SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous

Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3–4.8), 3.9% (2.6–5.1) and 3.6% (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9– 2.1%)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS- CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS- CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

none10020SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.openNepogodiev, Dmitri; Simoes, Joana FF; Li, Elizabeth; Picciochi, Maria; Glasbey, James C; Baiocchi, Glauco; Blanco‐Colino, Ruth; Chaudhry, Daoud; AlAmeer, Ehab; El‐Boghdadly, Kariem; Wuraola, Funmilola; Ghosh, Dhruva; Gujjuri, Rohan R; Harrison, Ewen M; Lule, Herman; Kaafarani, Haytham; Khosravi, Mohammad; Kronberger, Irmgard; Leventoğlu, Sezai; Mann, Harvinder; Mclean, Kenneth A; Mengesha, Mengistu Gebreyohanes; Modolo, Maria Marta; Ntirenganya, Faustin; Norman, Lisa; Outani, Oumaima; Pius, Riinu; Pockney, Peter; Qureshi, Ahmad Uzair; Roslani, April Camilla; Satoi, Sohei; Shaw, Catherine; Bhangu, Aneel; Nepogodiev, Dmitri; Omar, Omar M; Ahmed, Waheed‐Ul‐Rahman; Argus, Leah; Ball, Alasdair; Bhangu, Aneel; Bywater, Edward P; Blanco‐Colino, Ruth; Brar, Amanpreet; Chaudhry, Daoud; Dawson, Brett E; Duran, Irani; Elhadi, Muhammed; Glasbey, James C; 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Perez Rivera, Carlos J; Hadzibegovic, Ana Danic; Kopjar, Tomislav; Mihanovic, Jakov; Jiménez, Pablo Mijahil Avilés; Gouvas, Nikolaos; Klat, Jaroslav; Novysedlák, René; Amisi, Nicolas; Christensen, Peter; El‐Hussuna, Alaa; Batista, Sylvia; Lincango‐Naranjo, Eddy; Emile, Sameh; Sandoval, Danilo Alfonso Arévalo; Dhufera, Hailu; Hailu, Samuel; Mengesha, Mengistu G; Kauppila, Joonas H; Arnaud, Alexis P; Demetrashvili, Zaza; Albertsmeier, Markus; Lederhuber, Hans; Löffler, Markus W.; Acquah, Daniel Kwesi; Ofori, Bernard; Tabiri, Stephen; Metallidis, Symeon; Tsoulfas, Georgios; Aguilera‐Arevalo, Maria‐Lorena; Recinos, Gustavo; Mersich, Tamás; Wettstein, Dániel; Ghosh, Dhruva; Kembuan, Gabriele; Milan, Peiman Brouki; Khosravi, Mohammad Hossein; Mozafari, Masoud; Hilmi, Ahmed; Mohan, Helen; Zmora, Oded; Gallo, Gaetano; Pata, Francesco; Pellino, Gianluca; Fujimoto, Yuki; Kuroda, Naoto; Satoi, Sohei; Abou Chaar, Mohamad K.; Ayasra, Faris; Fakhradiyev, Ildar; Hamdun, Intisar Hisham Said; Jin‐Young, Jang; Jamal, Mohammad; Karout, Lina; Elhadi, Muhammed; Gulla, Aiste; Rasoaherinomenjanahary, Fanjandrainy; Samison, Luc Hervé; Roslani, April Camilla; Sánchez, Iran Irani Durán; Gonzalez, Diana Samantha; Martinez, Laura; Martínez, María José; Nayen, Alejandra; Medina, Antonio Ramos‐De; Nunez, Jade; Outani, Oumaima; Nashidengo, Pueya Rashid; Shah, Rakesh; Shrestha, Ashish Lal; Jonker, Pascal; Kruijff, Schelto; Noltes, Milou; Steinkamp, Pieter; Varghese, Chris; Wright, Deborah; Abdur‐Rahman, Lukman; Ademuyiwa, Adesoji; Adisa, Adewale; Osinaike, Babatunde; Seyi‐Olajide, Justina; Williams, Omolara; Williams, Emmanuel; Pejkova, Sofija; Al Balushi, Zainab; Qureshi, Ahmad Uzair; Sayyed, Raza; Mohsen, Mustafa Abo; Abukhalaf, Sadi A.; Cukier, Moises; Gomez‐Fernandez, Hugo; Yip, Sebastian Shu; Ojeda, Ximena Paola Vasquez; Sacdalan, Marie Dione; Major, Piotr; Azevedo, José; Cunha, Miguel F.; Santos, Irène; Zarour, Ahmad; Bonci, Eduard‐Alexandru; Negoi, Ionut; Efetov, Sergey; Kochetkov, Viktor; Litvin, Andrey; Ingabire, Jc Allen; Bucyibaruta, Georges; Faustin, Ntirenganya; Habumuremyi, Sosthene; Imanishimwe, Alphonsine; Dieu, Haragirimana Jean; Munyaneza, Emmanuel; Ncogoza, Isaie; Alameer, Ehab; Ndong, Abdourahmane; Radenkovic, Dejan; Chew, Min Hoe; Koh, Frederick; Ngu, James; Panyko, Arpád; Bele, Uros; Košir, Jurij Aleš; Daoud, Hassan; Blanco‐Colino, Ruth; Bravo, Ana Maria Minaya; Jayarajah, Umesh; Wickramasinghe, Dakshitha; Adam, Mohammed Elmujtba Adam Essa; Rutegård, Martin; Sund, Malin; Adamina, Michel; Gialamas, Eleftherios; Horisberger, Karoline; Alshaar, Muhammad; Huang, Abel; Lohsiriwat, Varut; Charles, Shane; Jlassi, Haithem; Isik, Arda; Leventoğlu, Sezai; Lekuya, Hervé Monka; Lekuya, Hervé Monka; Lule, Herman; Kopetskyi, Slava; Alsaadi, Hayder; Alshryda, Sattar; Alser, Osaid; Bankhead‐Kendall, Brittany; Breen, Kerry; Kaafarani, Haytham; Mashbari, Hassan; Cal, Fernando Bonilla; Al‐Naggar, Hamza; Maimbo, Mayaba; Mazingi, Dennis; Abbott, Tom; Adamina, Michel; Akhbari, Melika; Benson, Ruth; Bhanderi, Shivam; Biccard, Bruce; Caruana, Edward; Chakrabortee, Sohini; Chapatwala, Reema; Costas‐Chavarri, Ainhoa; Demetriades, Andreas K; Desai, Anant; Di Saverio, Salomone; Drake, Thomas; Edwards, John; Evans, Jonathan; Fiore, Marco; Ford, Samuel; Fotopoulou, Christina; Fowler, Alexander; Futaba, Kaori; Ganly, Ian; James, Harelimana Grace; Griffiths, Ewen; Gronchi, Alessandro; Hutchinson, Peter; Hyman, Gabriella Yael; Incorvia, Joseph; Jain, Ritu; Jenkinson, Michael; Khan, Tabassum; Knight, Stephen Richard; Kolias, Angelos; Kudsk‐Iversen, Søren; Kwan, Tsun Yu; Leung, Elaine; Mayol, Julio; McKay, Siobhan; Meara, John G.; Mills, Emily; Moug, Susan; Patel, Akshay; Perinotti, Roberto; Rice, Henry E.; Roberts, Keith; Schache, Andrew; Shaw, Richard; Smart, Neil; Stephens, Matthew; Stewart, Grant D.; Teasdale, Ella; Vaughan‐Shaw, Peter; Vidya, Raghavan; Wright, Naomi; Wuraola, Funmilola; Zimmelman, Natalie; Agastra, Ervis; Thereska, Dariel; Dajti, Irida; Lucchini, Sergio Martin; Laudani, Veronica; Boccalatte, Luis; Chwat, Carina; Salazar, Ivana Ines Pedraza; Pantoja Pachajoa, Diana Alejandra; Lucchini, Sergio Martin; Duro, Agustin; Arancibia, José Alfredo Calderón; Cox, Daniel; D’Aulerio, Giuliana; Dudi‐Venkata, Nagendra; Egoroff, Natasha; Farik, Shebani; Lott, Natalie; Moss, Jana‐Lee; Rennie, Sarah; Tan, Lorwai; Varghese, Chris; Vo, Uyen Giao; Watson, David; Watters, David; Wright, Deborah; Bright, Tim; Hollington, Paul; Zhou, Xuanyu; Kroon, Hidde M; Farfus, Anthony; Barker, John; Watson, Eleanor; Stevens, Sean; Latif, Haider; Dawson, Amanda Caroline; Chuan, Alwin; Muralidharan, Vijayaragavan; Wong, Enoch; Ackermann, Travis; Pacilli, Maurizio; Hodgson, Russell; Heriot, Alexander; Choong, Peter; Brown, Wendy; Lidder, Surjit; Yeung, Justin; Traeger, Luke; Regalo, Guillermo; Gourlay, Ralph; Pockney, Peter; Pockney, Peter; Badiani, Sarit; Koh, Cherry; Putnis, Soni; Dawson, Amanda Caroline; Haider, Fayza; Mitul, Ashrarur Rahman; Komen, Niels; Dhondt, Bert; Cappeliez, Serge; Pigeolet, Manon; Ramshorst, Gabrielle; Schoneveld, Martijn; Stijns, Jasper; Oosterlinck, Wouter; Flamey, Nicolas; Kpangon, Cyrille; Agbadebo, Mouhamed; Tobome, Smèvo Romaric; Lawani, Ismaïl; Cerovac, Anis; Barros, Aldo Vieira; Júnior, Samuel Aguiar; Baiocchi, Glauco; Amaral Campos, Heloisa Galvão; Gross, Jefferson; Coimbra, Felipe José Fernandez; Kowalski, Luiz Paulo; Makdissi, Fabiana; Nakagawa, Suely; Neto, Joao Pedreira Duprat; Vartanian, Jose Guilherme; Yazbek, Guilherme; Zequi, Stenio C; Flumignan, Ronald; Slavchev, Mihail; Jaworska, Natalia; Dell, Angela; Shanthanna, Harsha; Martin, Janet; Behzadi, Abdollah; Nessim, Carolyn; Mozel, Michelle; St‐germain, Pascal; Russell, Crispin; Groot, Gary; Safieddine, Najib; Wijeysundera, Duminda; Eskander, Antoine; Chadi, Sami; MacKenzie, Shawn; Flexman, Alana; Heredia, Fernando; Modolo, Maria Marta; Villanueva, Julio; Waissbluth, Sofia; Macchiavello, Roberto; Escudero, Mario I; Fuentes, Tyare; Mimica, Ximena; Olivos, Maricarmen; Saenz, Dinimo Bolivar; Caicedo, Lina; Alzate, Juan Pablo; Luna, Joaquin; Alonso, Nestor Fabian Pedraza; Silva, Camilo Ortiz; Perez Rivera, Carlos J; Rodriguez, Juliana; Silva‐Igua, Liliana; Torres, Martha Luz; Trujillo, Lina María; Calvache, Albaro José Nieto; Balanta‐Melo, Julián; Figueroa‐Casanova, Rafael; García‐Montoya, Oscar‐Julián; Toro, Carlos Andres Marulanda; Botero, Marcela Velez; Arango, Maria Clara Mendoza; Martinez, Eneida Diaz; Perdomo, Valentina Gutiérrez; Calvache, Jose Andres; Calvache, Jose Andres; Montenegro, Emileth; Mihanovic, Jakov; Jiménez, Pablo Mijahil Avilés; Gouvas, Nikolaos; Novysedlák, René; Rodriguez‐Abreu, Julia; Mejía, Dolores; Lincango‐Naranjo, Eddy; Abouelnagah, Galal; Shehata, Sameh; Rida, Ahmed Hossam Eldin Fouad; Hassan, Ramy A.; Saad, Mahmoud M.; Loaloa, Mohamed Reda; Mostafa, Badr; Qassem, Mohamed; Fahmy, Mohamed; Abozied, Hesham; Azzam, Ahmed Y; Ghozy, Sherief; Sallam, Asser; Shehta, Ahmed; Emile, Sameh; Abdelkhalek, Mohamed; Samaka, Rehab; Morsy, Amr; Sherif, Ahmed Elshawadfy; Sandoval, Danilo Alfonso Arévalo; Negussie, Abraham; Fisseha, Tigist; Shumbash, Kibruyisfaw; Abebe, Metasebia; Hailu, Samuel; Yasin, Seid Mohammed; Akililu, Yemisirach Bizuneh; Megersa, Abebe; Tefera, Teshome; Assefa, Melatework; Atnafu, Bahru; Tsegaye, Bereket; Bezabih, Yoseph Solomon; Sisay, Silamlak; Bekele, Kebebe; Jira, Moa; Mengesha, Mengistu G; Derilo, Habtamu; Degefa, Eyueal; Tadesse, Anteneh; Nidaw, Melkamu; Sarjanoja, Elise; Kauppila, Joonas H; Testelin, Sylvie; Boucher, Sophie; Jouffret, Lionel; Lakkis, Zaher; Le Bian, Alban Zarzavadjian; Harper, Luke; Déserts, Marc Danguy; André, Benoît; Slim, Karem; Verhaeghe, Romain; Police, Andrea; Girard, Edouard; Chebaro, Alexandre; Nkembi, Armande Subayi; Arnalsteen, Laurent; Ballouhey, Quentin; Mege, Diane; Jeandel, Clement; Duchalais, Emilie; Bouche, Pierre‐Alban; Manceau, Gilles; Crétolle, Célia; Hervieux, Erik; Girard, Noémie; Seguin‐Givelet, Agathe; Gaujoux, Sebastien; De Simone, Belinda; Boisson, Matthieu; Bergeat, Damien; Arnaud, Alexis P; Fredon, Fabien; Nappi, Francesco; Kassir, Radwan; Scalabre, Aurélien; Migliorelli, Federico; Verhaeghe, Romain; Ezanno, Anne‐Cecile; Seeliger, Barbara; Vaysse, Charlotte; Charbonneau, Helene; Misrai, Vincent; Abbo, Olivier; Angeles, Martina Aida; Brunaud, Laurent; Demetrashvili, Zaza; Modabber, Ali; Wolf, Sebastian; Kamphues, Carsten; Höhn, Philipp; Glowka, Tim R.; Rokohl, Alexander Christopher; Bork, Ulrich; Fluegen, Georg; Horch, Raymund E.; Schmedding, Andrea; Schnitzbauer, Andreas; Eberbach, Helge; Schlager, Daniel; Spelsberg, Fritz; Keppler, Lena; Hecker, Andreas; Wolfer, Susanne; Ronellenfitsch, Ulrich; Nitschke, Christine; Peiper, Christian; Hakami, Ibrahim; Welter, Stefan; Nikolaieva, Karine; Roth, Andreas; Lindert, Judith; Gousias, Konstantinos; Rissmann, Anke; Linz, Valerie Catherine; Rahbari, Nuh; Rassweiler‐Seyfried, Marie‐Claire; Gut, Anna Eleonora; Gempt, Jens; Reim, Daniel; Wagner, Arthur; Albertsmeier, Markus; Keppler, Alexander M.; Stoleriu, Mircea Gabriel; Saier, Tim; Stadler, Josef; Kaiser, Julia Christina; Brunner, Stefan M.; Pfister, Karin; Herzberg, Jonas; Nowak, Kai; Reinhard, Tobias; Stavrou, Gregor A.; Königsrainer, Alfred; Konrads, Christian; Quante, Markus; Laban, Simon; Pusch, Silke; Hirschburger, Markus; Doerner, Johannes; Wiegering, Armin; Tampaki, Ekaterini Christina; Ruiz, Alitza Gutiérrez; Rodas, Alejandra; Portilla, Ana Lucía; Recinos, Gustavo; Aguilera‐Arevalo, Maria‐Lorena; Carrera, Jacqueline; Duarte, Amalia Barrios; Lowey, Megan; Barillas, Sabrina; Suroy, Atul; Vaishnav, Dhaivat; Chowdappa, Raghunandan Gorantlu; Madabhavi, Irappa; Bhat, Dhananjaya; Venkatappa, Sunil Kumar; Thakar, Sumit; Jain, Kavitha; Kumar, Aruna; Nagar, Manoj; Mishra, Tushar; Sekar, Arunkumar; Gupta, Anand; Kaman, Lileswar; Karthigeyan, Madhivanan; Tripathi, Manjul; Rammohan, Ashwin; Vayoth, Sudheer Othiyil; Rajanbabu, Anupama; Subbian, Anbukkani; Gupta, Rahul; Raut, Monish; Evelyn, Nissi; Kannaiyan, R Lavanya; Matai, Anil; Misra, Sanjeev; Bhende, Vishal; Muthu, Sathish; Ghosh, Indranil; Sharma, Abhishek; Bajaj, Ankur; Rajan, Shiv; Agarwal, Gaurav; Pawar, Pranay; Alexander, Philip; Vijayakumar, M Vijayakumar; Hameed, Zeeshan; Badareesh, L; Chaudhry, Navneet Kumar; Baliarsing, Lipika; Dharap, Satish; Kulkarni, Amruta; Thyavihally, Yuvaraja; Sharma, Rahul Deo; Pramesh, C S; Soni, Rajesh; Dube, Surya Kumar; Sharma, Shilpa; Singh, Harvinder; Bains, Lovenish; Ghodke, Rahul; Kumar, Ashwani; Sodhai, Vivek; Maji, Suvendu; Basu, Somprakas; Mahakalkar, Chandrashekhar; Kannan, Ravi; Mehraj, Asif; Ranganath, N; Phadnis, Ashish; Yadev, I; Kavalakat, Alfie; Mittal, Rohin; Vallam, Karthik Chandra; Akhavizadegan, Hamed; Maleki, Esmaeil Rezghi; Kandevani, Naser Yousefzadeh; Ikele, Hilary; McNestry, Catherine; Fleming, Christina; O’Brien, Stephen; Elwahab, Sami Abd; Davis, Niall; Javadpour, Mohsen; McDonnell, Brendan; Connor, Clare O; Bolger, Jarlath; Clancy, Cillian; Croghan, Stefanie M; Donlon, Noel; Cullinane, Carolyn; Creavin, Ben; Muheilan, Muheilan; Earley, Helen; Kabir, Syed Mohammad Umar; Fahadullah, Muhammad; 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Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

32324restrictedrestrictedDmitri Nepogodiev; Joana Ff Simoes; Elizabeth Li; Maria Picciochi; James C Glasbey; Glauco Baiocchi; Ruth Blanco-Colino; Daoud Chaudhry; Ehab AlAmeer; Kariem El-Boghdadly; Funmilola Wuraola; Dhruva Ghosh; Rohan R Gujjuri; Ewen M Harrison; Herman Lule; Haytham Kaafarani; Mohammad Khosravi; Irmgard Kronberger; Sezai Leventoğlu; Harvinder Mann; Kenneth A Mclean; Mengistu Gebreyohanes Mengesha; Maria Marta Modolo; Faustin Ntirenganya; Lisa Norman; Oumaima Outani; Riinu Pius; Peter Pockney; Ahmad Uzair Qureshi; April Camilla Roslani; Sohei Satoi; Catherine Shaw; Aneel Bhangu; Dmitri Nepogodiev; Omar M Omar; Waheed-Ul-Rahman Ahmed; Leah Argus; Alasdair Ball; Aneel Bhangu; Edward P Bywater; Ruth Blanco-Colino; Amanpreet Brar; Daoud Chaudhry; Brett E Dawson; Irani Duran; Muhammed Elhadi; James C Glasbey; Rohan R Gujjuri; Conor S Jones; Ewen M Harrison; Sivesh K Kamarajah; James M Keatley; Samuel Lawday; Elizabeth Li; Harvinder Mann; Ella J Marson; Kenneth A Mclean; Dmitri Nepogodiev; Lisa Norman; Riinu Ots; Oumaima Outani; Maria Picciochi; Irène Santos; Catherine Shaw; Joana Ff Simoes; Elliott H Taylor; Isobel M Trout; Chris Varghese; Mary L Venn; William Xu; Joana Ff Simoes; Irida Dajti; Arben Gjata; Salah Eddine Oussama Kacimi; Luis Boccalatte; Maria Marta Modolo; Daniel Cox; Peter Pockney; Philip Townend; Felix Aigner; Irmgard Elisabeth Kronberger; Elgun Samadov; Amer Alderazi; Kamral Hossain; Greg Padmore; Gabrielle van Ramshorst; Ismaïl Lawani; Anis Cerovac; Samir Delibegovic; Glauco Baiocchi; Gustavo Mendonça Ataíde Gomes; Igor Lima Buarque; Muhammad Gohar; Mihail Slavchev; Chukwuemeka Nwegbu; Arnav Agarwal; Amanpreet Brar; Janet Martin; Joshua Ng-Kamstra; Maria Marta Modolo; Maricarmen Olivos; Wenhui Lou; Dong-Lin Ren; Jose Andres Calvache; Carlos J Perez Rivera; Ana Danic Hadzibegovic; Tomislav Kopjar; Jakov Mihanovic; Pablo Mijahil Avilés Jiménez; Nikolaos Gouvas; Jaroslav Klat; René Novysedlák; Nicolas Amisi; Peter Christensen; Alaa El-Hussuna; Sylvia Batista; Eddy Lincango-Naranjo; Sameh Emile; Danilo Alfonso Arévalo Sandoval; Hailu Dhufera; Samuel Hailu; Mengistu G Mengesha; Joonas H Kauppila; Alexis P Arnaud; Zaza Demetrashvili; Markus Albertsmeier; Hans Lederhuber; Markus W Löffler; Daniel Kwesi Acquah; Bernard Ofori; Stephen Tabiri; Symeon Metallidis; Georgios Tsoulfas; Maria-Lorena Aguilera-Arevalo; Gustavo Recinos; Tamás Mersich; Dániel Wettstein; Dhruva Ghosh; Gabriele Kembuan; Peiman Brouki Milan; Mohammad Hossein Khosravi; Masoud Mozafari; Ahmed Hilmi; Helen Mohan; Oded Zmora; Gaetano Gallo; Francesco Pata; Gianluca Pellino; Yuki Fujimoto; Naoto Kuroda; Sohei Satoi; Mohamad K Abou Chaar; Faris Ayasra; Ildar Fakhradiyev; Intisar Hisham Said Hamdun; Jang Jin-Young; Mohammad Jamal; Lina Karout; Muhammed Elhadi; Aiste Gulla; Fanjandrainy Rasoaherinomenjanahary; Luc Hervé Samison; April Camilla Roslani; Iran Irani Durán Sánchez; Diana Samantha Gonzalez; Laura Martinez; María José Martínez; Alejandra Nayen; Antonio Ramos-De la Medina; Jade Nunez; Oumaima Outani; Pueya Rashid Nashidengo; Rakesh Shah; Ashish Lal Shrestha; Pascal Jonker; Schelto Kruijff; Milou Noltes; Pieter Steinkamp; Chris Varghese; Deborah Wright; Lukman Abdur-Rahman; Adesoji Ademuyiwa; Adewale Adisa; Babatunde Osinaike; Justina Seyi-Olajide; Omolara Williams; Emmanuel Williams; Sofija Pejkova; Zainab Al Balushi; Ahmad Uzair Qureshi; Raza Sayyed; Mustafa Abo Mohsen; Sadi A Abukhalaf; Moises Cukier; Hugo Gomez-Fernandez; Sebastian Shu Yip; Ximena Paola Vasquez Ojeda; Marie Dione Sacdalan; Piotr Major; José Azevedo; Miguel F Cunha; Irène Santos; Ahmad Zarour; Eduard-Alexandru Bonci; Ionut Negoi; Sergey Efetov; Viktor Kochetkov; Andrey Litvin; Jc Allen Ingabire; Georges Bucyibaruta; Ntirenganya Faustin; Sosthene Habumuremyi; Alphonsine Imanishimwe; Haragirimana Jean de Dieu; Emmanuel Munyaneza; Isaie Ncogoza; Ehab Alameer; Abdourahmane Ndong; Dejan Radenkovic; Min Hoe Chew; Frederick Koh; James Ngu; Arpád Panyko; Uros Bele; Jurij Aleš Košir; Hassan Daoud; Ruth Blanco-Colino; Ana Maria Minaya Bravo; Umesh Jayarajah; Dakshitha Wickramasinghe; Mohammed Elmujtba Adam Essa Adam; Martin Rutegård; Malin Sund; Michel Adamina; Eleftherios Gialamas; Karoline Horisberger; Muhammad Alshaar; Abel Huang; Varut Lohsiriwat; Shane Charles; Haithem Jlassi; Arda Isik; Sezai Leventoğlu; Hervé Monka Lekuya; Hervé Monka Lekuya; Herman Lule; Slava Kopetskyi; Hayder Alsaadi; Sattar Alshryda; Osaid Alser; Brittany Bankhead-Kendall; Kerry Breen; Haytham Kaafarani; Hassan Mashbari; Fernando Bonilla Cal; Hamza Al-Naggar; Mayaba Maimbo; Dennis Mazingi; Tom Abbott; Michel Adamina; Melika Akhbari; Ruth Benson; Shivam Bhanderi; Bruce Biccard; Edward Caruana; Sohini Chakrabortee; Reema Chapatwala; Ainhoa Costas-Chavarri; Andreas K Demetriades; Anant Desai; Salomone Di Saverio; Thomas Drake; John Edwards; Jonathan Evans; Marco Fiore; Samuel Ford; Christina Fotopoulou; Alexander Fowler; Kaori Futaba; Ian Ganly; Harelimana Grace James; Ewen Griffiths; Alessandro Gronchi; Peter Hutchinson; Gabriella Yael Hyman; Joseph Incorvia; Ritu Jain; Michael Jenkinson; Tabassum Khan; Stephen Richard Knight; Angelos Kolias; Søren Kudsk-Iversen; Tsun Yu Kwan; Elaine Leung; Julio Mayol; Siobhan McKay; John G Meara; Emily Mills; Susan Moug; Akshay Patel; Roberto Perinotti; Henry E Rice; Keith Roberts; Andrew Schache; Richard Shaw; Neil Smart; Matthew Stephens; Grant D Stewart; Ella Teasdale; Peter Vaughan-Shaw; Raghavan Vidya; Naomi Wright; Funmilola Wuraola; Natalie Zimmelman; Ervis Agastra; Dariel Thereska; Irida Dajti; Sergio Martin Lucchini; Veronica Laudani; Luis Boccalatte; Carina Chwat; Ivana Ines Pedraza Salazar; Diana Alejandra Pantoja Pachajoa; Sergio Martin Lucchini; Agustin Duro; José Alfredo Calderón Arancibia; Daniel Cox; Giuliana D'Aulerio; Nagendra Dudi-Venkata; Natasha Egoroff; Shebani Farik; Natalie Lott; Jana-Lee Moss; Sarah Rennie; Lorwai Tan; Chris Varghese; Uyen Giao Vo; David Watson; David Watters; Deborah Wright; Tim Bright; Paul Hollington; Xuanyu Zhou; Hidde M Kroon; Anthony Farfus; John Barker; Eleanor Watson; Sean Stevens; Haider Latif; Amanda Caroline Dawson; Alwin Chuan; Vijayaragavan Muralidharan; Enoch Wong; Travis Ackermann; Maurizio Pacilli; Russell Hodgson; Alexander Heriot; Peter Choong; Wendy Brown; Surjit Lidder; Justin Yeung; Luke Traeger; Guillermo Regalo; Ralph Gourlay; Peter Pockney; Peter Pockney; Sarit Badiani; Cherry Koh; Soni Putnis; Amanda Caroline Dawson; Fayza Haider; Ashrarur Rahman Mitul; Niels Komen; Bert Dhondt; Serge Cappeliez; Manon Pigeolet; Gabrielle van Ramshorst; Martijn Schoneveld; Jasper Stijns; Wouter Oosterlinck; Nicolas Flamey; Cyrille Kpangon; Mouhamed Agbadebo; Sèmèvo Romaric Tobome; Ismaïl Lawani; Anis Cerovac; Aldo Vieira Barros; Samuel Aguiar Júnior; Glauco Baiocchi; Heloisa Galvão do Amaral Campos; Jefferson Gross; Felipe José Fernandez Coimbra; Luiz Paulo Kowalski; Fabiana Makdissi; Suely Nakagawa; Joao Pedreira Duprat Neto; Jose Guilherme Vartanian; Guilherme Yazbek; Stenio C Zequi; Ronald Flumignan; Mihail Slavchev; Natalia Jaworska; Angela Dell; Harsha Shanthanna; Janet Martin; Abdollah Behzadi; Carolyn Nessim; Michelle Mozel; Pascal St-Germain; Crispin Russell; Gary Groot; Najib Safieddine; Duminda Wijeysundera; Antoine Eskander; Sami Chadi; Shawn MacKenzie; Alana Flexman; Fernando Heredia; Maria Marta Modolo; Julio Villanueva; Sofia Waissbluth; Roberto Macchiavello; Mario I Escudero; Tyare Fuentes; Ximena Mimica; Maricarmen Olivos; Dinimo Bolivar Saenz; Lina Caicedo; Juan Pablo Alzate; Joaquin Luna; Nestor Fabian Pedraza Alonso; Camilo Ortiz Silva; Carlos J Perez Rivera; Juliana Rodriguez; Liliana Silva-Igua; Martha Luz Torres; Lina María Trujillo; Albaro José Nieto Calvache; Julián Balanta-Melo; Rafael Figueroa-Casanova; Oscar-Julián García-Montoya; Carlos Andres Marulanda Toro; Marcela Velez Botero; Maria Clara Mendoza Arango; Eneida Diaz Martinez; Valentina Gutiérrez Perdomo; Jose Andres Calvache; Jose Andres Calvache; Emileth Montenegro; Jakov Mihanovic; Pablo Mijahil Avilés Jiménez; Nikolaos Gouvas; René Novysedlák; Julia Rodriguez-Abreu; Dolores Mejía; Eddy Lincango-Naranjo; Galal Abouelnagah; Sameh Shehata; Ahmed Hossam Eldin Fouad Rida; Ramy A Hassan; Mahmoud M Saad; Mohamed Reda Loaloa; Badr Mostafa; Mohamed Qassem; Mohamed Fahmy; Hesham Abozied; Ahmed Y Azzam; Sherief Ghozy; Asser Sallam; Ahmed Shehta; Sameh Emile; Mohamed Abdelkhalek; Rehab Samaka; Amr Morsy; Ahmed Elshawadfy Sherif; Danilo Alfonso Arévalo Sandoval; Abraham Negussie; Tigist Fisseha; Kibruyisfaw Shumbash; Metasebia Abebe; Samuel Hailu; Seid Mohammed Yasin; Yemisirach Bizuneh Akililu; Abebe Megersa; Teshome Tefera; Melatework Assefa; Bahru Atnafu; Bereket Tsegaye; Yoseph Solomon Bezabih; Silamlak Sisay; Kebebe Bekele; Moa Jira; Mengistu G Mengesha; Habtamu Derilo; Eyueal Degefa; Anteneh Tadesse; Melkamu Nidaw; Elise Sarjanoja; Joonas H Kauppila; Sylvie Testelin; Sophie Boucher; Lionel Jouffret; Zaher Lakkis; Alban Zarzavadjian Le Bian; Luke Harper; Marc Danguy des Déserts; Benoît André; Karem Slim; Romain Verhaeghe; Andrea Police; Edouard Girard; Alexandre Chebaro; Armande Subayi Nkembi; Laurent Arnalsteen; Quentin Ballouhey; Diane Mege; Clement Jeandel; Emilie Duchalais; Pierre-Alban Bouche; Gilles Manceau; Célia Crétolle; Erik Hervieux; Noémie Girard; Agathe Seguin-Givelet; Sebastien Gaujoux; Belinda De Simone; Matthieu Boisson; Damien Bergeat; Alexis P Arnaud; Fabien Fredon; Francesco Nappi; Radwan Kassir; Aurélien Scalabre; Federico Migliorelli; Romain Verhaeghe; Anne-Cecile Ezanno; Barbara Seeliger; Charlotte Vaysse; Helene Charbonneau; Vincent Misrai; Olivier Abbo; Martina Aida Angeles; Laurent Brunaud; Zaza Demetrashvili; Ali Modabber; Sebastian Wolf; Carsten Kamphues; Philipp Höhn; Tim R Glowka; Alexander Christopher Rokohl; Ulrich Bork; Georg Fluegen; Raymund E Horch; Andrea Schmedding; Andreas Schnitzbauer; Helge Eberbach; Daniel Schlager; Fritz Spelsberg; Lena Keppler; Andreas Hecker; Susanne Wolfer; Ulrich Ronellenfitsch; Christine Nitschke; Christian Peiper; Ibrahim Hakami; Stefan Welter; Karine Nikolaieva; Andreas Roth; Judith Lindert; Konstantinos Gousias; Anke Rissmann; Valerie Catherine Linz; Nuh Rahbari; Marie-Claire Rassweiler-Seyfried; Anna Eleonora Gut; Jens Gempt; Daniel Reim; Arthur Wagner; Markus Albertsmeier; Alexander M Keppler; Mircea Gabriel Stoleriu; Tim Saier; Josef Stadler; Julia Christina Kaiser; Stefan M Brunner; Karin Pfister; Jonas Herzberg; Kai Nowak; Tobias Reinhard; Gregor A Stavrou; Alfred Königsrainer; Christian Konrads; Markus Quante; Simon Laban; Silke von Pusch; Markus Hirschburger; Johannes Doerner; Armin Wiegering; Ekaterini Christina Tampaki; Alitza Gutiérrez Ruiz; Alejandra Rodas; Ana Lucía Portilla; Gustavo Recinos; Maria-Lorena Aguilera-Arevalo; Jacqueline Carrera; Amalia Barrios Duarte; Megan Lowey; Sabrina Barillas; Atul Suroy; Dhaivat Vaishnav; Raghunandan Gorantlu Chowdappa; Irappa Madabhavi; Dhananjaya Bhat; Sunil Kumar Venkatappa; Sumit Thakar; Kavitha Jain; Aruna Kumar; Manoj Nagar; Tushar Mishra; Arunkumar Sekar; Anand Gupta; Lileswar Kaman; Madhivanan Karthigeyan; Manjul Tripathi; Ashwin Rammohan; Sudheer Othiyil Vayoth; Anupama Rajanbabu; Anbukkani Subbian; Rahul Gupta; Monish Raut; Nissi Evelyn; R Lavanya Kannaiyan; Anil Matai; Sanjeev Misra; Vishal Bhende; Sathish Muthu; Indranil Ghosh; Abhishek Sharma; Ankur Bajaj; Shiv Rajan; Gaurav Agarwal; Pranay Pawar; Philip Alexander; M Vijayakumar Vijayakumar; Zeeshan Hameed; L Badareesh; Navneet Kumar Chaudhry; Lipika Baliarsing; Satish Dharap; Amruta Kulkarni; Yuvaraja Thyavihally; Rahul Deo Sharma; C S Pramesh; Rajesh Soni; Surya Kumar Dube; Shilpa Sharma; Harvinder Singh; Lovenish Bains; Rahul Ghodke; Ashwani Kumar; Vivek Sodhai; Suvendu Maji; Somprakas Basu; Chandrashekhar Mahakalkar; Ravi Kannan; Asif Mehraj; N Ranganath; Ashish Phadnis; I Yadev; Alfie Kavalakat; Rohin Mittal; Karthik Chandra Vallam; Hamed Akhavizadegan; Esmaeil Rezghi Maleki; Naser Yousefzadeh Kandevani; Hilary Ikele; Catherine McNestry; Christina Fleming; Stephen O'Brien; Sami Abd Elwahab; Niall Davis; Mohsen Javadpour; Brendan McDonnell; Clare O Connor; Jarlath Bolger; Cillian Clancy; Stefanie M Croghan; Noel Donlon; Carolyn Cullinane; Ben Creavin; Muheilan Muheilan; Helen Earley; Syed Mohammad Umar Kabir; Muhammad Fahadullah; Éanna Ryan; Tara Connelly; Oded Zmora; Daisuke Hashimoto; Majdi Ali Alqudah; Amer Alajalen; Rand Y Omari; Faris Ayasra; Abdulrahman Qasem; Yazan Alawneh; Amer Ahmad; Omar Aladawi; Bourhan Alrayes; Hanan Haidar; Shatha Husain; Faisal Qassem; Adnan Sumadi; Ala'a Abu Salhiyeh; Balqees Mahmoud Al-Manaseer; Zaid Alsunna; Hazim Ra'ed; Faten Reyad Bani Hamad; Amro Abuleil; Mohamad K Abou Chaar; Elmi Ahmed Mohamed Jimaale; Marah Abu-Mehsen; Noor Olaywah; Omar Wafi; Hazim Ababneh; Luai Abu-Ismail; Almu'atasim Khamees; Ahmad Alkhatib; Raikhan Bolatbekova; Mukhtar Kulimbet; Talgat Nurgozhin; Timur Saliev; Baurzhan Zhussupov; Ydyrys Almabayev; Ildar Fakhradiyev; Timur Saliev; Dilyara Kaidarova; Khalil Tamoos; Ahmed Aqeelah; Alsnosy Abdullah Khalefa Mohammed; Faraj Al Maadany; Ghadah Alkadeeki; Milad Gahwagi; Wafa Aldressi; Mohamed Amnaina; Arowa Hassan Abdulrahman Alansari; Akram Alkaseek; Ghozlan Yagoub; Anass Ben Amer; Marwa Salem; Ayman Almugaddami; Dania Burgan; Mohammed Abdelkabir; Khayriyah Alshareef; Rayet Al Islam Ben Jouira; Ayman Meelad; Ahmad Bouhuwaish; Sumayya Essayah Dwaga; Houda Khalifa; Bushray Almiqlash; Taha Suliaman; Mohammed Alawami; Fras Elhajdawe; Hajir Aboazamazem; Ibrahim Ellojli; Ahmed Msherghi; Ismail Ali Saleh; Mohammed Alayan; April Camilla Roslani; Marcel Didier Ndayishyigikiye; Akutu Munyika; Philipp Plarre; David W Borowski; Pueya Rashid Nashidengo; Milou Noltes; Pieter Steinkamp; Cameron Wells; Rebecca Teague; Brodie Elliott; David Kieser; Omar Mohyieldin; Chris Varghese; Nick McIntosh; Cheyaanthan Haran; Sarah Rennie; Jasmin King; Jeong Ha; Matthew James McGuinness; Opeoluwa Adesanya; Julius Olaogun; Akinola Akinmade; Kefas Bwala; Peter Agbonrofo; Akinwale Afolabi; Usang Usang; Sebastian Ekenze; Samson Olori; Taiwo Akeem Lawal; Justina Seyi-Olajide; Abiodun Okunlola; Omolara Williams; Adewale Adisa; Lukman Abdur-Rahman; Stephen Kache; Danjuma Sale; Lofty-John Anyanwu; Chukwuma Okereke; Musliu Adetola Tolani; Venko Filipce; Lazar Todorovic; Sofija Pejkova; Sotir Stavridis; John George Massoud; Sareyah Alsibai; Rizwan Sultan; Humera Naz Altaf; Abu Bakar Hafeez Bhatti; Shahzad Hussain Waqar; Aliya Aziz; Asad Ali Kerawala; Lajpat Rai; Mariyah Anwer; Aiman Tariq; Bushra Ayub; Sami Ullah Niazi; Muhammad Yasir Naseem; Muhammad Zeeshan Sarwar; Muhammad Imran Khokhar; Imdad Ahmad Zahid; Haroon Javaid Majid; Nabila Talat; Muhammad Asif; Muhammad Hamid Chaudhary; Umer Farooq; Siddique Ahmad; Waleed Mabood; Syed Imran Bukhari; Muhammad Tariq; Eesha Yaqoob; Saad Javed; Saad Javed; Muhammad Usman Malik; Hassan Nawaz Yaqoob; Moises Cukier; Glenda Marina Falcon Pacheco; Robinson Mas Melendez; Arazzelly Del Pilar Paucar Urbina; Jose Rios Chiuyari; Carlos Eduardo Otiniano Alvarado; Lorena Fuentes Rivera Lau; Giuliano Borda-Luque; Milagros Niquen-Jimenez; Claudia Arias; Sergio Zegarra; Jenner Betalleluz Pallardel; Regina Amparo Ugarte Oscco; Gian Mendiola; Yahaira Tatiana Carpio Colmenares; Carlos Shiraishi Zapata; Maria Rosa Ortiz; Marie Dione Sacdalan; Piotr Major; Filipe Castro Borges; Octavio Viveiros; Pedro Serralheiro; Paulo Santos-Costa; Filipa Mendes; Miguel Rocha Melo; Paulo Cardoso; Ana Soares; José Azevedo; Rita Gonçalves Pereira; Nelson Silva; André Caiado; Maria Luís Sacras; Pedro Azevedo; Rui Almeida-Reis; Miguel F Cunha; João Oliveira; Jorge Nogueiro; Mafalda Sampaio-Alves; Luciana Cidade Costa; Catarina Baía; Ana Cláudia Deus; Rita Branquinho; André Marçal; André Tojal; Ahmad Zarour; Ahmad Zarour; Silviu Tiberiu Makkai-Popa; Aurel Mironescu; Florin Grama; Elena Adelina Toma; Ionut Negoi; Daniela Filipescu; Nicolae Bacalbasa; Natalia Motas; Sebastian Ionescu; Octav Ginghina; Radu Costea; Narcis Octavian Zarnescu; Radu Drasovean; Eduard-Alexandru Bonci; Mihail-Gabriel Dimofte; Vlad Porumb; Mikhail Kirov; Yegor Molitvin; Andrey Litvin; Vadim Pykhteev; Marianna Raevskaya; Sergey Efetov; Aleksandr Butyrskii; Mushabab Alshahrani; Azah Althumairi; Nasser Alzerwi; Ahmed Al Ameer; Ahmed Al Ameer; Tariq Madkhali; Abddulrahman Saleh Almulhim; Salman Ghazwani; Abdu Ayoub; Othman Iskander; Mohammed Ghunaim; Mohammed Alharthi; Turki M Alzaidi; Azah Althumairi; Mohammad Alyami; Abdulrahman Al Amri; Azah Althumairi; Abdullah AlFakhri; Amal Alhefdhi; Sharfuddin Chowdhury; Thamer Nouh; Ameen Alshehri; Abdulrahman Alzahrani; Yousef Alalawi; Selmy Awad; Ibrahima Konate; Abdourahmane Ndong; Jacques Tendeng; Nan Zun Teo; Frederick Koh; Jurij Aleš Košir; Uros Bele; Sabra Aqil; Cristina Barrena López; Ana Sánchez Mozo; Antonio Rodriguez Infante; Patricia Caja Vivancos; Mikel Prieto; Igor Alberdi San Roman; Laura Gomez Fernandez; Josep Maria Muñoz Vives; Anna Carreras-Castañer; Berta Díaz-Feijoo; Ramon Sieira-Gil; Victor Turrado-Rodriguez; Anna Sánchez López; Santiago Sánchez-Cabús; Marta Jimenez Toscano; MªPilar Canals Sin; Saura García Laura; Oriol Martin Sole; Pedro Palazon Bellver; Sonia Pérez-Bertólez; Jordi Prat-Ortells; Mireia Riba Martínez; Josep Rubio-Palau; Xavier Tarrado; Jorge Nuñez; Veronica Alonso Mendoza; Coro Bescós; Eloy Espin-Basany; Martin Espinosa-Bravo; Daniel Gil-Sala; Susana González-Suárez; Nuria Montferrer Estruch; Jorge Nuñez; Lucia Porteiro Mariño; Ana Rodríguez-Tesouro; Fabian Rojas Portilla; M Pilar Tormos Pérez; Inmaculada Vives; Unai Garcia De Cortazar; Kiara Tudela; Aitor Landaluce-Olavarria; Mercedes Estaire Gómez; Jorge Almoguera; Bakarne Ugarte-Sierra; Virginia Jimenez; Marta Bertrand; Laura Cárdenas Puiggrós; Olga Delisau-Puig; Jorge Garcia-Adamez; David Julià Bergkvist; Eloy Maldonado-Marcos; Lucia Diego García; Marta Roldón Golet; Iván Soto-Darias; Aida Cristina Rahy-Martín; Diego Enjuto; Adolfo Ramos-Luengo; Juan Delgado Fernandez; Carolina Lugo Duarte; Cristina Ojeda Thies; Lucila Marquez; Diana Crego Vita; Jana Dziakova; Ana Maria Minaya Bravo; Jorge Caño Velasco; Olga Mateo-Sierra; Begoña Quintana-Villamandos; Cristina Rey Valcarcel; Javier Rio; Laura Román García de León; Marcello Di Martino; Jorge Prada; Javier Serrano González; Manuel Losada; Jose Tomas Castell Gomez; Ramon Corripio-Sanchez; Alexander Forero-Torres; José Manuel Morales-Puebla; Hanna Perez-Chrzanowska; Santiago Valderrabano Gonzalez; Alvaro Yebes; Ignacio Zapardiel; Manuel Diez Alonso; Nelson Morales Palacios; Alberto Cabañero Sánchez; Fátima Sánchez Fernández; Alfredo Abad Gurumeta; Ane Abad-Motos; Fernando Corella; Javier Ripollés-Melchor; Rosa Sanz-Gonzalez; Marta Alcaraz Fuentes; Maria Teresa Fernández Martín; Pablo Calvo Espino; Milagros Carrasco Prats; Antonio-José Fernández-López; Damián García Escudero; Vanesa Garcia Soria; Jesús Aarón Martínez Alonso; Miguel Ruiz-Marín; Beatriz Gómez Pérez; Joaquin Moya-Angeler; Daniel Fernández Martínez; Heura Llaquet Bayo; Enrique Colás-Ruiz; Susana Bella Romera; M Teresa Gavaldà Pellicé; Misericòrdia Jordà Solé; Enrique Jose Ruiz Velasquez; Bernardo Núñez; Raul Jimenez; Jon Zabaleta; Maria Jose González-Gimeno; Irene Ortega Vázquez; Antonio Perez Ferrer; Rubén Martín-Láez; Marcelo Moreno Suarez; Miguel Angel Freiria Eiras; Irene Ramallo-Solís; Juan-Carlos Gomez-Rosado; Jose Ramon Oliver Guillen; Mar Achalandabaso Boira; Juan Carlos Catalá Bauset; Julio Domenech; Rafael Badenes; Juan Carlos Bernal-Sprekelsen; Jorge Sancho-Muriel; Beatriz De Andrés-Asenjo; Francisco J Tejero-Pintor; Marc Vallve-Bernal; Alba Vazquez Melero; Laura Sánchez Blasco; Jorge Escartin; Victoria Duque Mallén; Selvaratnam Srishankar; Umesh Jayarajah; Charitha Sooriyabandara; Oshan Basnayake; Nalaka Gunawansa; Dakshitha Wickramasinghe; Prabuth Dulanjan Weeraddana; Thanusan Vimalakanthan; Shanthamoorthy Gishanthan; Pramodh Chandrasinghe; Eleftherios Gialamas; Marc-Olivier Sauvain; Ahmad Ghazal; Yusra Al-Sabbagh; Turki Alhassoun; Sara Maa Albared; Antoine Naem; Hareth Alnahr; Ghassan Jisry; Ali Hammed; Arda Isik; Okedi Francis Xaviour; Gaston Turinawe; Isaac Mubezi; Franck K Sikakulya; Andrew Kakeeto; Wilberforce M Kabweru; Hervé Monka Lekuya; Ronald Kiweewa; Herman Lule; Paul Matovu; Otolia Isaac; Mohamed Mashhour; Amin El Helw; Sattar Alshryda; Safeena Kherani; Awadelkarim Mohamed; Ferial Mohamed Ali Abbas; Diary Mohammed; Ehab Aldlyami; Rakesh Kundra; Mohamed Mashhour; Mohamed Mashhour; Antony Louis Rex Michael; Hayder Alsaadi; Kareem S Khalil; Rachel Dbeis; Shafaque Shaikh; Jenny Ferry; Aiman Jamal; Haleema Siddique; Rishi Das; Nikhil Ponugoti; Sivesh K Kamarajah; Pornjittra Rattanasirivilai; Asma Sultana; Frances Mosley; Matthew Chan; Antony Bateman; Gareth Davies-Jones; Fanourios Georgiades; Grant D Stewart; Navid Ahmadi; Aman Coonar; Mariam Baig; Chetan Khatri; Arthika Surendran; Julian Sonksen; Robert Sinnerton; Caitlin Brennan; Gemma Faulkner; Michael Greenhalgh; Hannah Emerson; Kiran Singisetti; Joshua Totty; Michael Wilson; Terence Lo; Harriet Corbett; Ijeoma Okonkwo; Gill Arbane; Kariem El-Boghdadly; Cyrus Kerawala; Chetan Parmar; Tom Abbott; Michael Bath; Funlayo Odejinmi; Jayesh Sagar; Rishi Talwar; Samuel Newman; John Hammond; John Moir; Natalie Duric; Tamas Szakmany; Ahmar Iftikhar Talib; Mina Youssef; Christopher Lewis-Lloyd; Christopher Lewis-Lloyd; Mariam Lami; Khurram Ayub; Benjamin Dean; Supriya Balasubramanya; Sathya Lakpriya; Luke Rogers; Paul Turner; Mark Maher; Kohila Sigamoney; John Edwards; Jihène El Kafsi; John Hardie; David Johnson; Christin Henein; Marianne Hollyman; Ketan Agarwal; Simon Powell; Govind Singh Chauhan; Rakesh Patel; Joel Gagnier; Heather Carmichael; Aurora; Kristofor A Olson; Eric Etchill; Joseph Incorvia; Sameer Hirji; Matthew Naunheim; Frederick Drake; Haytham Kaafar

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

ObjectiveTo document the recovery of vascular services in Europe following the first COVID-19 pandemic peak.MethodsAn online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume.ResultsThe impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence.ConclusionCentres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries