Post-COVID 19 Patients Undergoing Surgery

Study Overview
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Brief Summary
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More and more patients are undergoing elective surgery after SARS-CoV-2 infection, and little is known about the residual pulmonary changes in these patients after infection and postoperative pulmonary complications. So, we propose an observational study comparing postCOVID-19 patients with normal population (control group) undergoing surgery.

Detailed Description
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The most common lung complications of severe COVID-19 are pneumonia and hypoxemic respiratory failure/ARDS. Manifestations of lung inflammation or fibrosis were also observed in late stages of COVID-19 causing respiratory sequelae. Fibrous lesions may form during the healing of pulmonary chronic inflammation or proliferative diseases, with gradual replacement of cellular components by scar tissues indicating a poor outcome of COVID-19. Ultrasound allows to stratify the severity of lung damage and combined with the clinic, can help estimate the patient's prognosis and support therapeutic decision-making. On the other hand, pulmonary inflammatory processes and fibrosis are responsible for a decrease in respiratory distensibility or pulmonary compliance. Pulmonary parenchyma distensibility is known as static distensibility or compliance and it´s calculated by mechanical ventilators during general anesthesia. There are no studies that determine the results of lung ultrasound and pulmonary compliance in preoperative and intraoperative period respectively in postCOVID patients, and the postoperative complications of postCOVID patients are poorly understood.

Official Title
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Post-COVID 19 Patients Undergoing Surgery: Determination of Residual Lung Abnormalities and Postoperative Adverse Effects

Conditions
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Covid19

Intervention / Treatment
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* Procedure: scheduled surgery


Participation Criteria
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Eligibility Criteria
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Control group Inclusion criteria.: -Patients over the age of 18 who did not have COVID-19 and who are going to undergo scheduled surgery Exclusion criteria: Patients under the age of 18. Unstable patients in shock Patients in current state of pulmonary hypertension or heart failure Patients with moderate-severe pulmonary pathology prior to surgery. Patients previously surgery for chest surgery Patients in current state of respiratory infection Post-COVID group Inclusion criteria -Post-COVID-19 patients (confirmed by PCR) >18 years undergoing scheduled surgery without pulmonary disease prior to SARS-CoV-2 infection, that at the time of surgery present negative PCR and absence of clinic due to SARS-CoV-2 infection. Exclusion criteria: Patients under the age of 18 Unstable patients in shock Patients in current state of pulmonary hypertension or heart failure Patients with moderate-severe pulmonary pathology prior to SARS-CoV-2. Patients previously surgery for chest surgery Patients in current state of respiratory infection

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 95 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 |
| --- | --- |
| Post-COVID-19 group<br>The Post-COVID-19 group or case group includes post-COVID patients (confirmed by PCR) >18 years undergoing scheduled surgery without pulmonary disease prior to SARS-CoV-2 infection that at the time of surgery present negative PCR and absence of clinic due to SARS-CoV-2. | Procedure: scheduled surgery<br>* Patients undergoing scheduled surgery with lung ultrasound before surgery and determination of lung compliance during general anesthesia<br>|
| Control group<br>The control group includes patients over the age of 18 who did not have COVID-19 and without moderate-severe pulmonary pathology prior to surgery and in conditions of hemodynamic and respiratory stability at time of surgery. | Procedure: scheduled surgery<br>* Patients undergoing scheduled surgery with lung ultrasound before surgery and determination of lung compliance during general anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determination of residual pulmonary alterations in post-COVID patients | 1. Determination of residual pulmonary alterations using preoperative lung ultrasound and obtaining intraoperative compliance in postCOVID-19 patients undergoing surgery. | 1 month | 
| Correlation between lung ultrasound and pulmonary compliance | Analyze the correlation between the values obtained with pulmonary ultrasound and the pulmonary compliance obtained by mechanical ventilation in patients with general anesthesia. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative complications | Determine postoperative complications one month after surgery. | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post-COVID patients, pulmonary sequelae, postoperative complications