The following is a summary of “Effect of COVID-19 and its vaccines on surgical and postsurgical mortality, ICU admission and 90-day readmission for elective surgical procedures in a United States veteran population,” published in the SEPTEMBER 2023 issue of Surgery by Elsayed, et al.
For a study, researchers sought to investigate the impact of COVID-19 infection and vaccination on elective surgical outcomes. Four surgical procedures were selected for analysis, namely carotid endarterectomy, coronary artery bypass grafting (CABG), hip replacement, and colectomy.
The study conducted a retrospective comparison of three groups: veterans with a pre-pandemic (P) history, veterans with COVID-19 infection (C) more than three weeks before surgery, and veterans with no COVID-19 (NC) history. Subgroup analysis was performed to assess outcomes in vaccinated individuals. Propensity matching based on age and sex was carried out, and conditional logistic regression was used to analyze the following outcomes: one-year mortality, 90-day readmission, and intensive care unit (ICU) requirements. A total of 2,076 P, 1,038 NC, and 519 C patients were included, selected from a pool of 61,641 veterans.
Among the three groups (NC, C, and P), similar ICU requirements and mortality rates were observed. However, the NC group had fewer readmissions compared to the C group. Remarkably, the NC individuals who received at least one COVID-19 immunization had lower readmission and mortality rates than C patients who received at least one vaccine dose.
A history of SARS-CoV-2 infection increased readmissions without significantly affecting surgical patients’ ICU requirements or mortality rates. It was also noted that patients with a history of COVID-19 infection and at least one vaccination displayed worse outcomes than those with only one vaccination. Further research was needed to assess whether these poorer outcomes were due to incomplete vaccination or data limitations.