TIAN Wenxin , SUN Yaoguang , WU Qingjun , MA Chao , JIAO Peng , YU Hanbo , HUANG Chuan , LI Donghang , TIAN Yi , TONG Hongfeng
  • Department of Thoracic Surgery, Beijing Hospital, National Center of Gerontology , Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;
TONG Hongfeng, Email: georgetwx@163.com
COVID-19; lung surgery; perioperative complications
10.7507/1007-4848.202307052
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Objective  To evaluate the perioperative safety of lung surgery for patients with COVID-19. Method  We retrospectively analyzed the clinical data of the patients recovered from COVID-19 infection and received lung surgery from December 2022 to February 2023 in the Department of Thoracic Surgery at Beijing Hospital. Patients who performed lung surgery and without COVID-19 at the same time were selected as a control group. Perioperative data between the two groups were compared. Results  A total of 103 patients were included with 44 males and 49 females at average age of 62.2±2.1 years. All surgeries were performed by single-utility video-assisted thoracoscopic surgery (VATS). Among patients who recovered from COVID-19, 53 (51.5%) performed lobectomy, 30 (29.1%) performed segmentectomy, and 20 (19.4%) performed wedge resection. The interval between diagnosis of infection and lung surgery was less than 1 month in 32 (31.1%) patients, and more than 1 month in 71 (68.9%) patients. The results of nucleic acid test for all patients before surgery were negative. 13 (12.6%) patients had positive COVID-19 antibody of IgM, and 100 (97.1%) patients had positive IgG. A total of 20 patients experienced perioperative complications (13 patients with pulmonary air leakage, 3 with chylothorax, 2 with atrial fibrillation, and 2 patients with severe pulmonary complications). There was one perioperative death. Compared the patients who recovered from COVID-19 with those without COVID-19, there was no statistical difference in perioperative data including surgical duration, postoperative drainage, duration of thoracic tube, and duration of postoperative stay (P>0.05). There was no significant difference in perioperative complications between the two groups (P>0.05). Multivariable logistical regression analysis demonstrated that positive IgM before surgery (OR=7.319, 95%CI 1.669 to 32.103, P=0.008), and longer duration of surgery (OR=1.016, 95%CI 1.003 to 1.028, P=0.013) were independent risk factors of perioperative complications for patients who recovered from COVID-19. Conclusion  It is safe for patients recover from COVID-19 to receive lung surgery when symptoms disappeared and the nucleic acid test turned negative. However, positive COVID-19 IgM was an independent risk factor for perioperative complications. We suggest that lung surgery could be performed when the nucleic acid test and COVID-19 IgM were both negative for patients recover from COVID-19 infection.