70 research outputs found
The impact of Mn nonstoichiometry on the oxygen mass transport properties of La0.8Sr0.2MnyO3±δ thin films
- Author
- Publication venue
- IOP Publishing Ltd
- Publication date
- 01/10/2022
- Field of study
Oxygen mass transport in perovskite oxides is relevant for a variety of energy and information technologies. In oxide thin films, cation nonstoichiometry is often found but its impact on the oxygen transport properties is not well understood. Here, we used oxygen isotope exchange depth profile technique coupled with secondary ion mass spectrometry to study oxygen mass transport and the defect compensation mechanism of Mn-deficient La0.8Sr0.2Mn (y) O-3 +/-delta epitaxial thin films. Oxygen diffusivity and surface exchange coefficients were observed to be consistent with literature measurements and to be independent on the degree of Mn deficiency in the layers. Defect chemistry modeling, together with a collection of different experimental techniques, suggests that the Mn-deficiency is mainly compensated by the formation of La-x(Mn) antisite defects. The results highlight the importance of antisite defects in perovskite thin films for mitigating cationic nonstoichiometry effects on oxygen mass transport properties
High pressure electrochemical reduction of CO2 to formic acid/formate: a comparison between bipolar membranes and cation exchange membranes
- Author
- Publication venue
- 'American Chemical Society (ACS)'
- Publication date
- 01/01/2019
- Field of study
A high pressure semicontinuous batch electrolyzer is used to convert CO2 to formic acid/formate on a tin-based cathode using bipolar membranes (BPMs) and cation exchange membranes (CEMs). The effects of CO2 pressure up to 50 bar, electrolyte concentration, flow rate, cell potential, and the two types of membranes on the current density (CD) and Faraday efficiency (FE) for formic acid/formate are investigated. Increasing the CO2 pressure yields a high FE up to 90% at a cell potential of 3.5 V and a CD of ∼30 mA/cm2. The FE decreases significantly at higher cell potentials and current densities, and lower pressures. Up to 2 wt % formate was produced at a cell potential of 4 V, a CD of ∼100 mA/cm2, and a FE of 65%. The advantages and disadvantages of using BPMs and CEMs in electrochemical cells for CO2 conversion to formic acid/formate are discussed
High-pressure electrochemical reduction of CO2 to formic acid/formate: effect of pH on the downstream separation process and economics
- Author
- Publication venue
- 'American Chemical Society (ACS)'
- Publication date
- 01/01/2019
- Field of study
We use a high-pressure semicontinuous batch electrochemical reactor with a tin-based cathode to demonstrate that it is possible to efficiently convert CO2 to formic acid (FA) in low-pH (i.e., pH < pKa) electrolyte solutions. The effects of CO2 pressure (up to 50 bar), bipolar membranes, and electrolyte (K2SO4) concentration on the current density (CD) and the Faraday efficiency (FE) of formic acid were investigated. The highest FE (∼80%) of FA was achieved at a pressure of around 50 bar at a cell potential of 3.5 V and a CD of ∼30 mA/cm2. To suppress the hydrogen evolution reaction (HER), the electrochemical reduction of CO2 in aqueous media is typically performed at alkaline conditions. The consequence of this is that products like formic acid, which has a pKa of 3.75, will almost completely dissociate into the formate form. The pH of the electrolyte solution has a strong influence not only on the electrochemical reduction process of CO2 but also on the downstream separation of (dilute) acid products like formic acid. The selection of separation processes depends on the dissociation state of the acids. A review of separation technologies for formic acid/formate removal from aqueous dilute streams is provided. By applying common separation heuristics, we have selected liquid–liquid extraction and electrodialysis for formic acid and formate separation, respectively. An economic evaluation of both separation processes shows that the formic acid route is more attractive than the formate one. These results urge for a better design of (1) CO2 electrocatalysts that can operate at low pH without affecting the selectivity of the desired products and (2) technologies for efficient separation of dilute products from (photo)electrochemical reactors
Identifying Where REDD+ Financially Out Competes Oil Palm in Floodplain Landscapes Using a Fine-Scale Approach
- Author
- A Angelsen
- A Baccini
- A Borrego
- A Caro-Borrero
- A Grainger
- A Wich Serge
- AC Morel
- AD Ziegler
- Alexandra C. Morel
- AM Larson
- Andrew T. Knight
- AT Knight
- AT Knight
- B Fisher
- Benoit Goossens
- BW Heumann
- C Burnett
- C Vancutsem
- CE Lovelock
- Christian Del Valle
- DC Donato
- DJ Stark
- Douglas C. MacMillan
- DP Edwards
- E McLeod
- E Meijaard
- ED Reinhardt
- EP Crist
- GHJ de Koning
- Harjinder Kler
- I Matsuda
- Isabelle Lackman
- J Chave
- J Estes
- J Ghazoul
- J Lee
- J Leventon
- J Levin
- J McMorrow
- JA Wells
- Joseph Tzanopoulos
- JQ Yuen
- JW den Besten
- K Tockner
- K Tockner
- KM Carlson
- L Dengsheng
- L Feintrenie
- L Miles
- L Pendleton
- L Schalatek
- Laurentius Ambu
- Lian Pin Koh
- Lucy Peter
- M Ancrenaz
- M Estrada
- M Fosci
- M Hernández-Morcillo
- M Peters-Stanley
- M Skutsch
- Marc Ancrenaz
- MC Bottrill
- MH Hoang
- Nicola K. Abram
- NK Abram
- NK Abram
- NS Sodhi
- O Venter
- O Venter
- OA Somorin
- OJ Cacho
- P Delacote
- P Parolin
- P Saner
- Panteleimon Xofis
- QT Vo
- R Veloo
- RA Butler
- RA Butler
- RA Monserud
- Robert Ong
- Robin Chung
- S Brown
- S Pagiola
- Sarah C. Davis
- SS Saatchi
- SW Broch
- T Plieninger
- UC Benz
- V Tauli-Corpuz
- William Baya
- X Giam
- Publication venue
- 'Public Library of Science (PLoS)'
- Publication date
- 01/01/2016
- Field of study
Reducing Emissions from Deforestation and forest Degradation (REDD+) aims to avoid forest conversion to alternative land-uses through financial incentives. Oil-palm has high opportunity costs, which according to current literature questions the financial competitiveness of REDD+ in tropical lowlands. To understand this more, we undertook regional finescale and coarse-scale analyses (through carbon mapping and economic modelling) to assess the financial viability of REDD+ in safeguarding unprotected forest (30,173 ha) in the Lower Kinabatangan floodplain in Malaysian Borneo. Results estimate 4.7 million metric tons of carbon (MgC) in unprotected forest, with 64% allocated for oil-palm cultivations. Through fine-scale mapping and carbon accounting, we demonstrated that REDD+ can outcompete oil-palm in regions with low suitability, with low carbon prices and low carbon stock. In areas with medium oil-palm suitability, REDD+ could outcompete oil palm in areas
with: very high carbon and lower carbon price; medium carbon price and average carbon stock; or, low carbon stock and high carbon price. Areas with high oil palm suitability, REDD + could only outcompete with higher carbon price and higher carbon stock. In the coarse-scale model, oil-palm outcompeted REDD+ in all cases. For the fine-scale models at the landscape level, low carbon offset prices (US 3MgCO2e)wouldenableREDD+tooutcompeteoil−palmin5527 million to secure these areas for 25 years. Higher carbon offset price (US 30MgCO2e)wouldincreasethecompetitivenessofREDD+withinthelandscapebutwouldstillonlycapturebetween69380–416 million in carbon financing. REDD+ has been identified as a strategy to mitigate climate change by many countries (including Malaysia). Although REDD+ in certain scenarios cannot outcompete oil palm, this research contributes to the global REDD+ debate by: highlighting REDD+ competitiveness in tropical floodplain landscapes; and, providing a robust approach for identifying and targeting limited REDD+ funds
Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
- Author
- 14 | COVIDSurg COllabOratIVe Tzovaras G. (General University Hospital of Larissa)
- Aawsaj Y.
- Abad Gurumeta A.
- Abad-Motos A.
- Abate E.
- Abbott D.
- Abdalla M.
- Abdeldayem H.
- Abdelkader Salama I.
- Abdelkarim M.
- Abdur-Rahman L.
- Abel M. K.
- Aboelkassem Ibrahim A.
- Abou Chaar M. K.
- Abreu da Silva A.
- Abubakar A.
- Acebes García F.
- Achalandabaso Boira M. Sales Mallafré R. (Hospital Universitari de Tarragona Joan XXIII)
- Acher A.
- Acrich E.
- Adamina M.
- Aderombi A.
- Adeyeye A.
- Adiamah A.
- Afonso J.
- Agapov M.
- Agnes A.
- Agostini C.
- Agresta F.
- Aguado H. (Hellín Hospital)
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- Ahmed Z.
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- Aimé A.
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- Al Awwad S.
- Al Habes H.
- Al Maadany F. S. (Al-Jalaa Hospital)
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- Alawneh F. (King Hussein Cancer Center). Libya: Alkadeeki G.
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- Aljiffry M.
- Alma Mater Studiorum University of Bologna)
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- Alnumani T. (King Fahad 16 | COVIDSurg COllabOratIVe General Hospital)
- Alobeed O.
- Alonso de la Fuente N. Jimenez Toscano M. (Hospital del Mar)
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- Alqannas M.
- Alselaim N. (King Saud Bin Abdulaziz University for Health Sciences
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- Argentina: Alurralde C.
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- COVIDSurg COllabOratIVe | 15 Violante T. (IRCCS Azienda Ospedaliero – Universitaria di Bologna
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- Day A. (East Surrey Hospital)
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- Spartalis E.
- Spencer N.
- Spiezio G. (Colorectal Surgical Oncology Unit – Istituto Nazionale Tumori Fondazione
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- Sriram R. K.
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- St John S.
- Stafford J. (George Eliot Hospital)
- Stavrinidou O.
- Steele C. (Sheffield Teaching Hospital NHS Foundation Trust)
- Steidle C.
- Steinke J.
- Stevens K.
- Stevenson J. (The Ottawa Hospital). Croatia: Bačić G.
- Stevic D.
- Stewart K. E.
- Stylianides N. (Manchester Royal Infirmary)
- Stylianidis G. (Evaggelismos General Hospital)
- Subhi M. T. (Alkhadra Hospital)
- Subocius A.
- Subramaniam S. (Queen Elizabeth Hospital and Universiti Malaysia Sabah
- Sundaram Venkatesan G. (Glan Clwyd Hospital)
- Suszták N. (Szent Borbála Kórház). India: Bhat G. A.
- Sutherland A. (Coffs Harbour Health Campus)
- Swinson B. (Royal Brisbane and Women’s Hospital). Austria: Messner F.
- Syed W. A. S.
- Syllaios A.
- Szatmary P.
- Szubota I. (Hospital and Oncological Centre Novy Jicin). Denmark: Ebbehøj A. L.
- Sánchez del Pueblo C.
- Sánchez Fuentes N.
- Sánchez- Pernaute A.
- Sánchez- Rubio M.
- Sánchez-García S.
- Taddei A.
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- Taibi A. (Chu Limoges)
- Talal El-Abur I.
- Talwar R. (Luton and Dunstable University Hospital)
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- Tanal M.
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- Tanzanu M.
- Tartaglia D. (Azienda Ospedaliero Universitaria Pisana)
- Tasis N. (Athens Naval and Veterans Hospital)
- Tatar O. C.
- Tavares F.
- Tayeh S. (Homerton University Hospital)
- Tebala G. D.
- Teixeira J. (Centro Hospitalar Universitário do Algarve – Unidade de Faro)
- Teixeira M. (Centro Hospitalar do Tamega e Sousa)
- Tejero- Pintor F. J. (Hospital Universitario Río Hortega)
- Testa V. (Santa Croce E. Carle Hospital
- Tewari N. (University Hospitals Coventry and Warwickshire NHS Trusts)
- Tezas S. (Furness General Hospital)
- Thaha M.
- Thanapal M. R. (Hospital Kuala Lumpur)
- Theodosopoulos T.
- Theophilidou E. (Royal Derby Hospital)
- Thian A.
- Thomas A. (Royal Liverpool University Hospital)
- Thompson D. (Morriston Hospital Swansea)
- Thornhill M. (Dell Seton Medical Center at the University of Texas)
- Thrumurthy S. (Epsom and St Helier University Hospitals NHS Trust)
- Thulasiraman S. V.
- Timbrell S.
- Tirloni L.
- Titu S. (Prof. Dr. Ion Chiricuta Institute of Oncology). Russia: Garmanova T.
- Tonini V. (S. Orsola-Malpighi Hospital)
- Torres A. (Hospital Clínico de Madrid)
- Torres Arcos C.
- Townson A.
- Trabulsi N. (King Abdulaziz University Hospital)
- Travaglio E. (Regina Montis Regalis Hospital
- Tribillon E. (Institut Mutualiste Montsouris)
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- TU Dresden)
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- Tweedle E. (Addenbrooke’s Hospital)
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- Uludağ S. S.
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- Universiti Sains Malaysia)
- University of Amsterdam)
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- Uslu G.
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- Uyanik M. S. (Samsun Training and Research Hospital)
- Uzunoglu F. G. (University Medical Center Hamburg–Eppendorf). Greece: Antonakis P.
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- Valbuena Jabares V. (Marqués de Valdecilla University Hospital)
- Valdes- Hernandez J. (Hospital Universitario Virgen Macarena)
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- Vassiliu P. (Attikon University General Hospital)
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- Velidedeoglu M.
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- Vera Mansilla C. (Hospital Universitario Principe de Asturias)
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- Vervoort D.
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- Vezakis A. (Aretaieion Hospital)
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- Vieira B. (Centro Hospitalar de Trás-Os-Montes e Alto Douro
- Vieira Caroço T. (IPO Coimbra)
- Vieira Paiva Lopes A. C. (Hospital de Torres Vedras – Centro Hospitalar do Oeste)
- Vignali A. (San Raffaele Scientific Institute
- Vigorita V. (Álvaro Cunqueiro Hospital)
- Vijayan D. (Queen Elizabeth Hospital Birmingham)
- Villalabeitia Ateca I. (Hospital Universitario Cruces)
- Vimalachandran D. (Countess of Chester Hospital)
- Viswanath Y. K. S. (James Cook University Hospital)
- Vitali A. (Ospedale San Giovanni di Dio)
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- Vucic N.
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- Walkes K. (Queen Elizabeth Hospital). Belgium: Flamey N.
- Wani R. (Sher-I-Kashmir Institute of Medical Sciences)
- Waqar S. H. (Pakistan Institute of Medical Sciences). Poland: Major P. (Jagiellonian University Medical College). Portugal: Azevedo C.
- Warren O. (Chelsea and Westminster Hospital)
- Watson L. J. (Sunderland Royal Hospital)
- Watson N. (King’s Mill Hospital)
- Weitz J.
- Welsch T. (Carl-Gustav-Carus University Hospital
- Werner J. (LMU Klinikum Campus Innenstadt)
- Westwood E. (James Paget University NHS Foundation Trust Hospital)
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- Whitmore H. (Torbay and South Devon NHS Trust)
- Wilkin R. J. W. (South Warwickshire NHS Foundation Trust)
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- Williams G. (Royal Gwent Hospital)
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- Xavier R. G.
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- Xynos E. (University Hospital of Heraklion Crete and Interclinic Hospital of Crete). Hong Kong: Futaba K.
- Yang W.
- Yassin N. (Royal Wolverhampton NHS Trust)
- Ye G.
- Yesantharao P.
- Yetkin S. G. (Sisli Hamidiye Etfal Training and Research Hospital)
- Yeşilyurt D. (University of Health Sciences Tepecik Training and Research Hospital)
- Yiallourou A. (Nicosia General Hospital). Czechia: Martinek L.
- Yıldırım A.
- Yildiz A. (Yildirim Beyazit University Yenimahalle Training and Research Hospital). Uganda: Lule H.
- Young R. (York Teaching Hospitals NHS Trust)
- Yousof E. A. (Assiut University Hospital)
- Youssef M. (Norfolk and Norwich University Hospital)
- Yurttas C. (University Hospital Tuebingen)
- Yánez C. (Royo Villanova)
- Yüksel E. (Kocaeli University Teaching Hospital)
- Zafar S. N. (University of Wisconsin)
- Zakaria A. D.
- Zakaria Z. (School of Medical Sciences and Hospital
- Zambon M. (Policlinico Umberto I Sapienza University of Rome)
- Zanus G. (Ca’ Foncello Treviso – DISCOG – Università di Padova)
- Zegarac M. (Institute for Oncology and Radiology of Serbia)
- Zelić M. (University Hospital Center Rijeka)
- Zengin A. K. (Istanbul Universty – Cerrahpaşa Medical Faculty)
- Zerbib P. (CHU Lille)
- Zervas K.
- Zese M. (Santa Maria degli Angeli Hospital ULSS 5 – Adria)
- Zhang H. (Concord Repatriation General Hospital)
- Zizzo M. (Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia)
- Zografos C. (Laiko University Hospital)
- Zorrilla Ortúzar J. (Hospital General Universitario Gregorio Marañón)
- Zourntou S. (General Hospital of Larissa ‘Koutlimpaneio and Triantafylleio’)
- Zubaidi A. M. (King Saud University). Serbia: Aleksić L.
- Ângelo M.
- Çelebi F.
- Çolak E.
- Öfner D. (Medical University of Innsbruck)
- Öhlberger L.
- Özçelık M. F.
- Öğücü H.
- Überrück L.
- Ćoza I.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic
Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study
- Author
- Aaraj M. A.
- Abate E.
- Abbott S. J.
- Abbott T. E. F.
- Abdalaziz H.
- Abdalla M. O.
- Abdelaal A. S.
- Abdelkarim M.
- Abdou H.
- Aboelkassem-Ibrahim A.
- Abuown A.
- Acebes-Garcia F.
- Acharya M.
- Adamina M.
- Addae-Boateng E.
- Aftab R.
- Aguilar J.
- Aherne T. M.
- Ahmed Y.
- Aitken E.
- Al-Azzawi M.
- Al-Embideen S.
- Al-Masri M.
- Al-Najjar H.
- Al-Sukaini A.
- Alam R.
- Alanbuki A.
- Ali I. A. M.
- Ali O. M.
- Aliyeva Z.
- Aljanadi F.
- Almaadany F. S.
- Almasri M.
- Almeida A. C.
- Alonso-Ortuno P.
- Alrahawy M. M.
- Alser O.
- Altintoprak F.
- Alvarez M. R.
- Ambler G. K.
- Amira G.
- Amjad R.
- Anania G.
- Andabaka T.
- Andreani S. M.
- Angelou D.
- Annamalai S.
- Annessi V.
- Anthoney J.
- Antonanzas L. L.
- Anwar S.
- Anwer M.
- Aoun S. G.
- Aragon-Chamizo J.
- Archer J. E.
- Ardito A.
- Arigoni M.
- Armao T.
- Arminio A.
- Armstrong L.
- Arnaud A. P.
- Asaad P.
- Ashcroft J.
- Ashmore C.
- Ashoush F. M.
- Asqalan A.
- Asti E.
- Aubry E.
- Avellana R. B.
- Ayeni F. A.
- Ayorinde J. O.
- Aytac E.
- Ayuso-Herrera E.
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- Baeza M.
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of 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 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). 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
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
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- Publication venue
- J Clin Oncol
- Publication date
- 01/01/2020
- Field of study
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study
- Author
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- Zourntou S.
- Zouzoulas D.
- Zubaidi A.
- Zullo A.
- Publication venue
- 'American Society of Clinical Oncology (ASCO)'
- Publication date
- 01/01/2021
- Field of study
PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
- Author
- Liza
- - AP-HP) Bertrand Dousset (H\uf4pital Cochin
- - APHP) Anne Thomin (H\uf4pital Trousseau
- - ASST Rhodense) Carlo Corbellin (Ospedale Di Rho
- - NYU Winthrop Hospital) Amir H Sohail (NYU Langone Health
- - Xarxa Assistencial Universit\ue0ria de Manresa) Pablo Collera Ormazabal (Fundaci\uf3 Althaia
- / Columbia University Medical Center) Miriam Callahan (NewYork-Presbyterian
- 3 University Hospital) Bridget Egan (Tallaght
- 4 Lapolla Pierfrancesco
- 5 Spain: Eduardo E Rubio Susana Henriques (Hospital Garcia de Orta).
- 6 G\uf3mez Marcos
- \u2013 IRCCS Francesca Gaino (Humanitas Clinical and Research Center
- \u2013 Italy) 20089 Rozzano (MI)
- \uc1ngel Hern\ue1ndez Bartolom\ue9 Miguel
- A Aaraj Mahmoud
- A Ayeni Funbi
- A Bass Gary
- A Benson Ruth
- A Bozkurt Mehmet
- A Breen Kerry
- A Breen Kerry
- A Breen Kerry
- A Callcut Rachael
- A Chung Eric
- A Coughlin Patrick
- A de Gheldere Charles
- A De Marchi Joshua
- A Elliott Jessie
- A Fahey Brian
- A Griffiths Ewen
- A Griffiths Ewen
- A Griffiths Ewen
- A Guariglia Claudio
- A Hirji Sameer
- A Khalefa Mohamed
- A Marra (Fondazione Policlinico Universitario Agostino Gemelli) Angelo
- A Nguyen (Frankfurt University Hospital Truong
- A Olson (Duke University Medical Center) Steven
- A Raptis Dimitri
- A Rollett Rebecca
- A Saeed Samerah
- A Salama Hiba
- A Salamah Abdulrauf
- A Schnitzbauer Andreas
- A Schnitzbauer Andreas
- A Singh Aminder
- A Stevens Kent
- A Stylianides Nicholas
- A Thaha Mohamed
- A Vega (12 de Octubre University Hospital) Viviana
- A Vivas Alfredo
- A Zappa Marco
- Abate Emmanuele
- Abdalaziz (Gloucestershire Royal Hospital) Hossam
- Abdelkarim Mostafa
- Abdou Hossam
- Aboelkassem-Ibrahim Ahmad
- Abuown Ala
- Acebes-Garcia Fernando
- Acharya Metesh
- Adamina Michel
- Addae-Boateng Emmanuel
- Adolfo Pisanu (Cagliari University Hospital) Mauro Podda
- Aftab Raiyyan
- AG Moir John
- Agarwal Arnav
- AH Ibrahim Mohamed
- Aitken (Queen Elizabeth University Hospital) Emma
- Al-Azzawi Marwa
- Al-Embideen Somya
- Al-Sukaini Ahmad
- Alakaloko Felix
- Alam (Heartlands Hospital) Ruhina
- Alameer Ehab
- Alderson Derek
- Ali Mohamed Ali (Queen Elizabeth Hospital King's Lynn) Inthekab
- Aliyeva (Acibadem Mehmet Ali Aydinlar University Zumrud
- Aljanadi Firas
- Almasri Murad
- Alonso Poza (Hospital Universitario del Sureste) Alfredo
- Alonso-Ortu\uf1o Paula
- Alser Osaid
- Alser Osaid
- Alser Osaid
- Altintoprak (Sakarya University Faculty of Medicine) Fatih
- Amalina Che Bakri Nur
- Amjad Rabbia
- Anania Gabriele
- and Westminster Hospital NHS FT and Imperial College London) Chelsea
- Andabaka Tatjana
- Andrea Pisani Ceretti (ASST Santi Paolo e Carlo) Nicol\uf2 M Mariani
- Angelou Dimitrios
- Anita Volpe (New York Presbyterian Queens) Stephen Merola
- Annamalai Seethalakshmi
- Annessi Valerio
- Anthoney James
- Anuradha R Bhama (Rush University Medical Center) Alfonso Torquati
- Anwar Sibtain
- Aragon-Chamizo Juan
- Ardito Antonella
- Arigoni Michele
- Armao Teodora
- Arminio (Ospedali Riuniti Azienda Ospedaliera Universitaria Foggia) Armando
- Armstrong Lara
- Asaad Peter
- Ashcroft James
- Ashmore Christopher
- Asqalan Ahmad
- Asti (IRCCS Policlinico San Donato Emanuele
- Aubry Emmanuelle
- Aytac Erman
- Ayuso-Herrera Esther
- Azerbaijan:Elgun Samadov Joana FF Simoes (Chair). 2 Collaborators: (denotes Local Principal Investigator) Algeria: Faraj S Almaadany (\uc9tablissement Hospitalier Sp\ue9cialis\ue9 en Canc\ue9rologie - Centre Pierre-et- Marie-Curie).
- B Avellana Rocio
- B Catton Andrew
- B Fonsi Giovanni
- B Hing Caroline
- B O'Meara Lindsay
- B Schaffer Kathryn
- B Yousuf (Tobruk Medical Center) Farhat
- B\ue0mbina (Fabrizio Spaziani Hospital Fabrizio
- Bailon-Cuadrado (Hospital Universitario R\uedo Hortega) Martin
- Baldi Caterina
- Baldini Edoardo
- Baldo (Ospedale Santa Corona Stefano
- Ballabio Michele
- Baloyiannis Ioannis
- Baltazar Gerard
- Bandiera Alessandro
- Barlow Emma
- Barmasse (Ospedale Regionale Umberto Parini) Roberto
- Barmpagianni Christina
- Baronio (Policlinico San Pietro) Gianluca
- Barra Fabio
- Bartholomew's Hospital) St
- Bartsch Anne-Marie
- Basgaran Amedra
- Basha Amr
- Bashkirova (North Middlesex University Hospital) Varvara
- Bastazza Marco
- BB Sullivan (The Royal London Hospital) Tom
- Beak Philip
- Belcher Elizabeth
- Belgium: Gabrielle H van Ramshorst Sevda Jafarova (Leyla Medical Center).
- Beltr\ue1n de Heredia Juan
- Belvedere Angela
- Ben\uedtez-Linero Inmaculada
- Benjamin Franklin) Campus
- Bergeat Damien
- Bernasconi Matteo
- Bhalla Ashish
- Bhangu Aneel
- Bianco Federica
- Bisagni Pietro
- BJ Borgstein Alexander
- Blake (Southport and Formby District General Hospital) Iain
- Blanco-Colino Ruth
- Blazquez-Martin (Hospital Principe De Asturias) Alma
- Boal Matthew
- Bologna) Ausl
- Bonavina Giulia
- Bonavina Luigi
- Bond-Smith Giles
- Booth (Freeman Hospital) Karen
- Borges Filipe
- Borghi Felice
- Borja De Lacy (Hospital Clinic Barcelona) F
- Bourke Grainne
- Boyle Emily
- Brachini Gioia
- Brain Jessie
- Brar Amanpreet
- Breckles Lisa
- Brendan L Skelly (Altnagelvin Area Hospital) Catherine Rossborough
- Brianza) Carate
- Brixton Genevieve
- Bruzzaniti Placido
- Bueser Teofila
- Burnside Nathan
- C Bosanquet David
- C Brown (Manchester University NHS Foundation Trust Benjamin
- C De Souza Anthony
- C Glasbey James
- C Glasbey James
- C Hopkins James
- C Lauscher Johannes
- C McIntyre Robert
- C Mckay Siobhan
- C Neary Paul
- C Nugent III William
- C Rodriguez-Sanjuan (Marqu\ue9s de Valdecilla University Hospital) Juan
- C Roslani April
- C Tucker Sarah
- C Velmahos (Massachusetts General Hospital) George
- C Winter Stuart
- Caballero Albert
- Cairo University) Mahmoud MA Elfiky (Kasr Alainy Faculty of Medicine
- Calcerrada-Alises Enrique
- Camacho Fern\ue1ndez-Pacheco (Complejo Hospitalario Universitario Insular-Materno Infantil) Borja
- Camarero Enrique
- Campagnaro Tommaso
- Campanelli Michela
- Candiani Massimo
- Cannoletta (Royal Brompton Hospital) Marina
- Cantalejo-Diaz (Hospital Universitario Miguel Servet) Miguel
- Cao Han
- Capizzi Vita
- Carcano (Ospedale di Circolo Giulio
- Carissimi Francesca
- Carlini Massimo
- Carlos Bernal-Sprekelsen Juan
- Carlos Catal\ue1 Bauset (Consorcio Hospital General Universitario) Juan
- Carlucci Michele
- Carmela Giuffrida Maria
- Carmichael Heather
- Carrasco Milagros
- Carrillo Mariana
- Carvello Michele
- Casati Massimiliano
- Castoro Carlo
- Castro Ruiz Carolina
- Catalan Vanesa
- Catriona R Luney (Nuffield Orthopaedic Centre) Benjamin JF Dean
- Cavaleiro Salom\ue9
- Cellerino Paola
- Center Amsterdam) Cancer
- Centinaio (Ospedale Maggiore di Lodi) Giovanna
- Cernei Cristina
- Cervellera Maurizio
- Chakrabortee Sohini
- Chamberlain Stephanie
- Chan Jeffrey
- Chang Grace
- Chaudhry Daoud
- Chebaro Alexandre
- Chen (Jamaica Hospital) David
- Chetty Govind
- Chia (Royal Derby Hospital) Zoe
- Chiappini Ambra
- Chiarugi (Azienda Ospedaliero Universitaria Pisana) Massimo
- Chidambaram Swathikan
- Chiozza Matteo
- Cholewa Hanna
- Chong (Evelina London Children's Hospital) Clara
- Choolani-Bhojwani Ekta
- Christian Cotsoglou (ASST Vimercate) Stefano Granieri
- Chui Karen
- Chung Choyin
- Cirillo Bruno
- Citterio Davide
- Clermidi Pauline
- Coccolini Federico
- Colletti Gaia
- Compagnoni Bruno
- Concepci\uf3n-Mart\uedn Vanesa
- Confalonieri Marco
- Connolly Hannah
- Conso Christel
- Conti Luigi
- Cooper Zara
- Corral Javier
- Costa Marta
- Costanzi Andrea
- Cox Daniel
- Cozza Valerio
- CR Wormald Justin
- Croatia: Jakov Mihanovic Nicolas Duchateau (Heilig Hart Ziekenhuis Lier).
- CS Clough Ethan
- Cuming Tamzin
- Cuneo)
- Curtis Miles
- Cuschieri Joseph
- D Baron Ryan
- D Bosch Karen
- D Brown Oliver
- D Bueno-Ca\uf1ones Alejandro
- D Cato Liam
- D Drake Thomas
- D Jenkinson Michael
- D Jenkinson Michael
- D Liyanage Aloka S
- D Pinkney Thomas
- D Rajgor Amarkumar
- D Stewart Grant
- D Tebala Giovanni
- D'Agruma Michele
- D'Andrea Giancarlo
- D\uedaz P\ue9rez David
- D\uedaz-Garc\ueda (Hospital Universitario Nuestra Se\uf1ora de Candelaria) Alberto
- Da Roit Anna
- da Saliceto\u201d Patrizio Capelli (Ospedale \u201cG.
- Dare Oliver
- Darko Ebenezer
- Data Monitoring and Ethics Committee: Deborah S Keller H. Hunt Batjer (University of Texas Southwestern).
- Day Andrew
- De Andr\ue9s-Asenjo Beatriz
- de Medicina Facultad
- De Miguel-Ardevines Maria-Carmen
- De Nardi Paola
- De Simone Veronica
- De Toma Giorgio
- Deepti Sinha (University College London Hospital) Nicholas Kalavrezos
- Dehal (Kaiser Permanente Panorama City Medical Center) Ahmed
- Dehart Dustin
- Del Giudice Roberto
- Delgado-Oliver Eduardo
- Denmark: Henry G Smith Bernarda Bakmaz (Zadar General Hospital).
- Denning Max
- Desai Anant
- Desender (Ghent University Hospital) Liesbeth
- Dester (ASST Valcamonica Ospedale di Esine) Sara
- Di Candido Francesca
- Di Chiara Francesco
- Di Franco Gregorio
- Di Giuseppe (Ente Ospedaliero Cantonale del Canton Ticino) Matteo
- Di Saverio Salomone
- Di Saverio Salomone
- Di Saverio Salomone
- Di Saverio Salomone
- Diaz-Pe\uf1a Patricia
- Dieguez Fernandez Beatriz
- Dissemination Committee: Michel Adamina Aneel Bhangu.
- Dolores Del Toro M
- Domodossola
- Doussot Alexandre
- Duff Sarah
- Dunning Joel
- Dunstan Matt
- Duque-Mallen Victoria
- Dziakova Jana
- E Canova Michaela
- e Carle Hospital Chiara Peluso (Santa Croce
- e Carlo ASST Santi Paolo
- E Dawson Brett
- E Dickson Kathryn
- E Hudson Victoria
- E Jenny (Johns Hopkins Hospital) Hillary
- E Lewis Sophia
- E Nita George
- e Oftalmico) Giulio Iacob (Ospedale Fatebenefratelli
- E P\ue9rez-S\ue1nchez Luis
- E Rice Henry
- E Ssentongo Anna
- e Universit\ue1rio de Coimbra) Ana C Almeida (Centro Hospitalar
- E Xyda Souzana
- Edward Fitzgerald J
- EF Abbott Tom
- EF Abbott Tom
- Egan Richard
- Egypt: Mohamed El Kassas University of Copenhagen).
- El Youzouri Hanan
- El-Ali (Queen's Hospital Abess
- Elaine YL Leung (The Pan Birmingham Gynaecological Cancer Centre) Sudha Sundar
- Elfeki Hossam
- Elhadi Muhammed
- Eljareh (Aljalaa Hospital) Mohammed
- Elkadi Hannah
- Elkady Ramy
- Elkhafeefi Fatimah
- Elmore Ugo
- Elmoslemany (The Walton Centre NHS Foundation Trust) Tarek
- EM Bouhuwaish Ahmad
- EM Brathwaite Collin
- Emmerson (North Manchester General Hospital) Oliver
- Enemosah Ibrahim
- English Camilla
- English William
- Ereidge Simon
- Escartin Jorge
- Estaire-Gomez Mercedes
- EuroSurg
- Evans (Queen Elizabeth the Queen Mother Hospital Margate) Jessica
- Exley Rebecca
- F Bath Michael
- F Cunha Miguel
- F Cunha Miguel
- F Davis Niall
- F Ridgway Paul
- Fabbri Nicol\uf3
- Falco Giuseppe
- Familiari Pietro
- Fancellu (Cliniche San Pietro Alessandro
- Fanjul G\uf3mez Mar\ueda
- Farik Shebani
- Farr\ue9 Font Roser
- Farrell Tony
- Fehervari Matyas
- Fell Adam
- Fern\ue1ndez- Mart\uednez Mar\ueda
- Fern\ue1ndez-Gomez Cruzado (Hospital Urduliz) Laura
- Fern\ue1ndez-Mar\uedn Reyes
- Fernandez-Camu\uf1as Angel
- Ferrara)
- Ferrara Francesco
- Ferrari Guglielmo
- Ferrero Simone
- FF Simoes Joana
- FF Simoes Joana
- Findlay Laura
- Fiore Marco
- Fiore Marco
- Fiori Enrico
- FJ Dunne Declan
- Flatman Michael
- Flindall Ian
- Fontana (Vittorio Emanuele Tommaso
- Ford (The Robert Jones and Agnes Hunt Orthopaedic Hospital) David
- Ford Samuel
- Forlani Stefano
- Fr\ue9d\ue9ric Bretagnol (H\uf4pital Louis-Mourier - GHU AP-HP. Nord - Universit\ue9 de Paris) David Moszkowicz
- France: Zaher Lakkis Mohamed Sherief (MISR Cancer Center/MISR International Hospital).
- Francisco de Vitoria Universidad
- Francone Elisa
- Frattaruolo Colomba
- Frio (Institute of Neurological Sciences of Bologna Federico
- Frosinone)
- G Aoun Salah
- G Barranquero Alberto
- G Blazer III Dan
- G Collins Chris
- G Edwards John
- G Edwards John
- G Morton Dion
- G Povey Meical
- G Velopulos Catherine
- G Wade Ryckie
- Gabriel Kinnaman (IU Health Methodist Hospital) Ashley D Meagher
- Gagliano Annalisa
- Gagliardi Filippo
- Gahunia Sukhpreet
- Gala Tanzeela
- Galfrascoli Elisa
- Galimberti Luca
- Galindo Jara (Hospital Universitario de Torrej\uf3n Pablo
- Gallagher Phoebe
- Galleano Raffaele
- Gallo Gaetano
- Gallo Gaetano
- Gallo Gaetano
- Galv\ue1n-P\ue9rez Armando
- Gamal Amira Ibrahim Sallam
- Gammeri Emanuele
- Ganau Mario
- Garc\ue9s-Garc\ueda Ra\ufal
- Garcia Fernandez Andres
- Garcia-Conde Delgado Maria
- Garulli (Ospedale Infermi di Rimini) Gianluca
- Gascon-Ferrer Isabel
- Gattolin (Regina Montis Regalis Hospital Andrea
- Gaujoux Sebastien
- Gentilli Sergio
- Georgiades Fanourios
- Germany: Carsten Kamphues Didier Ollat (Institut Mutualiste Montsouris).
- Gerogiannis (Kingston Hospital NHS Foundation Trust) Ioannis
- Ghanbari (Homerton University Hospital) Amir
- Ghosh Dhruv
- Giacometti Marco
- Giblin Anna-Victoria
- Gilbert (Surrey and Sussex Healthcare NHS Trust) Catherine
- Gim\ue9nez Clara
- Giorgakis Emmanouil
- Gipponi Manuel
- Glen Paul
- GlobalPaedSurg GlobalSurg
- Goatly Giles
- Gobatti (San Carlo Borromeo Hospital Davide
- Godbole Chintamani
- Gohil Kajal
- Gomez-Rosado Juan-Carlos
- Gonullu Emre
- Gonzalez-De Miguel Melania
- Gonzalez-Gonzalez Enrique
- Gordini Luca
- Gracia Isabel
- Gracia-Roche Carlos
- Greece: Konstantinos Bouchagier Markus W L\uf6ffler (University Hospital Tu\u308bingen).
- Green Susanna
- Grivon Manuela
- Grove (Department of Colorectal Surgery Thomas
- Guaglio Marcello
- Guaitoli (Perrino) Eleonora
- Guglielmi Alfredo
- Guha Soumya
- Gustavino (Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino Genoa) Claudio
- Guti\ue9rrez Samaniego Mar\ueda
- H Babu Bheemanakone
- H Chowdhury Abeed
- H Davidson Giana
- H Davidson Giana
- H Davidson Giana
- H Elfallal Ahmed
- H Emile Sameh
- H Kirmani Bilal
- H Liu Helen
- H Murphy Suzanne
- H van Ramshorst Gabrielle
- H\uf6lzle Frank
- Habeeb Amir
- Hagger Robert
- Hakmi Hazim
- Halkias Constantine
- Halkias Constantine
- Hampton (Rotherham District General Hospital) Matthew
- Handa Siddhartha
- Haq Iram
- Harky (Liverpool Heart and Chest Hospital) Amer
- Harries (Morriston Hospital Rhiannon
- Harrison Joseph
- Hasan Raashad
- Hawari Mohammad
- Hawkin Paul
- Hebblethwaite Bethany
- Helier University Hospitals NHS Trust) St
- Heritage Emily
- Hernandez Garcia Miguel
- Hernandez-Juara Pilar
- Herrero-Lopez Maria
- Hervieux Erik
- Heyd Bruno
- Higgs Simon
- Hitchman (Hull University Teaching Hospitals NHS Trust) Louise
- Ho Beatrice
- Hogan Aisling
- Hospital of Varese University
- Hospital Universitario del Henares) Miguel Angel Garcia-Ure\uf1a (Universidad Francisco de Vitoria
- Hospital) Atakent
- Hospital) Wythenshawe
- Hossain Tanvir
- Houston Roy
- Hurt Libor
- HV Byrne Matthew
- i Pujol) Alba Zarate (Hospital Germans Trias
- I Roxo (Brigham and Women's Hospital) Vanessa
- I van Berge Henegouwen (Amsterdam UMC Mark
- I Alessandro Di Bartolomeo (Policlinico Umberto
- Iannone Immacolata
- Ibrahim Sherif
- Iovino Domenico
- Ireland: Arnold DK Hill Paraskevi Tourountzi (Kavala General Hospital).
- Isik Arda
- Israel: Oded Zmora Thomas M Aherne (Galway University Hospital).
- Italy: Maurizio Zizzo Nadav Kugler (Shamir Medical Center).
- J Abbott Sarah
- J Baker Olivia
- J Baldwin Alexander
- J Beamish Andrew
- J Carlos William
- J Caruana Edward
- J Caruana Edward
- J Davies Emma
- J Diaz Jose
- J Doe Matthew
- J Eardley Nicola
- J Fern\ue1ndez Antonio
- J G\uf3mez D\uedaz Carlos
- J Hainsworth Alison
- J Hall Bria
- J Holme Thomas
- J Hutchinson Peter
- J Hutchinson Peter
- J Kalkwarf Kyle
- J Lin Daniel
- J Lowery Aoife
- J McCluney Simon
- J Mehigan Brian
- J Mills Sarah
- J Pachl (Birmingham Children's Hospital) Max
- J Rogers Luke
- J Ryan \uc9anna
- J Scurrah Rachel
- J Shackcloth Michael
- J Smart Neil
- J Steinkamp Pieter
- J Tejero-Pintor Francisco
- J Thomas Amy
- J Torres Antonio
- J Warren Oliver
- J Warren Oliver
- J Williams Katherine
- James RW Hall (Stepping Hill Hospital) Claire Hall
- James's Hospital) Conor P Barry (St.
- Jamil Tahir
- Jayaraju (University Hospital of Wales) Ullas
- Jenner Edward
- JG Chase Thomas
- Jha Shane Lester (James Cook University Hospital) Madan
- Jimenez-Higuera Elisa
- Jimeno Jaime
- JM Dunne Naomi
- JM Ferguson Henry
- Jo\ue3o Lima Maria
- Johnstone Jack
- Jones Mark
- Jordan: Mahmoud Al-Masri Gela).
- JS Wall Joshua
- Judkins Nicholas
- JW Wilkin Richard
- K Abou Chaar Mohamad
- K Ambler Graeme
- K Bankhead-Kendall Brittany
- K Bankhead-Kendall Brittany
- K Bankhead-Kendall Brittany
- K Brown Allison
- K Fusai Giuseppe
- K Gill Charn
- K Kamarajah Sivesh
- K Patel Panna
- K Ubhi Harmony
- K Weerasinghe Chamindri
- K\uf6nigsrainer Alfred
- Kalidindi Venugopala
- Kamal Mona
- Kang Chong
- Kara Yasin
- Karam Edward
- Karim Ahmed
- Kashora Florence
- KC Jonker (University Medical Center Groningen (University of Groningen) Pascal
- Kearney (Beaumont Hospital) David
- Khajuria Apoorva
- Khan Azam
- Khan Umul
- Khatri Chetan
- Kinross James
- Kler Aaron
- Klimopoulos (Evangelismos General Hospital) Serafeim
- Kocata\u15f (Kanuni Sultan Suleyman Training and Research Hospital) Ali
- Kolias Angelos
- Kolias Angelos
- Kontovounisios Christos
- Kourdouli (Leicester Royal Infirmary) Amar
- Krishnan Emily
- Kristinsson Sverrir
- Kruijff Schelto
- KS Viswanath Yirupaiahgari
- Kudsk-Iversen S\uf8ren
- Kufeji Dorothy
- Kulkarni Rugved
- Kurihara Hayato
- L Biffl Walter
- L Coleman Natasha
- L Collins Michelle
- L Engel (Temple University Hospital) Jamie
- L Fowler Amy
- L Garcia Galocha Jose
- L Hughes Jane
- L J\uf6nsson (Bispebjerg Hospital Maria
- L Labib Peter
- L Marsh (Scripps Memorial Hospital) Christopher
- L McKevitt Kevin
- L Osorio Alexander
- L Romera Jose
- L Serevina Olivia
- L Venn Mary
- L Venn Mary
- L Venn Mary
- L Wright Franklin
- L Young Alastair
- L\ue1zaro Andr\ue9
- La Torre Filippo
- Laface (Ospedale Vittorio Emanuele III Letizia
- Lami Mariam
- Landaluce-Olavarria Aitor
- Laura Hansen 9
- Lawani Ismail
- Lawday (Southmead Hospital) Samuel
- Lawday Samuel
- Le Roy Bertrand
- Lecco) Asst
- Lecolle Katia
- Lederhuber Hans
- Lederhuber Hans
- Leeds)
- Leicester)
- Leventoglu Sezai
- Li Elizabeth
- Li Elizabeth
- Li Zoe
- Libya: Ghadah Z Alkadeeki Hani Al-Najjar (King Hussein Cancer Center).
- Liew Ignatius
- Ligure (SV) Pietra
- Lima Buarque Igor
- Lisi Giorgio
- Lizzi Vincenzo
- Lo Terence
- Lombardia) Regione
- Lomiento Daniele
- Longhi Marco
- Lopez Antonanzas (Hospital Clinico San Carlos Leyre
- Losada Ruiz Manuel
- Lostis Emilie
- Lostoridis Eftychios
- Loubani Mahmoud
- Lowy- Benoliel Alejandro
- Lucianetti (Papa Giovanni XXIII Hospital) Alessandro
- Luigi MP Marino Cosentino (PO San Filippo Neri - ASL ROMA 1) Andrea Sagnotta
- luis Blas Laina Juan
- Luke Evans (Norfolk and Norwich University Hospital) Mina MG Youssef
- Luke Louis
- Lunevicius Raimundas
- Luraghi Marco
- Lye George
- M Alrahawy (Menofiya University Hospital) Mahmoud
- M Andreani Stefano
- M Ashoush Fouad
- M Bajomo Oreoluwa
- M Blundell Chris
- M Cicerchia Pierfranco
- M Connolly Tara
- M Diez-Alonso Manuel
- M Dur\ue1n-Mu\uf1oz-Cruzado (Hospital Universitario Virgen del Rocio) Virginia
- M Emslie Katy
- M Harrison Ewen
- M Holbrook Charlotte
- M Isolani Simone
- M Keatley James
- M Leite-Moreira Andr\ue9
- M Mithany Reda H
- M Mohan Helen
- M Mohan Helen
- M Monteiro Joana
- M Morgom (Tripoli Central Hospital) Marwa
- M Muguerza Jose
- M Nunes Quentin
- M Nygaard Rachel
- M Omar Aneel Bhangu Omar
- M Philp Matthew
- M Pollok Joerg
- M Rooney Siobhan
- M Sampietro Gianluca
- M Sewards Joseph
- M Tang Alethea
- M Trout Isobel
- M Walters (Harborview Medical Center Andrew
- MA Kaafarani Haytham
- MA Kaafarani Haytham
- MA Kaafarani Haytham
- Maarten van Heinsbergen (VieCuri Medisch Centrum) Joop Konsten
- Mabrouk Islam
- Macchi Alberto
- MacDonald Luisa
- Machairas (Royal Free Hospital) Nikolaos
- Madonini Marco
- Madrid)
- Madrid)
- Magalh\ue3es Maia Mariana
- Magne Augestad Knut
- Magowan Drew
- Maha H Haqqani (Boston Medical Center) Frederick T Drake
- Maisonneuve Emeline
- Majkowska Agata
- Majkowski (Northern General Hospital Lawrence
- Mak (Queen Elizabeth Hospital Birmingham) Jason
- Malabarba Stefano
- Malerba Michele
- Maninder Kalkat 7
- Mannan Syed
- Manson Joanna
- Mansuri Ahmer
- Mantoglu (Sakarya University Research and Educational Hospital) Baris
- Manu Nichola
- Manzoni 56 Via
- Maqsood Afnan
- Marano Alessandra
- Marchbank Adrian
- Marcos-Santos Pablo
- Marinos Kouris (Buckinghamshire Healthcare NHS Trust) Spyros
- Marqueta De Salas Maria
- Marrano Enrico
- Mart\uedn-Rom\ue1n Lorena
- Mart\uednez P\ue9rez Carolina
- Mart\uednez-dePaz Fernando
- Martel Lozano Saida
- Martin (St Mary's Hospital) Guy
- Martin Emmeline
- Martin Janet
- Martin-Albo Lorena
- Martine Uittenbogaart (M\ue1xima Medical Center) Wouter KG Leclercq
- Martinelli Fabio
- Martinez-German Antonio
- Martinez-Pinedo Carlos
- Martins Ricardo
- Marwan Hisham
- Marzi Federica
- MAS Baig Mirza
- Mateos-Sierra (Hospital General Universitario Gregorio Mara\uf1\uf3n) Olga
- Mater Studiorum University of Bologna) Alma
- Mathieu (CHU Besan\ue7on) Pierre
- Matute-Najarro Maria-Soledad
- Maw Andrew
- Mazingi Dennis
- Mazzaferro (Fondazione IRCCS Istituto Nazionale dei Tumori Vincenzo
- McCanny (Antrim Area Hospital) Andrew
- McKenzie Katherine
- McLarty (Northumbria NHS Hospital Trust) Nicola
- McPherson Iain
- Medina Esther
- Mediratta Saniya
- Medone Marzia
- Mehra (Guy's and St Thomas\u2019 NHS Foundation Trust) Gautam
- Mele Simone
- Melero-Cort\ue9s Lidia
- Melody Baeza (Morales Meseguer University Hospital) Jos\ue9 Aguilar
- Mendon\ue7a Ata\uedde Gomes Gustavo
- Mendoza-Moreno Fernando
- Meneghini Simona
- Merate
- Mercante Giuseppe
- Merdrignac (Rennes University Hospital) Aude
- Metallidis Symeon
- Michel (Pinderfields Hospital) Martin
- Migliore Marco
- Milan)
- Milan)
- Milan)
- Miller Douglas
- Minaya- Bravo Ana
- Minaya-Bravo Ana
- Minaya-Bravo Ana
- Minaya-Bravo Ana
- Mingoli Andrea
- Minto Gary
- Mirabella Antonello
- Misra Nikhil
- Mitrasinovic Stefan
- Miu Victor
- Moawad (Royal Victoria Hospital) Nader
- Mochet Sylvie
- Modabber Ali
- Mohammad Adam
- Mohan Midhun
- Moliner-S\ue1nchez Carmen
- Mondov\uec)
- Mongelli Francesco
- Monteleone (Ospedale San Leopoldo Mandic Michela
- Montuori Mauro
- Moore Rachel
- Mora-Guzm\ue1n (Hospital Santa B\ue1rbara) Ismael
- Morales Dieter
- Morales Xavier
- Morelli Luca
- Morelli Lucia
- Morgan Richard
- Morris Chris
- Mortini Pietro
- Mosca Angelo
- Moszkowicz David
- Moszkowicz David
- Motter Dema
- Moug Susan
- Mukherjee Samrat
- Munoz Rivas Ana
- Murcia)
- N Bence Matthew
- N Hopkinson David
- N Mashbari Hassan
- N Mashbari Hassan
- N Mashbari Hassan
- N Naumann David
- N Rao Jagan
- N Townshend David
- N\ufa\uf1ez Jordi
- Najdy Manhal
- Nakas (Glenfield Hospital Apostolos
- Namazov Ilgar
- Naredla Pradyumna
- Nasef Emmhamed
- Nassa Heeam
- Nath Rahul
- Navarro-S\ue1nchez Antonio
- Nazarian (Bupa Cromwell Hospital) Scarlet
- Neal Bhutiani (University of Louisville Hospital and Norton Hospital) Robert CG Martin
- Negri Giampiero
- Nehra Deepika
- Neil-Dwyer Jason
- Nepogodiev Dmitri
- Nepogodiev Dmitri
- Nepogodiev Dmitri
- Neri Jacopo
- Netherlands: Suzanne S Gisbertz Mustafa R Bulugma (Zawia Teaching Hospital). Mexico: Fernando Cordera (ABC Medical Center).
- Newton (Manchester Royal Infirmary) Katy
- Nikaj (Azienda Ospedaliero Universitaria Maggiore della Carit\ue0 Herald
- Niquen Milagros
- Nobile (Azienda Ospedaliera Universitaria Integrata di Verona) Sara
- Nogueiro Jorge
- Nogues Pevidal (Royo Villanova) Ana
- Novara)
- Ntirenganya Faustin
- Nugent Michael
- O Ademuyiwa Adesoji
- O Kavanagh Dara
- O Larkin John
- Oca\uf1a Juan
- of Amsterdam University
- of Ferrara) University
- of Insubria University
- of Milan) University
- of Surgeons in Training (ASiT) Association
- of Surgery) Department
- of Washington) University
- Okafor Barbara U.
- Okechukwu Valentine
- Oliva-Mompean (Hospital Universitario Virgen Macarena) Fernando
- Oliveira Ana
- OM Abdalla Mutwakil
- Omar M Omar
- OO Ayorinde John
- Osagie-Clouard (Epsom &
- Osman (Walsall Manor Hospital) Khabab
- Ottolina Jessica
- Ourieff (Mount Sinai Hospital) Jared
- Outani Oumaima
- Oyewole Bankole
- P Arnaud Alexis
- P Arnaud Alexis
- P Arnaud Alexis
- P Baker Markus
- P Belgaumkar Ajay
- P Boddy Alexander
- P Duffy (Nottingham City Hospital) John
- P Evans Jonathan
- P Hazelton Joshua
- P Jones Andrew
- P Jones Robert
- P Joyce Doireann
- P Kisiel Aaron
- P Pezzuto Anna
- P Singh Rabindra
- P\ue9rez-Gonz\ue1lez Marta
- P\ue9rez-Saborido Baltasar
- Pacheco-Sanchez David
- Padilla-Valverde (Hospital General Universitario De Ciudad Real) David
- Pai (Hammersmith Hospital) Madhava
- Paiella Salvatore
- Paisley (Brighton and Sussex NHS Trust Samuel
- Palermo)
- Palini Gianmarco
- Palmeri Matteo
- Parente Alessandro
- Parlanti Daniele
- Parmar Chetan
- Pascual Angela
- Pata Francesco
- Pata Francesco
- Patel Mahul
- Pathak Abhijit
- Patil Sangram
- Pattyn Piet
- Peckham- Cooper Adam
- Pedram Panahi (University Hospitals Plymouth NHS Trust) Mariam Rela
- Pedrazzani Corrado
- Pellino Gianluca
- Pereira Andr\ue9
- Pereira-Neves Ant\uf3nio
- Perez-Diaz Md
- Perivoliotis (General University Hospital of Larissa) Konstantinos
- Perkins Clare
- Perotto (CHU Saint Etienne) Ornella
- Perra Teresa
- Petrone Patrizio
- Phenix George
- Piacenza)
- Picazo Sara
- Picon-Rodriguez Rafael
- Piloni Martina
- Pingarr\uf3n-Mart\uedn Lorena
- Pinotti Enrico
- Pizzini Paolo
- PM de Vries Jean-Paul
- Pockney Peter
- Podolsky Dina
- Poggioli Gilberto
- Pompili Cecilia
- Pontari Michael
- Porcu Alberto
- Portugal: Hugo Santos-Sousa Pakistan: Mariyah Anwer (Jinnah postgraduate medical center).
- Potter (Royal Bournemouth Hospital) Ryan
- Price Claire
- Prita Daliya 8
- Pruvot (Lille University Hospital) Fran\ue7ois-Ren\ue9
- PTSurg ItSURG
- Pujol-Muncunill Roger
- Puppo Andrea
- Q Mehdi (University of Texas Medical Branch) Mohammad
- Quante Markus
- Quintana-Villamandos Bego\uf1a
- Qureshi Ali
- R Burke Joshua
- R Davidson Brian
- R Dixon Jan
- R Fretwell Kenneth
- R Gujjuri Rohan
- R Gujjuri Rohan
- R Kowal Mikolaj
- R O\u2019Neill John
- R Sarma Diwakar
- R Spalding Duncan
- R Springford Laurie
- Rachel Baumber (Royal National Orthopaedic Hospital) James T Parry
- Radenkovic Dejan
- Rahman Saad (Medway Maritime Hospital) Abdel
- Rakvin Ivan
- Ramallo-Sol\ueds Irene
- Ramcharan Sean
- Ramos Diego
- Ramos-Bonilla Antonio
- Ramos-De la Medina Antonio
- Ramzi Joussi
- Rathinam Sridhar
- Rausa Emanuele
- Ravaioli Matteo
- Ravindran Sharanya
- Raymond (Royal Lancaster Infirmary) Thomas
- Razik Aisha
- Redfern (Furness General Hospital) Jennifer
- Reguera-Rosal Julio
- Rey-Biel Juan
- Rey-Valcarcel Cristina
- RG Sheel Andrea
- Ribolla Marta
- Richards Tomos
- Richmond (University of Maryland Medical Center) Michael
- Righini (Ospedale del Delta Erminio
- Rio-Gomez Javier
- Riuniti Villa Sofia-Cervello Ospedali
- Riyat Harjoat
- Rizvi Sana
- Roberts Keith
- Roberts Matthew
- Robertson (University Hospitals Coventry and Warwickshire) Stuart
- Robertson (University of Arkansas for Medical Sciences) Ronald
- Robin-Valle Alvaro
- Rochon Melissa
- Rojo Mikel
- Rolli Luigi
- Romano Silvio
- Rome)
- Romford)
- Ross Elizabeth
- Ross Howard
- Rottoli Matteo
- Royal Hospital) Princess
- Ruiz (Hospital General Universitario Reina Sof\ueda Miguel
- Ruiz- Grande Fernando
- Ruiz-Martin (Rey Juan Carlos University Hospital) Irene
- Ruiz-Soriano (Hospital Cl\uednico Universitario de Valladolid) Mar\ueda
- Ruzzenente Andrea
- Ryska Ondrej
- S Abdelaal (Alexandria Main University Hospital) Ahmed
- S Al Maadany Faraj
- S Faria Carlos
- S Hammond John
- S Hossain Fahad
- S Jeyaretna Deva
- S Jones Conor
- S Khan (Queen Alexandra Hospital) Jim
- S Moura Francisco
- S Ng-Kamstra Joshua
- S Sica Giuseppe
- S Tamimy Muhammad
- S Wadley Martin
- S\ue1nchez- Arteaga Alejandro
- SA Taher Ahmed
- Saez Carlos
- Sahnan Kapil
- Sahni Arun
- Salim Ali
- Salvia Roberto
- Sammarco Giuseppe
- Sampaio-Alves Mafalda
- San Miguel-Mendez Carlos
- Sanchez del Pueblo Cristina
- Sanchez-Fuentes Maria-Nieves
- Sanchez-Pelaez Daniel
- Sanchez-Perez Coral
- Sanchez-Rubio Maria
- Sancho-Muriel Jorge
- Sanchon Fructuoso Lorena
- Sanders Julie
- Santero-Ramirez Maria-Pilar
- Santora Thomas
- Santoro Antonio
- Santos Irene
- Sapienza Paolo
- Sartarelli (Sant\u2019Orsola Hospital Lodovico
- Sarveswaran Janahan
- Sasia Diego
- Sassari) A. O. U.
- Saudemont Alain
- Saudi-Moro Sef
- Saxena Dolly
- Saxena Shobhit
- Sayasneh Ahmad
- Scalabre Aurelien
- Schache Andrew
- Schiavina Riccardo
- Schineis (Charit\ue9 University Medicine Christian
- Schreckenbach Teresa
- Scorza Antonella
- Scott Lucy
- Seegert (ProMedica Toledo Hospital) Sara
- Seguin-Givelet Agathe
- Senent-Boza Ana
- Serrano Gonz\ue1lez Javier
- Sette Laghi Asst
- Seymour Keith
- Shabana Amanda
- Shah (The Whittington Hospital) Sujay
- Shah Jigar
- Shah Karishma
- Shah Preena
- Shakir Taner
- Shalaby (Mansoura University Hospital) Mostafa
- Shankar (Oxford University Hospitals NHS Foundation Trust Sushma
- Shaw Richard
- Sheffield)
- Shehata Sameh
- Shelley Hwang E.
- Shen Ban Vin
- Shenfine Amy
- Sheridan Kelda
- Sherief Ahmed
- Sherif Mohamed
- Shinkwin Michael
- Shu Sebastian
- Siaw-Acheampong Kwabena
- Sileri (San Raffaele Scientific Institute Pierpaolo
- Singh Abhinav
- Singh Shailendra
- Sinha Sanjay
- Siragusa (Policlinico Tor Vergata Hospital Leandro
- Sivaprakasam Rajesh
- Sivayoganathan Sriharan
- SJ Ledesma Frances
- Smillie Robert
- Smith (Countess of Chester Hospital) Claire
- Smith Andrew
- Smith Christopher
- Sochorova (Royal Liverpool University Hospital) Dana
- Society of Coloproctology (ESCP) European
- Society of Colorectal Surgery (SICCR) Italian
- Soggiu Fiammetta
- Sohrabi (St Bartholomew's Hospital) Catrin
- Sohrabi (Whipps Cross University Hospital) Catrin
- Sohrabi Catrin
- Solari (Royal Gwent Hospital) Francesca
- Solli Piergiorgio
- Soreide Kjetil
- Soto Montesinos Cristina
- SpainSurg
- Spinelli Antonino
- Spinelli Antonino
- Spoletini (Sant'Eugenio Hospital) Domenico
- Spriano Giuseppe
- Sravanam Sanskrithi
- Ssentongo (Pennsylvania State University) Paddy
- Stanger Sophie
- Stavroulias Dionisios
- Steel (Sunderland Royal Hospital) Ben
- Stella Marco
- Stewart Robbie
- Stringer Sally
- Sudan: Osman M Ali Elima P Cagigal- Ortega (Hospital Universitario Severo Ochoa).
- Sulen Nina
- Sundar Sudha
- Sundhu (Aintree University Hospital) Matthew
- Surgical Research Collaborative (ISRC) Irish
- Suri (University of California Davis Health Avni
- Swansea)
- Switzerland: Dimitri Christoforidis Ali A Ali karar (Al-rajhi).
- Syed Arooj
- Szatmary Peter
- T Colonna Emily
- T Enjuto Diego
- T Montella (Azienda Unit\ue0 Sanitaria Locale-IRCCS di Reggio Emilia) Maria
- TA Neely David
- Tabiri Stephen
- Tadross Daniel
- Taglietti Lucio
- Tansey (Princess Alexandra Hospital) Rosamond
- Tartaglia Dario
- Tawheed (Endemic Medicine Department Ahmed
- Tayeh Salim
- Testa Valentina
- Tewari Nilanjana
- Thoenissen Philipp
- Thomas (Worcestershire Acute Hospitals NHS Trust) Kane
- Thrush Jessica
- Tierney Sean
- Tiwari Abhinav
- Tobias Teles (Hospital de Cascais - Dr. Jos\ue9 de Almeida) Pedro A Serralheiro
- Toledo Enrique
- Tonini Valeria
- Torkington Jared
- Torzilli Guido
- Totty Joshua
- Tousidonis Manuel
- Townend Philip
- Townsend Catherine
- Trompeter (St George's Hospital) Alex
- Trotta Francesco
- Truant St\ue9phanie
- Trujillo-D\uedaz Jeancarlos
- Tsoulfas George
- Tsoulfas Georgios
- Turco Celia
- Turkey: Volkan Ozben Georgios Peros (Kantonsspital Winterthur).
- Turrado- Rodriguez Victor
- Turri Giulia
- Tustin (Cumberland Infirmary) Harry
- Tyler Jayne
- Tzedakis Stylianos
- Tzovaras George
- Ullah Ramzan
- Unit\ue0 Sanitaria Locale di Ferrara Azienda
- United Kingdom: Richard J Davies Alp Yildiz (Yildirim Beyazit University Yenimahalle Training and Research Hospital).
- United States: John RT Monson (AdventHealth Orlando) Lavinia Onos (York Teaching Hospitals NHS Trust).
- University Hospitals NHS Trust) Nottingham
- University of Rome) Sapienza
- University) Goethe
- University) Helwan
- Urban (University of Colorado Hospital) Shane
- Urbani (Azienda Ospedaliero Universitaria San'Anna Alessia
- Usai Antonella
- V Bhavaraju Avi
- V Comini Lara
- V Feo Carlo
- V Marino Marco
- V Shaw Abigail
- V\ue1zquez- Fern\ue1ndez Andrea
- Vaccarella (Azienda Ospedaliera Gianpaolo
- Valdes- Hernandez Javier
- Valsecchi Luca
- Vashisht Rajiv
- VCO) Asl
- Venkatesan (Glan Clwyd Hospital) Gowtham
- Vera-Mansilla Cristina
- Vergari (Ospedali Riuniti di Ancona) Roberto
- Vescio (University 'Magna Graecia' of Catanzaro) Giuseppina
- Vidya Raghavan
- Vieira (Centro Hospital Universit\ue1rio S\ue3oJo\ue3o) Paula
- Vijay Vardhini
- Vimalachandran Dale
- Vimalachandran Dale
- Violante Tommaso
- Vovola Fernanda
- Vulliamy Paul
- W Endorf (Hennepin Healthcare) Frederick
- W Etchill Eric
- W L\uf6ffler Markus
- W L\uf6ffler Markus
- Wall Rosemary
- Wallwork Kate
- Ward Alex
- Warwick (University Hospital Southampton) David
- Waseem Saima
- Weaver Helen
- Wells Fiona
- Wen Jiaxin
- West Raha
- Whitehall Emma
- Wild Laura
- Wilkins Alex
- Williams Gethin
- Williams Matthew
- Winnand (University Hospital Aachen) Philipp
- Wong (Addenbrooke's Hospital) Ken
- Worku (Queen\u2019s Medical Centre Dawit
- Wright Naomi
- WS Ho (Leeds Teaching Hospitals NHS Trust Michael
- WT Ngu Albert
- y Cajal) Cristina Cerro (Hospital Universitario Ram\uf3n
- Y Oo (Department of Cardiothoracic Surgery Aung
- y Polit\ue9cnico La Fe) Blas Flor (Hospital Universitario
- Y van der Plas Willemijn
- Yalamanchili Seema
- Yershov (South Warwickshire NHS Foundation Trust) Danylo
- Young Richard
- Yousra Ahmed (Portsmouth Hospital NHS Trust) Simon Toh
- Yurttas Can
- Zadegan Frederic
- Zafar (Northwick Park Hospital) Noman
- Zakaria Rasheed
- Zambon Martina
- Zanini Nicola
- ZE Durst Alexander
- Zerbib Philippe
- Zonta (Ospedale San Biagio Sandro
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of 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
31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two
- Author
- Abassi Yama
- Abelin Jennifer G
- Abolhalaj Milad
- Abraham Tara S
- Adam Ammar
- Adams David
- Adams Homer
- Adams Sarah F
- Adamus Tomasz
- Addepalli Murali
- Addepalli Murali
- Adjei Alex A
- Agapova Larissa
- Agarwala Sanjiv
- Ager Casey
- Aggarwal Charu
- Agnello Giulia
- Agudo Judith
- Aguilar Ethan G
- Aguilera Todd
- Ahamadi Malidi
- Ahn Yong-Oon
- Ahrens Eric T
- Aizer Ayal
- Ajina Reham
- Akerley Wallace
- Al-Muftah Mariam
- Albershardt Tina C
- Albershardt Tina C
- Albrekt Ann-Sofie
- Alekar Shilpa
- Alemany Ramon
- Alemany Ramon
- Alexander Brian
- Allbritton Omaira
- Allen Clint T
- Alley Evan W
- Allison James
- Allison James
- Allison James
- Alston Tesha
- Alt Jürgen
- Alters Susan
- Amatulli Michael
- Anand Snjezana
- Anand Snjezana
- Anand Snjezana
- Anderson Clark
- Anderson Mark
- Andersson Bengt
- Andre Pascale
- Andtbacka Robert H I
- Andtbacka Robert H I
- Angiuoli Sam
- Ansari Tameem
- Anthony Scott
- Antonarakis Emmanuel S
- Antonia Scott J
- Anwar Firoz
- Aquino-Michaels Keston
- Archer Jacob F
- Arina Ainhoa
- Armand Philippe
- Armenta Paul
- Armet Caroline M
- Arnoux Thomas
- Ascarateil Stephane
- Askmyr David
- Atkins Michael
- Atkins Michael B
- Atkinson Victoria
- Au Katrina
- Autio Karen A
- Awad Mark
- Bagarazzi Mark
- Bai Dina
- Baia Gilson
- Baird Jason
- Bajaj Anshika
- Balatoni Timea
- Balboni Tracy
- Balch Leslie
- Bang Andrew
- Bao Riyue
- Bao Yangyi
- Bao Yangyi
- Barakat David
- Barberi Theresa
- Barker Christopher A
- Barnea Eytan
- Barras David
- Bartkowiak Todd
- Bartlett David
- Bartlett David
- Bartlett David
- Bartlett David
- Barton Sunjay M
- Barve Minal
- Bauer Todd
- Bauer Todd W
- Bauman Julie
- Baumgaertner Petra
- Bauml Joshua
- Beceren-Braun Figen
- Beck Kristen
- Becker Annette
- Beckers Johannes
- Beckett Michael A
- Bedognetti Davide
- Bedognetti Davide
- Bedognetti Davide
- Bell Bryan
- Bell Charles J M
- Bell Peter
- Beltran Pedro
- Bender Lewis H
- Bender Steven
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- Benz Steven
- Bera Tapan
- Berglund Peter
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- Berkey Sara
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- Berry John S
- Berzofsky Jay A
- Bhardwaj Nina
- Bian Zhen
- Bianco Alberto
- Biediger Ronald J
- Bifulco Carlo
- Bigley Alison
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- Bommareddy Praveen K
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- Booth Jamie
- Bornschlegl Svetlana
- Bose Nandita
- Bossenmaier Birgit
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- Bramante Simona
- Branstetter Daniel
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- Brockstedt Dirk G
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- Budkowska Marta
- Bueno Raphael
- Buettner Florian
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- Bullock Kim
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- Eriksson Emma
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- Facciabene Andrea
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- Facciponte John
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- Falchook Gerald
- Fantini Massimo
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- Fantini Massimo
- Farkas Emil
- Farren Matthew
- Faustman Denise
- Fa’ak Faisal
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- Franklin Wilbur
- Frascaro Federica
- Fraser Kathryn
- Frederix Kim
- Freimark Bruce
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- Frey Alan
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- Melssen Marit
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- Zeng Xue
- Zha Yuanyuan
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- Zhang Yanping
- Zhao Fei
- Zhao Leyna
- Zhao Xingli
- Zheng Lianxing
- Zheng Wenxin
- Zheng Xianxian
- Zheng Yi
- Zhong Hong
- Zhou Li
- Zhou Xiangjun
- Zippelius Alfred
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zou Jun
- Zuba-Surma Ewa
- Zubkova Olga
- Zureikat Amer
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Background
The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd.
Methods
We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background.
Results
First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001).
Conclusions
In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival
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