By Sola Ogundipe
A new study has shown that patients waiting for elective surgery should get COVID-19 vaccines ahead of the general population to avoid thousands of post-operative deaths linked to the virus.
The study funded by the NIHR for the COVIDSurg Collaborative international team of researchers, led by experts at the University of Birmingham, after studying data for 141,582 patients from across 1,667 hospitals in Nigeria and 115 other countries, found that between 0.6 per cent and 1.6 percent of patients develop COVID-19 infection after elective surgery.
The findings published in the BMJ and European Journal of Surgery) further noted that patients who develop COVID-19 infection are at between 4- and 8-fold increased risk of death in the 30 days following surgery.
“For example, whereas patients aged 70 years and over undergoing cancer surgery would usually have a 2.8 per cent mortality rate, this increases to 18.6 percent if they develop COVID-19 infection.
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“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 the over-70s and those undergoing surgery for cancer.
1,840 people aged 70 years and over in the general population need to be vaccinated to save one life over one year, this figure is only 351 in patients aged 70 years and over having cancer surgery.
Overall, the scientists estimate that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 COVID-19-related deaths in one year.”
The study also noted that 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.
Speaking, Co-lead author Mr Aneel Bhangu, from the University of Birmingham, said: “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.
“Many countries, particularly low- and middle-income countries, will not have widespread access to COVID vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at the highest risk of COVID-19 mortality. Our work can help to inform these decisions.”
Co-lead author Dr Dmitri Nepogodiev, from the University of Birmingham, commented: “Restarting elective surgery is a global priority. Over 15,000 surgeons and anesthetists from across 116 countries came together to contribute to this study, making it the largest ever scientific collaboration. It’s crucial that policymakers use the data we have collected to support a safe restart to elective surgery; COVID vaccination should be prioritised for elective surgery patients ahead of the general population.”
Also, Co-lead author and National lead for Nigeria Professor Adesoji Ademuyiwa from the Department of Surgery, College of Medicine, University of Lagos, added: “indeed vaccine supplies in LMICs are limited, but it is imperative to consider patients about to undergo elective surgery as a high-risk group for COVID vaccination.
He said during the first wave of the pandemic, up to 70 per cent 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, on-going 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 postoperative pulmonary complications – reducing intensive care use and overall healthcare costs.
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