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SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

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journal contribution
posted on 2021-09-01, 00:00 authored by COVIDSurg Collaborative, GlobalSurg Collaborative
Abstract

Background
Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.


Methods
The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty.


Results
NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year.


Conclusion
As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.

History

Journal

British Journal of Surgery

Volume

108

Issue

9

Pagination

1056 - 1063

Publisher

Oxford University Press (OUP)

Location

Oxford, Eng.

ISSN

0007-1323

eISSN

1365-2168

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

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