Impact of the Postponement of Surgery on Postoperative Morbidity After Sars-cov-2 Infection

Study Overview
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Brief Summary
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The deployment of vaccination against SARS-CoV-2 from 2021 led to a modification in June 2021of previous recommendations concerning the postponing scheduled surgery suggesting local adaptations of this delay if epidemic developments appear. Today, the evolutions of the pandemic make these recommendations obsolete and impose the updating of the data produced during the first epidemic wave of 2020. Among these evolutions, the two most important are the existence of a large vaccination coverage on the one hand and the emergence of variants of lesser severity on the other hand

Detailed Description
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Previous studies performed during the first COVID-19 epidemic wave in the first half of 2020 led to the recommendation, after taking into account the individual risk-benefit balance, of postponing scheduled surgery for ideally at least 6 completed weeks in a patient with a positive preoperative SARS-CoV-2 PCR. The deployment of vaccination against SARS-CoV-2 from 2021 led to a modification of these recommendations in June 2021 suggesting local adaptations of this delay if epidemic developments appear. Today, the evolutions of the pandemic make these recommendations obsolete and impose the updating of the data produced during the first epidemic wave of 2020. Among these evolutions, the two most important are the existence of a large vaccination coverage on the one hand and the emergence of variants of lesser severity on the other hand

Official Title
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Assessment of the Impact of the Postponement of Surgery on the Postoperative Morbidity After Sars-cov-2 Infection in 2022

Conditions
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SARS CoV 2 Infection

Intervention / Treatment
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* Other: Postponing surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients, Surgery performed in the operating room under general or locoregional anesthesia. Result of the preoperative SARS-COV-2 diagnostic test available on the day of the procedure or within 48 hours of the surgery. Emergency or scheduled surgery All surgical indications will be eligible with the exception of certain surgeries Exclusion Criteria: Minor patient Pregnant patient Surgery or an intervention performed outside the operating room Patient operated under sedation alone, Patient under guardianship or curatorship Patient without social protection Patient previously included in this study Patient without preoperative COVID-19 status on day of surgery and not diagnosable within 48 postoperative hours Patient whose immediate postoperative follow-up is planned in a structure other than those where the inclusion was made

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patient with a positive preoperative SARS-CoV-2 test<br>Patient with a positive preoperative SARS-CoV-2 test | Other: Postponing surgery<br>* Postponing surgery for patients with Sars-cov-2 infection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite endpoint, that consist of respiratory morbidity associated with occurrence of respiratory events and use or prolongation of mechanical ventilation. | The primary endpoint will be a composite endpoint, that consist of respiratory morbidity associated with occurrence of pneumonia (bacterial or viral), acute respiratory distress, symptomatic pulmonary embolism (i.e. having led to a diagnostic procedure and a treatment), and postoperative prolongation of mechanical ventilation or the use of unscheduled, during the postoperative hospital stay and within the limit of 30 postoperative days. | up to 30 postoperative days. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary Outcome Measures include hospital mortality, | The secondary endpoints will be the hospital mortality (number of death during hospitalization) | up to 30 postoperative days. | 
| Secondary Outcome Measures include mortality at D30, | The secondary endpoints will be the mortality at D30 (number of death since surgery until Day 30); | up to 30 postoperative days. | 
| Secondary Outcome Measures include the occurrence of a deep vein thrombosis, | The secondary endpoints will be the number of occurrence of a deep vein thrombosis (excluding pulmonary embolism), | up to 30 postoperative days. | 
| Secondary Outcome Measures include non-respiratory infection and septic shock, | The secondary endpoints will be the numberof non-respiratory infection or septic shock during the post-operative hospital stay and within the limit of postoperative 30 days. | up to 30 postoperative days. | 
| Secondary Outcome Measures include non-respiratory infection or septic shock, | The secondary endpoints will be the number of non-respiratory infection or septic shock during the post-operative hospital stay and within the limit of postoperative 30 days. | up to 30 postoperative days. | 
| Secondary Outcome Measures include length of hospital stay and length of critical care stay. | The secondary endpoints will be the length of hospital stay, length of critical care stay (if hospitalization in critical care). | up to 30 postoperative days. | 
| Secondary Outcome Measures include the need for re-hospitalization during the first 30 days after surgery | The secondary endpoints will be the need for re-hospitalization during the first 30 days after surgery (number of patients with re-hospitalization) | up to 30 postoperative days. |