atients who contract covid before or after surgery have a “very high” risk of death, UK researchers revealed today.
The findings could have a major impact on the NHS’s ability to tackle a backlog of about two million people who have been unable to have operations during the pandemic.
This is because they found an ongoing need to maintain strict infection control procedures, limiting the number of patients that can be treated each day.
The research, led by experts at Queen Mary, University of London, found that “highly effective” precautions meant that fewer than one in 100 surgical patients in NHS hospitals in England had covid.
But where patients did contract the virus, whether at home or in hospital, the death rate increased from 0.8 per cent to 21.9 per cent.
When the “crude data” was adjusted to remove factors such as age, gender and comorbidities, it meant that those with the virus were almost six times more likely to die.
Professor Rupert Pearse, one of the authors and an intensive care consultant at Barts Health NHS Trust, said: “The work seems to suggest that the safety protocols have been very effective. But we don’t think they can be safely relaxed because those patients who do get covid are so much more likely to die.
“The NHS has got this huge challenge to clear a backlog of two million cases. The NHS can’t relax its safety precautions to clear those patients quickly.”
The study, in partnership with researchers in Swansea, looked at 1.97 million patients who underwent surgery between January and October last year. Of these, 11,940 developed covid. The period included many months where the NHS had limited capacity to test patients and staff.
A total of 2,618 of the covid patients died – 21.9 per cent – compared with 16,482 of the 1.96m non-covid patients, equal to 0.8 per cent.
Of patients undergoing “elective” or non-emergency surgery, the death rate was 8.1 per cent in those with covid and 0.1 per cent in the non-covid group.
For patients requiring emergency surgery, 2,466 of the 9,742 with covid died – 25.3 per cent. The death rate in emergency patients without covid was 3.5 per cent.
Prof Pearse said: “One in 16,556 people who have surgery will die from covid. That is a very reassuring number for anybody who is waiting for surgery.
“If you are just Joe Bloggs waiting for surgery, the risk of you dying from covid during that [pre- and post-operative] period was incredibly low.
“What we emphasise, though, is that the precautions to avoid getting covid at the time of surgery are incredibly important.”
The study, funded by Barts Charity, confirms earlier reports of high mortality rates in surgical patients with covid but is one of the first to compare outcomes with non-covid patients during the pandemic.
It is thought that about half of the expected 4.5 million expected surgical procedures in the English NHS were cancelled or postponed last year as resources were focused on covid patients.
The use of covid testing pre-surgery, requirement for patients to quarantine for 10 days prior to admission, the creation of “green zones” in hospitals to isolate covid-negative patients and the need for staff to don personal protective equipment have limited the spread of covid but have also reduced capacity.