Thoracic Surgery during COVID-19 Outbreak How High is the Risk for Non Vaccinated Patients?

Leo F1*, Sobrero S1, Gagliasso M2, Roffinella M3, Mazza F4, Olivetti S5, Parini S6, Rena O6, Filosso P3, Mancuso M5, Melloni G4, Cavallo A2 and Ruffini E3

1Department of Thoracic Surgery, S. Luigi Hospital, University of Turin, Italy
2Department of Thoracic Surgery, S. Giovanni Bosco Hospital, Italy
3Department of Thoracic Surgery, Città della Salute Hospital, University of Turin, Italy
4Department of Thoracic Surgery, S. Croce Hospital, Italy
5Department of Thoracic Surgery, Alessandria Hospital, Italy
6Department of Thoracic Surgery, Ospedale della Carità, Italy

^*Correspondance to: Francesco Leo 

 PDF  Full Text DOI: 10.25107/2474-1647.3437

Abstract

Background: Despite legislation, guidelines and nudge strategies, a small but not negligible proportion of the population refuses vaccine against COVID-19. The actual risk for non vaccinated patients to undergo a thoracic surgery procedure during COVID outbreak remains undetermined. The aim of the study was to analyze the worst case scenario measuring that risk during the second wave period, when vaccines were not available. Materials and Methods: Cases of postoperative COVID infection were monitored in the 6 Thoracic Surgery Divisions in Piedmont, Italy, from October to December 2020. Postoperative COVID-19 infection was defined by the presence of a positive quantitative RT-PCR test on nasal swabs found within one month from the procedure. Positive cases were analyzed searching for clinical predictors of symptomatic infection by univariate (Student T test or Mann-Whitney test for continuous variables according to their distribution and Chi square test for categorical variables). Results: Twenty cases of postoperative COVID infection were identified on an overall population of 466 patients operated on during the considered period (overall incidence 4.2%). Eleven patients were operated for oncological reasons, 3 patients due to pleural infection, and 6 patients for recurrence pleural effusion or pneumothorax with persistent air leak. Infection was asymptomatic in 6 cases and symptomatic in 14 cases. In 3 patients, symptoms occurred after discharge. Five patients died due to consequences of COVID infection (mortality 25%). During the considered period, COVID-19 was responsible of an additional mortality of 1%. Older patients were more likely to develop symptomatic infection. Conclusion: In the second wave scenario in Italy, the additional overall mortality due to COVID was in the order of 1%. This figure indicates the risk during pandemic outbreak in absence of an effective vaccination and probably overestimates the actual risk. In fact, a large proportion of general population has been immunized since then, reducing viral circulation and exposure of non vaccinated patients.

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Cite the article

Leo F, Sobrero S, Gagliasso M, Roffinella M, Mazza F, Olivetti S, et al. Thoracic Surgery during COVID-19 Outbreak How High is the Risk for Non Vaccinated Patients?. Clin Surg. 2022; 7: 3437..