prognosis. However, postoperative infection with SARS-CoV-2 Omicron variant will still prolong the time of hospitalization, increase the ICU rate, and the risk of pulmonary complications.

Citation： XU Chenzhen, HUANG Zhixin, WANG Wenjie, LIU Bohao, ZUO Yifan, GAO Minglang, DENG Yu, LI Ning, GENG Qing. Clinical characteristics and risk factors for perioperative lung surgery patients with SARS‐CoV‐2 infection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(7): 950-955. doi: 10.7507/1007-4848.202301043 Copy

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6.	COVIDSurg Collaborative. Outcomes and their state-level variation in patients undergoing surgery with perioperative SARS-CoV-2 infection in the USA: A prospective multicenter study. Ann Surg, 2022, 275(2): 247-251.
7.	Iwata E, Hasegawa T, Yamada SI, et al. Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis. Surg, 2019, 165(5): 1003-1007.
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12.	COVIDSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
13.	Lal BK, Prasad NK, Englum BR, et al. Periprocedural complications in patients with SARS-CoV-2 infection compared to those without infection: A nationwide propensity-matched analysis. Am J Surg, 2021, 222(2): 431-437.
14.	Prasad NK, Lake R, Englum BR, et al. Increased complications in patients who test COVID-19 positive after elective surgery and implications for pre and postoperative screening. Am J Surg, 2022, 223(2): 380-387.
15.	Hu B, Guo H, Zhou P, et al. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol, 2021, 19(3): 141-154.
16.	Lugg ST, Agostini PJ, Tikka T, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax, 2016, 71(2): 171-176.
17.	Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
18.	刘昌平, 钟一鸣. 胸腔镜下肺楔形切除与解剖性肺段切除对IA1期非小细胞肺癌治疗效果的比较. 川北医学院学报, 2019, 34(3): 419-421.
19.	徐佳丽, 胡蓓蓓, 茅秋霞, 等. 新型冠状病毒肺炎患者的静脉血栓栓塞症风险评估与抗凝治疗. 中国呼吸与危重监护杂志, 2021, 20(2): 101-105.
20.	Zhao G, Su Y, Sun X, et al. A comparative study of the laboratory features of COVID-19 and other viral pneumonias in the recovery stage. J Clin Lab Anal, 2020, 34(10): e23483.

1. 彭丹萍, 邢翔宇, 汪杨, 等. 新型冠状病毒奥密克戎变异株的流行病学和临床特点. 中国病毒病杂志, 2022, 12(5): 385-389.
2. Fan Y, Li X, Zhang L, et al. SARS-CoV-2 Omicron variant: Recent progress and future perspectives. Signal Transduct Target Ther, 2022, 7(1): 141.
3. 王邵华, 阮征, 郑健, 等. 肺切除术后肺部并发症发生的危险因素分析. 中国胸心血管外科临床杂志, 2010, 17(4): 301-306.
4. Singhal R, Dickerson L, Sakran N, et al. Safe surgery during the COVID-19 pandemic. Curr Obes Rep, 2022, 11(3): 203-214.
5. Lino A, Cardoso MA, Martins-Lopes P, et al. Omicron—The new SARS-CoV-2 challenge? Rev Med Virol, 2022, 32(4): e2358.
6. COVIDSurg Collaborative. Outcomes and their state-level variation in patients undergoing surgery with perioperative SARS-CoV-2 infection in the USA: A prospective multicenter study. Ann Surg, 2022, 275(2): 247-251.
7. Iwata E, Hasegawa T, Yamada SI, et al. Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis. Surg, 2019, 165(5): 1003-1007.
8. Prasad N K, Mayorga-Carlin M, Sahoo S, et al. Mid-term surgery outcomes in patients with COVID-19: Results from a Nationwide analysis. Ann Surg, 2022. Online ahead of print.
9. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet, 2020, 396(10243): 27-38.
10. Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine, 2020, 21: 100331.
11. 沈小康, 任杰, 江文洋, 等. 17例手术后新型冠状病毒肺炎病例临床分析. 武汉大学学报(医学版), 2021, 42(2): 245-249.
12. COVIDSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
13. Lal BK, Prasad NK, Englum BR, et al. Periprocedural complications in patients with SARS-CoV-2 infection compared to those without infection: A nationwide propensity-matched analysis. Am J Surg, 2021, 222(2): 431-437.
14. Prasad NK, Lake R, Englum BR, et al. Increased complications in patients who test COVID-19 positive after elective surgery and implications for pre and postoperative screening. Am J Surg, 2022, 223(2): 380-387.
15. Hu B, Guo H, Zhou P, et al. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol, 2021, 19(3): 141-154.
16. Lugg ST, Agostini PJ, Tikka T, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax, 2016, 71(2): 171-176.
17. Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
18. 刘昌平, 钟一鸣. 胸腔镜下肺楔形切除与解剖性肺段切除对IA1期非小细胞肺癌治疗效果的比较. 川北医学院学报, 2019, 34(3): 419-421.
19. 徐佳丽, 胡蓓蓓, 茅秋霞, 等. 新型冠状病毒肺炎患者的静脉血栓栓塞症风险评估与抗凝治疗. 中国呼吸与危重监护杂志, 2021, 20(2): 101-105.
20. Zhao G, Su Y, Sun X, et al. A comparative study of the laboratory features of COVID-19 and other viral pneumonias in the recovery stage. J Clin Lab Anal, 2020, 34(10): e23483.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical characteristics and risk factors for perioperative lung surgery patients with SARS‐CoV‐2 infection

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