Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2021; 13(8): 788-795
Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.788
Surgical complications in COVID-19 patients in the setting of moderate to severe disease
Milena Gulinac, Ivan P Novakov, Svetozar Antovic, Tsvetelina Velikova
Milena Gulinac, Department of General and Clinical Pathology, Medical University, University Hospital "St George," Plovdiv 6000, Bulgaria
Ivan P Novakov, Department of Thoraco-abdominal Surgery, Medical University, Plovdiv 6000, Bulgaria
Svetozar Antovic, University Clinic for Digestive Surgery, Medical Faculty, Skopje 1000, Macedonia
Tsvetelina Velikova, Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Tsvetelina Velikova, Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Author contributions: Gulinac M and Velikova T wrote the manuscript; All authors wrote additional sections of the paper; All authors revised and approved the final version of the manuscript; All authors take full responsibility for the integrity of all aspects of the work.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article selected by an in-house editor and fully peer-reviewed by external reviewers. Following the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works differently terms, provided the original work properly cited and the use is non-commercial. See:
Corresponding author: Tsvetelina Velikova, MD, PhD, Assistant Professor, Department of Clinical Immunology, University Hospital Lozenetz, Kozyak 1 Street, Sofia 1407, Bulgaria.
Received: February 7, 2021
Peer-review started: February 7, 2021
First decision: March 16, 2021
Revised: March 30, 2021
Accepted: June 16, 2021
Article in press: June 16, 2021
Published online: August 27, 2021
Core Tip

Core Tip: The clinical outcomes of coronavirus disease 2019 (COVID-19) patients undergoing urgent or emergent surgeries have shown that the estimated duration of hospitalization is 10.55 d, with 15% admission in the intensive care unit and up to 15% in the postoperative period. Several complications are described in patients with COVID-19 who underwent surgical procedures, including acute respiratory distress syndrome and other pulmonary complications (e.g., pneumonia, shortness of breath, dyspnea, fever, cough). These complications lead to respiratory and cardiovascular system failure (i.e. heart attack, arrhythmia, and infarction), secondary infection, fatigue or myalgia, severe lymphopenia, sepsis/shock, acute kidney injury, etc. Pulmonary complications are considered the primary cause for the low survival rate and prolonged immobility in surgical COVID-19 patients. Lung involvement is also associated with high postoperative mortality, contributing to a 30-d mortality rate of 38%. Furthermore, cancer patients are more likely to contract COVID-19 than non-cancer patients. Therefore, they are more vulnerable to complications and have a higher mortality rate postoperatively. Thus, the impact of the COVID-19 pandemic on surgical patients in terms of delays or complications is noteworthy, and is expected to continue after the end of the pandemic.