Favorable Postoperative Outcomes for Children with COVID-19 Infection Undergoing Surgical Intervention: Experience at a Free-Standing Children's Hospital
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Jan 2021 · 1 min read
In brief
In brief
Retrospective study of 66 children with confirmed preoperative COVID-19 undergoing surgery demonstrates favorable outcomes with low complication rates (7%), minimal ICU utilization (9%), and zero mortality. Findings contrast sharply with adult perioperative COVID-19 experience, supporting safe surgical intervention in pediatric patients with concurrent infection.
Written by the GCMD Library team from the article.
Abstract
Background
Current literature has shown that adult patients with perioperative Coronavirus Disease-2019 (COVID-19) have increased rates of postoperative morbidity and mortality. We hypothesized that children with COVID-19 have favorable postoperative outcomes compared to the reported adult experience.
Methods
We performed a retrospective cohort study for children with a confirmed preoperative COVID-19 diagnosis from April 1st, 2020 to August 15th, 2020 at a free-standing children's hospital. Primary outcomes evaluated were postoperative complications, readmissions, reoperations, and mortality within 30 days of operation. Secondary outcomes included hospital resource utilization, hospital length of stay, and postoperative oxygen support.
Results
A total of 66 children with preoperative confirmed COVID-19 were evaluated with median age of 9.5 years (interquartile range (IQR) 5–14) with 65% male and 70% Hispanic White. Sixty-five percent of patients had no comorbidities, with abdominal pain identified as the most common preoperative symptom (65%). Twenty-three percent of patients presented with no COVID-19 related symptoms. Eighty-two percent of patients had no preoperative chest imaging and 98% of patients did not receive preoperative oxygen support. General pediatric surgeons performed the majority of procedures (68%) with the most common diagnosis appendicitis (47%). Forty-one percent of patients were discharged the same day as surgery with 9% of patients utilizing postoperative intensive care unit resources and only 5% receiving postoperative invasive mechanical ventilation. Postoperative complications (7%), readmission (6%), and reoperation (6%) were infrequent, with no mortality.
Conclusion
COVID-19+ children requiring surgery have a favorable postoperative course and short-term outcomes compared to the reported adult experience.
Type of study
Prognosis Study.
Level of evidence
Level IV.