303 - SARS-CoV-2 Infection and Perioperative Complications in Pediatric Surgical Patients

Poster Number: 303
Publication Number: 303.215

Jerri C. Price, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Jennifer J. Lee, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Caleb Ing, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Guohua Li, Columbia University, New York, NY, United States; Jacquelin Narula, Columbia University, New York, NY, United States; Mary K. Clark, New York Presbyterian Hospital, New York, NY, United States; Steven Stylianos, Columbia University, New York, NY, United States; Robert Whittington, Columbia University Irving Medical Centee, New York, NY, United States; Richard Levy, Columbia University, New York, NY, United States; lena Sun, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Background: Adult surgical patients who undergo procedures while infected with SARS-CoV-2 have an increased risk for perioperative adverse events. There are fewer reports characterizing the risks in pediatric surgical patients.

Objective: To investigate the association between SARS-CoV-2 infection and perioperative complications in pediatric surgical patients.

Design/Methods: A retrospective analysis was performed on patients aged 0-20 years who underwent surgery at Morgan Stanley Children’s Hospital/Columbia University Irving Medical Center from 2/1/2020 to 12/31/2020. Every SARS-CoV-2 positive patient was included and matched with two SARS-CoV-2 negative patients based on type of surgical procedure, age group, gender, and American Society of Anesthesiologists physical status. We compared perioperative respiratory adverse events using conditional logistic regression models taking into consideration the matched groups.

Results: During the study period, 45 surgical procedures were performed in SARS-CoV-2 positive children, who were matched with 90 SARS-CoV-2 negative children. Intraoperative findings include laryngospasm (0% in both groups), bronchospasm (2.2% in both groups, OR=1, 95% CI 0.05-18.92, p=1), and desaturation events (7.8% SARS-CoV-2 negative vs. 2.2% SARS-CoV-2 positive, OR=0.28, 95% CI 0.04-2.32, p=0.24). Postoperative findings include need for supplemental oxygen (27.8% SARS-CoV-2 negative vs. 35.6% SARS-CoV-2 positive, OR=2.96, 95% CI 0.72-12.08, p=0.13), unplanned non-invasive ventilation (1.1% SARS-CoV-2 negative vs. 2.2% SARS-CoV-2 positive, OR=2, 95% CI 0.13-31.98, p=0.62), and unplanned mechanical ventilation (0% in both groups).Conclusion(s): This study’s preliminary findings indicate that SARS-CoV-2 infection does not seem to be associated significantly with an elevated risk of intraoperative complications but association with an increased risk of postoperative complications needs to be further investigated. This finding differs from reports from other institutions that carried out similar retrospective studies, which found significantly increased rates of perioperative respiratory and other complications in patients infected with SARS-CoV-2. Increased sample size and further analysis examining factors that contribute to these observed differences, including health care disparities, patient, and provider characteristics will be needed.