Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection
Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection
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COVID-19感染潜伏期接受手术患者的临床特征和结局
DOI：
10.1016/j.eclinm.2020.100331
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发表时间：
2020-04-01
影响因子：
15.1
通讯作者：
Xia, Zhengyuan
中科院分区：
文献类型：
--
作者：
Lei, Shaoqing;Jiang, Fang;Xia, Zhengyuan
背景：2019年新型冠状病毒病(新冠肺炎)在武汉暴发的中国已在全球范围内迅速蔓延。在早期，我们遇到了少量但有意义的患者，他们在新冠肺炎潜伏期无意中安排了择期手术。方法：对武汉市人民医院、中南医院、同济医院、中心医院新冠肺炎潜伏期内的34例择期手术患者的临床资料进行回顾性分析。结果：34例手术患者中，智商43~63岁，中位年龄55岁，女性20例，占58.8%。所有患者在手术后不久出现新冠肺炎肺炎，胸部CT扫描有异常发现。常见症状有发热31例(91.2%)、乏力25例(73.5%)、干咳18例(52.9%)。15例(44.1%)患者在病情发展过程中需要进入重症监护病房(ICU)，7例(20.5%)患者在入院后死亡。与非ICU患者相比，ICU患者年龄更大，更有可能有潜在的合并症，经历了更困难的手术，以及更严重的实验室异常(如高白细胞、淋巴细胞减少)。死亡患者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。解释：在这项对34例确诊为新冠肺炎的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%。(C)2020年提交人(S)。爱思唯尔有限公司出版。
Background: 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.Methods: 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.Findings: 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.Interpretation: 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%. (C) 2020 The Author(s). Published by Elsevier Ltd.