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Impact of the COVID-19 Pandemic on the Outcomes of Patients Undergoing Oncological Surgeries: CORONAL Study

  • Global Health Services Research
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The impact of coronavirus disease 2019 (COVID-19) on postoperative recovery from oncology surgeries should be understood for the clinical decision-making. Therefore, this study was designed to evaluate the postoperative cumulative 28-day mortality and the morbidity of surgical oncology patients during the COVID-19 pandemic.

Methods

This retrospective cohort study included patients consecutively admitted to intensive care units (ICU) of three centres for postoperative care of oncologic surgeries between March to June 2019 (first phase) and March to June 2020 (second phase). The primary outcome was cumulative 28-day postoperative mortality. Secondary outcomes were postoperative organic dysfunction and the incidence of clinical complications. Because of the possibility of imbalance between groups, adjusted analyses were performed: Cox proportional hazards model (primary outcome) and multiple logistic regression model (secondary outcomes).

Results

After screening 328 patients, 291 were included. The proportional hazard of cumulative 28-day mortality was higher in the second phase than that in the first phase in the Cox model, with the adjusted hazard ratio of 4.35 (95% confidence interval [CI] 2.15–8.82). The adjusted incidences of respiratory complications (odds ratio [OR] 5.35; 95% CI 1.42–20.11) and pulmonary infections (OR 1.53; 95% CI 1.08–2.17) were higher in the second phase. However, the adjusted incidence of other infections was lower in the second phase (OR 0.78; 95% CI 0.67–0.91).

Conclusions

Surgical oncology patients who underwent postoperative care in the intensive care unit during the COVID-19 pandemic had higher hazard of 28-day mortality. Furthermore, these patients had higher odds of respiratory complications and pulmonary infections.

Trials registration The study is registered in the Brazilian Registry of Clinical Trials under the code RBR-8ygjpqm, UTN code U1111-1293-5414.

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Data availability

Data used in the analysis of the study may be made available through a request to the corresponding author.

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Acknowledgment

Authorship: FSLV: analysis and interpretation of data and writing of the manuscript; LLN: data acquisition and review of the manuscript for important scientific content; RT: data acquisition and review of the manuscript for important scientific content; APNJ: analysis and interpretation of data and review of the manuscript for important scientific content; JHFP: data acquisition and review of the manuscript for important scientific contents; RAJS: data acquisition and review of the manuscript for important scientific content; FPS: data acquisition and review of the manuscript for important scientific content; DR: data acquisition and review of the manuscript for important scientific content; BDBM: data acquisition and interpretation and review of the manuscript for important scientific content; LDD: data acquisition and interpretation and review of the manuscript for important scientific content; LMSM: data acquisition and interpretation and review of the manuscript for important scientific contents; URJ: data interpretation and review of the manuscript for important scientific content; and JMSJ: conception, design, data analysis and interpretation and writing of the manuscript. All authors approved the final manuscript and voted for publication. The study was not pre-registered in an independent registry.

Funding

The funding source had no role in the study design, conduction, or analysis. Funding was provided by A. C. Camargo Cancer Center, Faculdade de Medicina da Universidade de São Paulo, and Hospital de Câncer de Barretos.

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Authors and Affiliations

  1. Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

    Felipe Souza Lima Vianna MD, Luiz Marcelo Sá Malbouisson MD, Ulysses Ribeiro Jr. MD & João Manoel da Silva Jr. MD

  2. Hospital do Câncer de Barretos- Fundação Pio XII, Barretos, SP, Brazil

    Laura Leonardi Neves MD, João Henrique Ferdinando Peres MD, Rafael Ávila Justino da Silva MD, Fernanda de Paula Sales MD & João Manoel da Silva Jr. MD

  3. Fundação Antonio Prudente- A C Camargo Cancer Center, São Paulo, SP, Brazil

    Renato Testa MD & Antônio Paulo Nassar Jr. MD

  4. Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil

    Dante Raglione MD, Bruno Del Bianco Madureira MD, Luiz Dalfior Jr. MD, Luiz Marcelo Sá Malbouisson MD, Ulysses Ribeiro Jr. MD & João Manoel da Silva Jr. MD

  5. Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil

    Felipe Souza Lima Vianna MD & João Manoel da Silva Jr. MD

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  1. Felipe Souza Lima Vianna MD
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  2. Laura Leonardi Neves MD
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Correspondence to Felipe Souza Lima Vianna MD.

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Vianna, F.S.L., Neves, L.L., Testa, R. et al. Impact of the COVID-19 Pandemic on the Outcomes of Patients Undergoing Oncological Surgeries: CORONAL Study. Ann Surg Oncol 31, 3639–3648 (2024). https://doi.org/10.1245/s10434-024-15152-9

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