COVID-19 risk in elective surgery during a second wave: a prospective cohort study

Area of Science:

• Infectious Diseases
• Surgical Oncology
• Epidemiology

Background:

• The COVID-19 pandemic significantly disrupted elective surgical procedures due to patient and healthcare worker safety concerns.
• Resuming elective surgeries hinges on understanding the prevalence and transmission of SARS-CoV-2 among surgical patients.

Purpose of the Study:

• To determine the prevalence of active SARS-CoV-2 infection in patients undergoing elective surgery during the second wave in Victoria.
• To assess the risk of SARS-CoV-2 transmission in the context of elective surgical care.

Main Methods:

• A prospective cohort study was conducted across eight Victorian hospitals from July to August 2020.
• Adult and pediatric patients scheduled for elective surgery under general anesthesia were enrolled.
• Preoperative SARS-CoV-2 polymerase chain reaction (PCR) testing was the primary outcome measure, with postoperative testing for negative preoperative cases.

Main Results:

• A total of 4965 patients were enrolled in the study.
• The Bayesian estimated prevalence of SARS-CoV-2 infection was 0.12% (95% PI 0-0.26%), with four patients testing positive.
• No healthcare worker infections were linked to elective surgery during the study period or the subsequent two weeks.

Conclusions:

• The prevalence of SARS-CoV-2 among asymptomatic elective surgical patients during the second wave was approximately 1 in 833.
• The low likelihood of transmission supports the recommencement of elective surgeries, considering current hospital capacity.
• Mandatory screening checklists for surgical patients are recommended to mitigate risks.