BACKGROUND: Severe acute respiratory syndrome due to coronavirus 2 has rapidly spread worldwide in an unprecedented pandemic . Patients with an ongoing COVID-19 infection requiring surgery have higher risk of mortality and complications . This study describes the mortality and morbidity in patients with perioperative COVID-19 infection undergoing elective and emergency surgeries .

METHODS: Prospective cohort of consecutive patients who required a general, gastroesophageal, hepatobiliary, colorectal, or emergency surgery during COVID-19 pandemic at an academic teaching hospital . The primary outcome was 30-day mortality and major complications . Secondary outcomes were specific respiratory mortality and complications .

RESULTS: A total of 701 patients underwent surgery , 39 (5.6 %) with a perioperative COVID-19 infection . 30-day mortality was 12.8% and 1.4% in patients with and without COVID-19 infection, respectively (p <0.001). Major surgical complications occurred in 25.6% and 6.8% in patients with and without COVID-19 infection, respectively (p <0.001). Respiratory complications occurred in 30.8% and 1.4% in patients with and without COVID-19 infection, respectively (p <0.001). Mortality due to a respiratory complication was 100% and 11.1% in patients with and without COVID-19 infection, respectively (p <0.006).

CONCLUSIONS: 30-day mortality and surgical complications are higher in patients with perioperative COVID-19 infection. Indications for elective surgery need to be reserved for non-deferrable procedures in order to avoid unnecessary risks of non-urgent procedures.