Patients waiting for elective surgery should get COVID-19 vaccines ahead of the general population potentially helping to avoid thousands of post-operative deaths linked to the virus, according to a new global study conducted by the University of Birmingham.
The study evaluated data for 141,582 patients from across 1,667 hospitals in 116 countries – including Australia, Brazil, China, India, Japan, Nigeria, UAE, UK and USA – creating the world’s largest ever international study on surgery.
The study showed that between 0.6% and 1.6% of patients develop COVID-19 infection after elective surgery. Patients who develop COVID-19 infection are at a 4 to 8 fold increased risk of death in the 30 days following surgery.
Based on the high risks that surgical patients face, scientists calculate that vaccination of surgical patients is more likely to prevent COVID-19 related deaths than vaccines given to the population at large – particularly among those over 70 and those undergoing surgery for cancer.
The scientists estimate that global prioritisation of pre-operative vaccination for elective patients could prevent additional 58,687 COVID-19-related deaths in one year.
This could be particularly important for low- and middle-income countries (LMICs) where mitigation measures such as nasal swab screening and COVID-free surgical pathways, which can reduce the risk of complications related to the virus, are unlikely to be universally implemented, reveals the study.
During the first wave of the pandemic, up to 70% of elective surgeries were postponed, resulting in an estimated 28 million procedures being delayed or cancelled. Whilst surgery volumes have started to recover in many countries, ongoing disruption is likely to continue throughout 2021, particularly in the event of countries experiencing further waves of COVID-19. Vaccination is also likely to decrease post-operative pulmonary complications – reducing intensive care use and overall healthcare costs.
“Preoperative vaccination could support a safe re-start of elective surgery by significantly reducing the risk of COVID-19 complications in patients and preventing tens of thousands of COVID-19-related post-operative deaths,” commented co-lead author Aneel Bhangu, from the University of Birmingham,
“Many countries, particularly low- and middle-income countries, will not have widespread access to COVID-19 vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at highest risk of COVID-19 mortality. Our work can help to inform these decisions.”
“Restarting elective surgery is a global priority. Over 15,000 surgeons and anaesthetists from across 116 countries came together to contribute to this study, making it the largest ever scientific collaboration. It’s crucial that policy makers use the data we have collected to support a safe restart to elective surgery; COVID-19 vaccination should be prioritised for elective surgery patients ahead of the general population,” commented co-lead author Dr Dmitri Nepogodiev, from the University of Birmingham.