Does previous COVID-19 severity affect propofol sedation safety during ERCP?: A prospective observational study

Area of Science:

• Anesthesiology
• Pulmonology
• Infectious Diseases

Background:

• Propofol sedation for ERCP can cause respiratory and hemodynamic instability.
• Previous COVID-19 infection may impact sedation safety due to potential long-term pulmonary and cardiovascular effects.

Purpose of the Study:

• To evaluate the impact of COVID-19 infection severity on respiratory, hemodynamic, and recovery parameters during ERCP with propofol sedation.

Main Methods:

• Prospective observational study of 326 adult patients undergoing ERCP with propofol.
• Patients categorized as COVID-negative or COVID-positive (mild, moderate, severe).
• Primary outcome: hypoxemia; secondary outcomes: apnea, airway interventions, hemodynamic instability, recovery time, complications.

Main Results:

• No significant differences in hypoxemia or complications between COVID-negative and mild COVID-positive groups.
• Moderate-to-severe COVID-19 history linked to significantly higher rates of hypoxemia, apnea, airway interventions, vasopressor use, and prolonged recovery.
• History of moderate-to-severe COVID-19 identified as an independent risk factor for hypoxemia.

Conclusions:

• Patients with moderate-to-severe COVID-19 history are at increased risk for respiratory complications during propofol sedation for ERCP.
• Preoperative risk stratification should consider the severity of previous COVID-19 infection.