Published online Nov 20, 2022. doi: 10.5662/wjm.v12.i6.476
Peer-review started: April 15, 2022
First decision: August 1, 2022
Revised: September 1, 2022
Accepted: November 4, 2022
Article in press: November 4, 2022
Published online: November 20, 2022
Several unique clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19) infection, have been identified and characterized. One such feature, mostly among patients with severe COVID-19 infection, has become known as COVID-19-induced coagu
To perform a systematic review and meta-analysis of the literature on COVID-19 infections that led to thrombotic complications necessitating surgical intervention.
The current systematic review implemented an algorithmic approach to review all the currently available English medical literature on surgical interventions necessitated by COVID-19 thrombotic complications using the preferred reporting items for systematic reviews and meta-analysis principles. A comprehensive search of the medical literature in the “PubMed”, “Scopus”, “Google Scholar” top 100 results, and archives of Plastic and Reconstructive Surgery was performed using the key words “COVID-19” AND “surgery” AND “thromboembolism” AND “compli
The database search resulted in the final inclusion of 22 retrospective studies, after application of the inclusion/exclusion criteria. Of the included studies, 17 were single case reports, 3 were case series and 2 were cross sectional cohort studies. All studies were retrospective in nature. Twelve of the reported studies were conducted in the United States of America, with the remaining studies originating from Italy, Turkey, Pakistan, France, Serbia, and Germany. All cases reported in our study were laboratory confirmed SARS-CoV-2 positive. A total of 70 cases involving surgical intervention were isolated from the 22 studies included in this review.
There is paucity of data describing the relationship between COVID-19 infection and thrombotic complications necessitating the need for surgical intervention. Intestinal ischemia and acute limb ischemia are amongst the most common thrombotic events due to COVID-19 that required operative management. An overall postoperative mortality of 30% was found in those who underwent operative procedures for thrombotic complications, with most deaths occurring in those with bowel ischemia. Physicians should be aware that despite thromboprophylaxis, severe thrombotic complications can still occur in this patient population, however, surgical intervention results in relatively low mortality apart from cases of ischemic bowel resection.
Core Tip: Surgical patient with a history of or current active infection with severe acute respiratory syndrome coronavirus 2 bear a significantly high risk for postoperative thrombotic complications. These patients may require surgical intervention to treat severe thrombotic complications. In total, 70 cases of thromboembolic complications necessitating surgical intervention have been documented. These patients have an overall mortality rate of 30%. Intestinal ischemia and acute limb ischemia are the most common thrombotic complications that required operative management. Physicians should be aware that severe thrombotic complications can occur in this patient population, however, surgical intervention results in relatively low mortality apart from cases of ischemic bowel resection.