Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis
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RESEARCH
Open Access
Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis Semagn Mekonnen Abate1* , Bahiru Mantefardo2 and Bivash Basu3
Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature. Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute. Results: A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). Conclusion: The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients. Registration: This systematic review and meta-analysis was registered in Prospero’s international prospective register of systematic reviews (CRD42020203362) on August 10, 2020. Keywords: Perioperative, Mortality, Prevalence, Surgery, COVID-19
* Correspondence: [email protected] 1 Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, PO.BOX:419, Dilla, Ethiopia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated other
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