Abstract
Background: There seems to be a general consensus in the current published literature on postponing elective, nonurgent surgery on COVID-19-positive patients. However, thus far, no recommendations have been published on when and how to start carrying out elective, nonurgent surgery on COVID-19-negative patients after the epidemic peak.
Objective: The aims of the study are to determine the best approach for reintroduction of elective procedures based on their preoperative screening by the respiratory scoring system and to provide a scientific base for solid elective surgery protocols that may be implemented in the moment when a country or region meets the criteria to implement elective, nonurgent procedures.
Methodology: This was a retrospective chart review of patients who underwent bariatric surgery between March and June 2020, during the pandemic of COVID-19. The study was conducted in Riyadh, Saudi Arabia, in 2 different health institutions. The study participants were men and women with a body mass index (BMI) > 30 kg/m(2) and with a respiratory score of <= 3. The data were analyzed on SPSS version 22. Descriptive statistics for quantitative variables were reported as mean +/- SD or median (interquartile range [IQR]). The qualitative variables were reported as frequency and percentage.
Results: The total number of patients was 90. The mean age of the patients was 32.73 +/- 7.81 years, and a greater proportion (n = 48; 56.5%) of them were men. The mean BMI of the patients was 42.29 +/- 7.40 kg/m(2). About 37 (41.1%) patients reported a previous history of surgery. Moreover, 36 (40.0%) patients presented with comorbidities. Only 1 (1.1%) patient was tested for COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR) before surgery and tested negative. We observed that most patients (n = 80; 88.9% ) underwent lap sleeve gastrectomy. The median length of surgery was 50 (IQR, 17) minutes, and the median length of hospital stay was 36 (IQR, 24) hours. After surgery, none of the patients developed any complications, and none were admitted to the intensive care unit. After surgery, only 2 (2.2%) patients were tested for COVID-19 by RT-PCR, and 100% tested negative.
Conclusion: During the COVID-19 pandemic, before considering patients for elective surgery, they should be screened. For patients who are obese or have underlying comorbidities, if on screening, their respiratory score is <= 3, indicating low risk of respiratory illness, elective procedures should continue. Strict precautionary measures should be followed, and a limited number of surgeries should be performed.