{
  "abstract": "Objective To evaluate the relationship between preoperative COVID-19 infection and major postoperative pulmonary complications (PPC) risk after major elective surgeries during the Omicron wave.Design A multicentre, prospective, observational cohort study.Setting Four tertiary medical centres in Beijing, China.Participants All adult patients who underwent major elective surgeries under general anaesthesia from 30 December 2022 to 18 May 2023 were screened for eligibility. A total of 3211 patients were included.Primary and secondary measures The primary outcome was 30-day major PPC, defined as pneumonia, acute respiratory distress syndrome or unexpected postoperative ventilation. The secondary outcomes included length of hospital stay (LOS), reoperation and mortality.Results Major PPC occurred in 3.5% of patients with preoperative COVID-19 and 3.3% of those without. Inverse probability of treatment weighting-adjusted analysis showed no significant association between preoperative COVID-19 within 12 weeks and PPC risk (adjusted OR, 0.89; 95% CI 0.69 to 1.13). However, multivariable analysis revealed that COVID-19 infection within 3 weeks was independently associated with an increased PPC risk (OR, 3.44; 95% CI 1.37 to 8.68). Cardiothoracic surgery (OR, 12.47; 95% CI 8.11 to 19.17) and longer duration of surgery (OR, 1.24 per hour; 95% CI 1.13 to 1.37) were significant risk factors. In the cardiothoracic subgroup, PPC risk was significantly elevated within 7 weeks of infection. No significant differences were observed in LOS, reoperation rates or mortality between patients with and without preoperative COVID-19 infection.Conclusions Preoperative COVID-19 infection within 12 weeks was not associated with an increased overall risk of major PPC during the Omicron wave. Although very short infection-to-surgery intervals and cardiothoracic surgery showed exploratory signals of higher risk, these findings should be interpreted cautiously and support an individualised approach to perioperative risk assessment.Trial registration number ChiCTR2200067250.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Tian Wang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Yanhan Lyu"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University First Hospital, Beijing, China"
      ],
      "name": "Hong Zhang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Lei Zhao"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University People’s Hospital, Beijing, China"
      ],
      "name": "Yaqing Wu"
    },
    {
      "affiliations": [
        "Department of Emergency, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Qingbian Ma"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Dongsheng Yang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Rui Zhang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Zhengqian Li"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Yongzheng Han"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Chang Liu"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Xiangyang Guo"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University People’s Hospital, Beijing, China"
      ],
      "name": "Yi Feng"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University First Hospital, Beijing, China"
      ],
      "name": "Dongxin Wang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Tianlong Wang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Peking University Third Hospital, Beijing, China"
      ],
      "name": "Min Li"
    }
  ],
  "title": "Association between preoperative COVID-19 and major postoperative pulmonary complications: a multicentre observational cohort study in China",
  "uid": "593ed0b8-a120-5bca-976f-f396637c3983"
}