Lei Shaoqing, Jiang Fang, Su Wating, Chen Chang, Chen Jingli, Mei Wei, Zhan Li-Ying, Jia Yifan, Zhang Liangqing, Liu Danyong, Xia Zhong-Yuan, Xia Zhengyuan
Department of anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
State Key Laboratory of Pharmaceutical Biotechnology, the University of Hong Kong, Hong Kong, China.
EClinicalMedicine. 2020 Apr 5;21:100331. doi: 10.1016/j.eclinm.2020.100331. eCollection 2020 Apr.
The outbreak of 2019 novel coronavirus disease (COVID-19) in Wuhan, China, has spread rapidly worldwide. In the early stage, we encountered a small but meaningful number of patients who were unintentionally scheduled for elective surgeries during the incubation period of COVID-19. We intended to describe their clinical characteristics and outcomes.
We retrospectively analyzed the clinical data of 34 patients underwent elective surgeries during the incubation period of COVID-19 at Renmin Hospital, Zhongnan Hospital, Tongji Hospital and Central Hospital in Wuhan, from January 1 to February 5, 2020.
Of the 34 operative patients, the median age was 55 years (IQR, 43-63), and 20 (58·8%) patients were women. All patients developed COVID-19 pneumonia shortly after surgery with abnormal findings on chest computed tomographic scans. Common symptoms included fever (31 [91·2%]), fatigue (25 [73·5%]) and dry cough (18 [52·9%]). 15 (44·1%) patients required admission to intensive care unit (ICU) during disease progression, and 7 patients (20·5%) died after admission to ICU. Compared with non-ICU patients, ICU patients were older, were more likely to have underlying comorbidities, underwent more difficult surgeries, as well as more severe laboratory abnormalities (eg, hyperleukocytemia, lymphopenia). The most common complications in non-survivors included ARDS, shock, arrhythmia and acute cardiac injury.
In this retrospective cohort study of 34 operative patients with confirmed COVID-19, 15 (44·1%) patients needed ICU care, and the mortality rate was 20·5%.
National Natural Science Foundation of China.
中国武汉爆发的2019新型冠状病毒病（COVID-19）已在全球迅速传播。在疫情早期，我们遇到了一小部分但数量可观的患者，他们在COVID-19潜伏期内被无意安排进行择期手术。我们旨在描述这些患者的临床特征和结局。
我们回顾性分析了2020年1月1日至2月5日期间在武汉的人民医院、中南医院、同济医院和中心医院接受COVID-19潜伏期内择期手术的34例患者的临床资料。
34例手术患者的中位年龄为55岁（四分位间距，43 - 63岁），20例（58.8%）为女性。所有患者术后不久均出现COVID-19肺炎，胸部计算机断层扫描有异常表现。常见症状包括发热（31例[91.2%]）、乏力（25例[73.5%]）和干咳（18例[52.9%]）。15例（44.1%）患者在疾病进展过程中需要入住重症监护病房（ICU），7例患者（20.5%）在入住ICU后死亡。与非ICU患者相比，ICU患者年龄更大，更有可能有基础合并症，接受的手术更复杂，实验室异常也更严重（如白细胞增多、淋巴细胞减少）。非幸存者中最常见的并发症包括急性呼吸窘迫综合征、休克、心律失常和急性心脏损伤。
在这项对34例确诊COVID-19手术患者的回顾性队列研究中，15例（44.1%）患者需要ICU护理，死亡率为20.5%。
中国国家自然科学基金。
