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Routine testing of patients for COVID-19 before major surgery could reduce the risk of respiratory complications and save lives, a new study reveals.
Researchers working together around the world found that the use of a nasal swab test to confirm that an asymptomatic patient was not infected with SARS-CoV-2 was associated with a lower rate of postoperative complications. The main benefit was seen before major surgery and in areas with a higher rate of COVID-19.
The swab tests gave surgeons the opportunity to identify asymptomatic infected patients and postpone their operation, avoiding the severe risk of COVID-19 complications after surgery. Routine testing also helped prevent cross infection of symptom-free patients with other elective surgical patients upon admission to hospital.
Led by researchers from the University of Birmingham, the COVIDSurg Collaborative is made up of experts from more than 130 countries.
The group published its findings today in the British Journal of Surgery and calls for preoperative swab testing for all patients as part of a broader strategy to continue surgery safely during the pandemic.
The collaboration supports this call with the launch of a dedicated ‘toolkit’ that will help hospitals and healthcare providers around the world get elective surgery back on track, after more than 28 million patients were postponed. procedures in the first phase. of the global pandemic.
Collaborative leader, Dr. Aneel Bhangu, from NIHR’s Global Health Research Unit on Global Surgery, at the University of Birmingham, commented:
“Our findings demonstrate great variation across countries in the application of preoperative testing. While there was a clear benefit from testing, only 1 in 4 patients were screened for infections. This illustrates the need for global expansion and standardization. of swab tests around the world.
“Preoperative swab testing should not be viewed in isolation, but rather as part of a larger plan to minimize risks to patients, including establishing COVID-19-free surgical pathways in all hospitals performing elective surgery.
In major surgery, one serious postoperative complication was avoided for every 17 tests performed. We urge healthcare providers to provide a routine swab test for all patients undergoing elective surgery, whether or not they have symptoms. “
The COVIDSurg toolkit will support individual hospitals, regions and countries during a major global reorganization of surgical services during the pandemic and beyond, by:
- Summarize published data to support safe surgical practice;
- Guide effective surgical recovery plans; Y
- Create a five-year vision of safe and effective surgery that addresses global challenges, including gaps in access to surgery that existed before the pandemic.
Surgery is an essential part of all healthcare systems. On average, you will have 3-4 operations during your life. Surgery remains the cure for most cancers and supports the treatment of many non-infectious diseases. Our new set of tools will help everyone involved in surgical planning for the next 5 years, including providers, healthcare leaders, patients, governments, funders, and industry. It addresses global challenges, but is locally adapted to hospitals and settings with variable access to resources.. “
Dr James Glasbey, lead study author, University of Birmingham
Before the COVID-19 pandemic, 5 billion people lacked access to surgical care and 143 million more operations were required per year worldwide.
There was already a significant global inequality in access to safe and affordable surgery in low- and middle-income countries, with an urgent need to expand capacity.
This pandemic has seriously worsened the situation and highlighted the need to change the way surgery is performed.
Launched in March 2020, the COVIDSurg collaboration has provided the data needed to support this change in the fastest time period ever seen by a surgical research group, with data from 150,000 patients in 2,000 hospitals collected over the past 9 months.
Last month, in their previous report, COVIDSurg researchers asked hospitals to establish ‘COVID-19-free’ zones for surgical patients to help save lives during the second wave of the pandemic, reducing the risk of death. from lung infections associated with the coronavirus.
They found that patients who had their operation and hospital care in ‘COVID-19 free’ areas had better outcomes, improving the safety of surgery by having a strict policy that no COVID-19 treated patients mix with those who were underwent surgery.
Source:
Magazine reference:
Glasbey, J., et al. (2020) Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic. British Journal of Surgery. doi.org/10.1093/bjs/znaa051.
