EHS-COVID (250) Risks of COVID-19 infection among surgery patients - COVIDSurg Collaborative paper in BJS

28 March, 2021

Dear HIFA colleagues,

You might have seen some of the media coverage last week on a study that suggests that prioritising surgical patients for COVID-19 vaccination could save tens of thousands of lives globally. Here's the paper:

https://academic.oup.com/bjs/advance-article/doi/10.1093/bjs/znab101/618...

published on 25 March in BJS (incorporating the British Journal of Surgery and the European Journal of Surgery).

The authors are from the global COVIDSurg Collaborative, led by NIHR Global Health Research Unit in Global Surgery <https://globalsurg.org/about/> based at the University of Birmingham, using data for 141,582 patients from across 1,667 hospitals in 116 countries - the world’s largest international study on surgery.

In summary, they found that between 0.6% and 1.6% of patients develop COVID-19 infection after elective surgery, and are at between 4- and 8-fold increased risk of death in the 30 days following surgery. Based on the high risks that surgical patients face, the researchers calculate that vaccination of surgical patients is 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.

Overall, they estimate that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 COVID-19-related deaths in one year. This could be particularly important for low- and middle-income countries where mitigation measures such as nasal swab screening and COVID-free surgical pathways, which can reduce the risk of complications related to the virus, are unlikely to be universally implemented. Vaccination is also likely to decrease post-operative pulmonary complications - reducing intensive care use and overall healthcare costs.

The study estimated that up to 70% of elective surgeries were postponed during the first wave of the pandemic, resulting in an estimated 28 million procedures being delayed or cancelled globally.

Best regards,

Patrick Wilson

Head of Global Health Communications & Stakeholder Engagement, National Institute for Health Research (NIHR) www.nihr.ac.uk/globalhealth

HIFA profile: Patrick Wilson is Head of Global Health Communications & Stakeholder Engagement at the National Institute for Health Research (NIHR), UK . Professional interest: Global health research. @NIHRglobal patrick.wilson AT nihr.ac.uk