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Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study

  • Authors:
    • Vasiliki Epameinondas Georgakopoulou
    • Dimitrios Basoulis
    • Pantazis M. Voutsinas
    • Chrysovalantis V. Papageorgiou
    • Irene Eliadi
    • Georgios Karamanakos
    • Demetrios A. Spandidos
    • Nikolaos Mathioudakis
    • Petros Papalexis
    • Stavros Papadakos
    • George Fotakopoulos
    • Kyriakos Tarantinos
    • Nikolaos V. Sipsas

  • View Affiliations

  • Published online on: September 27, 2022     https://doi.org/10.3892/etm.2022.11629
  • Article Number: 693

  • Copyright: © Georgakopoulou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The coronavirus disease 2019 (COVID‑19) pandemic is a significant global concern that has had major implications for the healthcare system. Patients with severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) undergoing elective or emergency surgical procedures have a substantial risk of mortality and peri‑operative complications. The present study aimed to describe the characteristics of patients who underwent elective surgery and developed nosocomial SARS‑CoV‑2 infection post‑surgery. Patients who underwent thoracic, upper and lower abdominal or peripheral elective surgery with a polymerase chain reaction diagnosis of COVID‑19, at 3‑7 days after the surgery, were enrolled in the present retrospective study. Demographics, vaccination status against SARS‑CoV‑2, Charlson comorbidity index (CCI) and laboratory data were recorded upon admission to the hospital unit. In total, 116 subjects (80 males, 36 females; mean age, 67.31±16.83 years) fulfilling the inclusion criteria were identified. Among the 116 participants, 14 (12.1%) were intubated. From the 116 individuals analyzed, 84 were alive after 30 days (survivors), and 32 had succumbed to the disease (non‑survivors). The mortality rate was 27.6% (32/116). The non‑survivors had an older age and a higher CCI score. At the evaluation upon admission to the hospital unit, the survivors presented with higher serum albumin levels and a higher number of blood lymphocytes. In addition, the survivors exhibited lower levels of lactate dehydrogenase, aspartate aminotransferase, alkaline phosphatase (ALP) and C‑reactive protein (CRP), as well as a higher neutrophil to lymphocyte ratio (NLR) and CRP to albumin ratio (CAR) (P<0.05). The patients that were intubated had higher levels of gamma glutamyl‑transferase (GGT), ALP and ferritin, as well as a higher NLR and platelet to lymphocyte ratio upon admission to the hospital unit (P<0.05). According to the Cox proportional hazards multivariate regression analysis, the only independent predictors of mortality and intubation were ALP and GGT upon admission, respectively (P<0.05). On the whole, the findings of the present study suggest that more stringent guidelines are required in order to prevent infection during the post‑operative period.
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November-2022
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Spandidos Publications style
Georgakopoulou VE, Basoulis D, Voutsinas PM, Papageorgiou CV, Eliadi I, Karamanakos G, Spandidos DA, Mathioudakis N, Papalexis P, Papadakos S, Papadakos S, et al: Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study. Exp Ther Med 24: 693, 2022.
APA
Georgakopoulou, V.E., Basoulis, D., Voutsinas, P.M., Papageorgiou, C.V., Eliadi, I., Karamanakos, G. ... Sipsas, N.V. (2022). Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study. Experimental and Therapeutic Medicine, 24, 693. https://doi.org/10.3892/etm.2022.11629
MLA
Georgakopoulou, V. E., Basoulis, D., Voutsinas, P. M., Papageorgiou, C. V., Eliadi, I., Karamanakos, G., Spandidos, D. A., Mathioudakis, N., Papalexis, P., Papadakos, S., Fotakopoulos, G., Tarantinos, K., Sipsas, N. V."Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study". Experimental and Therapeutic Medicine 24.5 (2022): 693.
Chicago
Georgakopoulou, V. E., Basoulis, D., Voutsinas, P. M., Papageorgiou, C. V., Eliadi, I., Karamanakos, G., Spandidos, D. A., Mathioudakis, N., Papalexis, P., Papadakos, S., Fotakopoulos, G., Tarantinos, K., Sipsas, N. V."Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study". Experimental and Therapeutic Medicine 24, no. 5 (2022): 693. https://doi.org/10.3892/etm.2022.11629