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Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection : an international cohort study

(2020) LANCET. 396(10243). p.27-38
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Abstract
Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery.
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General Medicine, CONSENSUS DEFINITIONS

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MLA
Nepogodiev, Dmitri, et al. “Mortality and Pulmonary Complications in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection : An International Cohort Study.” LANCET, vol. 396, no. 10243, 2020, pp. 27–38, doi:10.1016/s0140-6736(20)31182-x.
APA
Nepogodiev, D., Bhangu, A., Glasbey, J. C., Li, E., Omar, O. M., Simoes, J. F., … COVIDsurg Collaborative, [missing]. (2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection : an international cohort study. LANCET, 396(10243), 27–38. https://doi.org/10.1016/s0140-6736(20)31182-x
Chicago author-date
Nepogodiev, Dmitri, Aneel Bhangu, James C Glasbey, Elizabeth Li, Omar M Omar, Joana FF Simoes, Tom EF Abbott, et al. 2020. “Mortality and Pulmonary Complications in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection : An International Cohort Study.” LANCET 396 (10243): 27–38. https://doi.org/10.1016/s0140-6736(20)31182-x.
Chicago author-date (all authors)
Nepogodiev, Dmitri, Aneel Bhangu, James C Glasbey, Elizabeth Li, Omar M Omar, Joana FF Simoes, Tom EF Abbott, Osaid Alser, Alexis P Arnaud, Brittany K Bankhead-Kendall, Kerry A Breen, Miguel F Cunha, Giana H Davidson, Salomone Di Saverio, Gaetano Gallo, Ewen A Griffiths, Rohan R Gujjuri, Peter J Hutchinson, Haytham MA Kaafarani, Hans Lederhuber, Markus W Löffler, Hassan N Mashbari, Ana Minaya-Bravo, Dion G Morton, David Moszkowicz, Francesco Pata, George Tsoulfas, Mary L Venn, Daniel Cox, April C Roslani, Felix Alakaloko, Jean-Paul PM de Vries, Mahmoud A Aaraj, Tom EF Abbott, Sarah J Abbott, Mutwakil OM Abdalla, Ahmed S Abdelaal, Adesoji O Ademuyiwa, Thomas M Aherne, Osman M Ali, Ghadah Z Alkadeeki, Ana C Almeida, Mahmoud M Alrahawy, Graeme K Ambler, Ehab Alameer, Stefano M Andreani, Beatriz De Andrés-Asenjo, Leyre Lopez Antonanzas, Salah G Aoun, Fouad M Ashoush, Knut Magne Augestad, Rocio B Avellana, Funbi A Ayeni, John OO Ayorinde, Bheemanakone H Babu, Mirza MAS Baig, Oreoluwa M Bajomo, Olivia J Baker, Markus P Baker, Alexander J Baldwin, Vin Shen Ban, Ryan D Baron, Alberto G Barranquero, Conor P Barry, Alessandro DI Bartolomeo, Gary A Bass, Michael F Bath, H Hunt Batjer, Andrew J Beamish, Ajay P Belgaumkar, Matthew N Bence, Ruth A Benson, Juan Carlos Bernal-Sprekelsen, Anuradha R Bhama, Avi V Bhavaraju, Walter L Biffl, Chris M Blundell, Alexander P Boddy, Alexander BJ Borgstein, David C Bosanquet, Karen D Bosch, Ahmad EM Bouhuwaish, Mehmet A Bozkurt, Collin EM Brathwaite, Benjamin C Brown, Oliver D Brown, Allison K Brown, Igor Lima Buarque, Alejandro D Bueno-Cañones, Mustafa R Bulugma, Joshua R Burke, Matthew HV Byrne, Elima P Cagigal-Ortega, Rachael A Callcut, Francesca DI Candido, Michaela E Canova, William J Carlos, Edward J Caruana, Liam D Cato, Andrew B Catton, Andrea Pisani Ceretti, Thomas JG Chase, Francesco Di Chiara, Abeed H Chowdhury, Eric A Chung, Pierfranco M Cicerchia, Ethan CS Clough, Natasha L Coleman, Chris G Collins, Michelle L Collins, Emily T Colonna, Lara V Comini, Patrick A Coughlin, Laura Fernández-Gomez Cruzado, Brian R Davidson, Richard J Davies, Emma J Davies, Niall F Davis, Brett E Dawson, Benjamin JF Dean, Maria Garcia-Conde Delgado, Jose J Diaz, Kathryn E Dickson, Manuel M Diez-Alonso, Jan R Dixon, Matthew J Doe, Thomas D Drake, Frederick T Drake, John P Duffy, Declan FJ Dunne, Naomi JM Dunne, Virginia M Durán-Muñoz-Cruzado, Alexander ZE Durst, Nicola J Eardley, John G Edwards, Ahmed H Elfallal, Mahmoud MA Elfiky, Jessie A Elliott, Sameh H Emile, Katy M Emslie, Frederick W Endorf, Jamie L Engel, Diego T Enjuto, Eric W Etchill, Jonathan P Evans, Brian A Fahey, Carlos S Faria, Carlo V Feo, Henry JM Ferguson, Beatriz Dieguez Fernandez, Andres Garcia Fernandez, Antonio J Fernández, Borja Camacho Fernández-Pacheco, J Edward Fitzgerald, Giovanni B Fonsi, Roser Farré Font, Amy L Fowler, Kenneth R Fretwell, Lorena Sanchon Fructuoso, Giuseppe K Fusai, Miguel Hernandez Garcia, Miguel Angel Garcia-Ureña, Charn K Gill, Suzanne S Gisbertz, Roberto Del Giudice, Maria Carmela Giuffrida, Matteo Di Giuseppe, María Fanjul Gómez, Ewen A Griffiths, Claudio A Guariglia, Alison J Hainsworth, Bria J Hall, James RW Hall, John S Hammond, Maha H Haqqani, Ewen M Harrison, Joshua P Hazelton, Maarten van Heinsbergen, Arnold DK Hill, Caroline B Hing, Sameer A Hirji, Michael WS Ho, Charlotte M Holbrook, Thomas J Holme, James C Hopkins, David N Hopkinson, Fahad S Hossain, Victoria E Hudson, Jane L Hughes, E. Shelley Hwang, Mohamed AH Ibrahim, Simone M Isolani, Michael D Jenkinson, Hillary E Jenny, Deva S Jeyaretna, Robert P Jones, Andrew P Jones, Pascal KC Jonker, Maria L Jönsson, Doireann P Joyce, Kyle J Kalkwarf, Sivesh K Kamarajah, Mohamed El Kassas, Dara O Kavanagh, James M Keatley, Mohamed A Khalefa, Jim S Khan, Bilal H Kirmani, Aaron P Kisiel, Spyros Marinos Kouris, Mikolaj R Kowal, Peter L Labib, John O Larkin, Johannes C Lauscher, Wouter KG Leclercq, Frances SJ Ledesma, André M Leite-Moreira, Elaine YL Leung, Sophia E Lewis, Maria João Lima, Daniel J Lin, Helen H Liu, Aoife J Lowery, Saida Martel Lozano, Catriona R Luney, Mariana Magalhães Maia, Nicolò M Mariani, Marco V Marino, Angelo A Marra, Christopher L Marsh, Robert CG Martin, Simon J McCluney, Robert C McIntyre, Siobhan C Mckay, Kevin L McKevitt, Ashley D Meagher, Mohammad Q Mehdi, Brian J Mehigan, Melania Gonzalez-De Miguel, Maria-Carmen De Miguel-Ardevines, Sarah J Mills, Helen M Mohan, John AG Moir, John RT Monson, Joana M Monteiro, Maria T Montella, Cristina Soto Montesinos, Marwa M Morgom, Francisco S Moura, Jose M Muguerza, Suzanne H Murphy, Paola De Nardi, David N Naumann, Paul C Neary, David TA Neely, Joshua S Ng-Kamstra, Albert WT Ngu, Truong A Nguyen, George E Nita, Quentin M Nunes, Rachel M Nygaard, Lindsay B O’Meara, John R O’Neill, Barbara U Okafor, Steven A Olson, Aung Y Oo, Pablo Collera Ormazabal, Alexander L Osorio, Max J Pachl, James T Parry, Panna K Patel, Luis E Pérez-Sánchez, Ana Nogues Pevidal, Anna P Pezzuto, Matthew M Philp, Thomas D Pinkney, Joerg M Pollok, Meical G Povey, Alfredo Alonso Poza, Amarkumar D Rajgor, Jagan N Rao, Dimitri A Raptis, Henry E Rice, Paul F Ridgway, Ana Munoz Rivas, Juan C Rodriguez-Sanjuan, Luke J Rogers, Anna Da Roit, Rebecca A Rollett, Jose L Romera, Siobhan M Rooney, Vanessa I Roxo, Bertrand Le Roy, Eduardo E Rubio, Carolina Castro Ruiz, Manuel Losada Ruiz, Éanna J Ryan, Abdel Rahman Saad, Samerah A Saeed, Hiba A Salama, Abdulrauf A Salamah, Gianluca M Sampietro, Diwakar R Sarma, Kathryn B Schaffer, Andreas A Schnitzbauer, Rachel J Scurrah, Olivia L Serevina, Pedro A Serralheiro, Joseph M Sewards, Michael J Shackcloth, Abigail V Shaw, Andrea RG Sheel, Giuseppe S Sica, Veronica De Simone, Aminder A Singh, Rabindra P Singh, Brendan L Skelly, Henry G Smith, Amir H Sohail, Duncan R Spalding, Laurie R Springford, Anna E Ssentongo, Pieter J Steinkamp, Kent A Stevens, Grant D Stewart, Nicholas A Stylianides, Tom BB Sullivan, Ahmed SA Taher, Muhammad S Tamimy, Alethea M Tang, Giovanni D Tebala, Francisco J Tejero-Pintor, Mohamed A Thaha, Amy J Thomas, Giorgio De Toma, Filippo La Torre, Antonio J Torres, David N Townshend, Isobel M Trout, Sarah C Tucker, Harmony K Ubhi, Viviana A Vega, George C Velmahos, Catherine G Velopulos, Yirupaiahgari KS Viswanath, Alfredo A Vivas, Ryckie G Wade, Martin S Wadley, Joshua JS Wall, Andrew M Walters, Oliver J Warren, Chamindri K Weerasinghe, Richard JW Wilkin, Katherine J Williams, Stuart C Winter, Justin CR Wormald, Franklin L Wright, Souzana E Xyda, Alastair L Young, Mina MG Youssef, Farhat B Yousuf, Hanan El Youzouri, Marco A Zappa, Emmanuele Abate, Hossam Abdalaziz, Mostafa Abdelkarim, Hossam Abdou, Ahmad Aboelkassem-Ibrahim, Ala Abuown, Fernando Acebes-Garcia, Metesh Acharya, Michel Adamina, Emmanuel Addae-Boateng, Raiyyan Aftab, Arnav Agarwal, José Aguilar, Yousra Ahmed, Emma Aitken, Marwa Al-Azzawi, Somya Al-Embideen, Mahmoud Al-Masri, Hani Al-Najjar, Ahmad Al-Sukaini, Ruhina Alam, Derek Alderson, Zumrud Aliyeva, Firas Aljanadi, Murad Almasri, Paula Alonso-Ortuño, Fatih Altintoprak, Gamal Amira, Rabbia Amjad, Gabriele Anania, Tatjana Andabaka, Dimitrios Angelou, Seethalakshmi Annamalai, Valerio Annessi, James Anthoney, Sibtain Anwar, Mariyah Anwer, Juan Aragon-Chamizo, Antonella Ardito, Michele Arigoni, Teodora Armao, Armando Arminio, Lara Armstrong, Alexis Arnaud, Peter Asaad, James Ashcroft, Christopher Ashmore, Ahmad Asqalan, Emanuele Asti, Emmanuelle Aubry, Erman Aytac, Esther Ayuso-Herrera, Melody Baeza, Martin Bailon-Cuadrado, Bernarda Bakmaz, Caterina Baldi, Edoardo Baldini, Stefano Baldo, Michele Ballabio, Ioannis Baloyiannis, Gerard Baltazar, Fabrizio Bàmbina, Alessandro Bandiera, Emma Barlow, Roberto Barmasse, Christina Barmpagianni, Gianluca Baronio, Fabio Barra, Anne-Marie Bartsch, Amedra Basgaran, Amr Basha, Varvara Bashkirova, Marco Bastazza, Rachel Baumber, Elizabeth Belcher, Angela Belvedere, Inmaculada Benítez-Linero, Damien Bergeat, Matteo Bernasconi, Ashish Bhalla, Neal Bhutiani, Federica Bianco, Pietro Bisagni, Iain Blake, Ruth Blanco-Colino, Alma Blazquez-Martin, Matthew Boal, Luigi Bonavina, Giulia Bonavina, Giles Bond-Smith, Karen Booth, Filipe Borges, Felice Borghi, Konstantinos Bouchagier, Grainne Bourke, Emily Boyle, Gioia Brachini, Jessie Brain, Amanpreet Brar, Lisa Breckles, Frédéric Bretagnol, Genevieve Brixton, Placido Bruzzaniti, Teofila Bueser, Nathan Burnside, Albert Caballero, Enrique Calcerrada-Alises, Miriam Callahan, Enrique Camarero, Tommaso Campagnaro, Michela Campanelli, Massimo Candiani, Miguel Cantalejo-Diaz, Han Cao, Patrizio Capelli, Vita Capizzi, Giulio Carcano, Francesca Carissimi, Massimo Carlini, Michele Carlucci, Heather Carmichael, Milagros Carrasco, Mariana Carrillo, Michele Carvello, Massimiliano Casati, Carlo Castoro, Vanesa Catalan, Salomé Cavaleiro, Paola Cellerino, Giovanna Centinaio, Cristina Cernei, Cristina Cerro, Maurizio Cervellera, Sohini Chakrabortee, Stephanie Chamberlain, Jeffrey Chan, Grace Chang, Dauod Chaudhry, Alexandre Chebaro, David Chen, Govind Chetty, Zoe Chia, Ambra Chiappini, Massimo Chiarugi, Swathikan Chidambaram, Matteo Chiozza, Hanna Cholewa, Clara Chong, Ekta Choolani-Bhojwani, Dimitri Christoforidis, Karen Chui, Choyin Chung, Bruno Cirillo, Davide Citterio, Pauline Clermidi, Federico Coccolini, Gaia Colletti, Bruno Compagnoni, Vanesa Concepción-Martín, Marco Confalonieri, Hannah Connolly, Christel Conso, Luigi Conti, Zara Cooper, Fernando Cordera, Javier Corral, Marta Costa, Andrea Costanzi, Christian Cotsoglou, Valerio Cozza, Tamzin Cuming, Miles Curtis, Joseph Cuschieri, Michele D’Agruma, Giancarlo D’Andrea, Prita Daliya, Oliver Dare, Ebenezer Darko, Andrew Day, Ahmed Dehal, Dustin Dehart, Eduardo Delgado-Oliver, Max Denning, Anant Desai, Liesbeth Desender, Sara Dester, Alberto Díaz-García, Patricia Diaz-Peña, Bertrand Dousset, Alexandre Doussot, Nicolas Duchateau, Sarah Duff, Joel Dunning, Victoria Duque-Mallen, Jana Dziakova, Bridget Egan, Richard Egan, Abess El-Ali, Hossam Elfeki, Muhammed Elhadi, Mohammed Eljareh, Ramy Elkady, Fatimah Elkhafeefi, Ugo Elmore, Tarek Elmoslemany, Oliver Emmerson, Ibrahim Enemosah, Camilla English, William English, Jorge Escartin, Mercedes Estaire-Gomez, Luke Evans, Jessica Evans, Rebecca Exley, Nicoló Fabbri, Giuseppe Falco, Pietro Familiari, Alessandro Fancellu, Shebani Farik, Tony Farrell, Matyas Fehervari, Adam Fell, Angel Fernandez-Camuñas, Reyes Fernández-Marín, María Fernández-Martínez, 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Stewart, Sally Stringer, Nina Sulen, Sudha Sundar, Matthew Sundhu, Avni Suri, Arooj Syed, Peter Szatmary, Stephen Tabiri, Daniel Tadross, Lucio Taglietti, Rosamond Tansey, Dario Tartaglia, Ahmed Tawheed, Salim Tayeh, Tobias Teles, Valentina Testa, Nilanjana Tewari, Philipp Thoenissen, Kane Thomas, Anne Thomin, Jessica Thrush, Sean Tierney, Abhinav Tiwari, Simon Toh, Enrique Toledo, Valeria Tonini, Jared Torkington, Alfonso Torquati, Guido Torzilli, Joshua Totty, Paraskevi Tourountzi, Manuel Tousidonis, Philip Townend, Catherine Townsend, Alex Trompeter, Francesco Trotta, Stéphanie Truant, Jeancarlos Trujillo-Díaz, Georgios Tsoulfas, Celia Turco, Victor Turrado-Rodriguez, Giulia Turri, Harry Tustin, Jayne Tyler, Stylianos Tzedakis, George Tzovaras, Martine Uittenbogaart, Ramzan Ullah, Shane Urban, Alessia Urbani, Antonella Usai, Gianpaolo Vaccarella, Javier Valdes-Hernandez, Luca Valsecchi, Rajiv Vashisht, Andrea Vázquez-Fernández, Mary Venn, Cristina Vera-Mansilla, Roberto Vergari, Giuseppina Vescio, Raghavan Vidya, Paula Vieira, Vardhini Vijay, Dale Vimalachandran, Tommaso Violante, Anita Volpe, Fernanda Vovola, Paul Vulliamy, Rosemary Wall, Kate Wallwork, Alex Ward, David Warwick, Saima Waseem, Helen Weaver, Fiona Wells, Jiaxin Wen, Raha West, Emma Whitehall, Laura Wild, Alex Wilkins, Gethin Williams, Matthew Williams, Philipp Winnand, Ken Wong, Dawit Worku, Naomi Wright, Seema Yalamanchili, Danylo Yershov, Alp Yildiz, Richard Young, Can Yurttas, Frederic Zadegan, Noman Zafar, Rasheed Zakaria, Martina Zambon, Nicola Zanini, Alba Zarate, Philippe Zerbib, Maurizio Zizzo, Oded Zmora, Sandro Zonta, Mark I van Berge Henegouwen, Willemijn Y van der Plas, Inthekab Ali Mohamed Ali, Nur Amalina Che Bakri, Juan Carlos Catalá Bauset, Mohamad K Abou Chaar, Luigi MP Marino Cosentino, Carlos J Gómez Díaz, Jose L Garcia Galocha, Charles de Gheldere, Gustavo Mendonça Ataíde Gomes, Juan Beltrán de Heredia, Dan G Blazer III, William C Nugent III, Ali A Ali karar, F Borja De Lacy, Juan luis Blas Laina, Madan Jha Shane Lester, Aloka S D Liyanage, Faraj S Al Maadany, Joshua A De Marchi, Antonio Ramos-De la Medina, Reda H M Mithany, Cristina Sanchez del Pueblo, Gabriëlle van Ramshorst, Maria Marqueta De Salas, Anthony C De Souza, M Dolores Del Toro, James E Archer, Abdulrahman Odeh, Simon Erridge, Hosni Khairy Salem, Gareth P Jones, Anne Gardner, Shiva S Tripathi, Anne Gregg, Reuben Jeganathan, Muhammad Harris Siddique, Celestino P Lombardi, Benjamin Martin, Cosimo Alex Leo, Debashis Dass, Gregorio Di Franco, Long R Jiao, Giulio Maria Mari, Luis-Cristobal Capitan-Morales, Tara M Connelly, Ammar Alanbuki, Armando De Virgilio, Clare Schilling, Carlos San Miguel Mendez, Gauri Kulkarni, Kulsoom Nizami, Stewart Walsh, Harry Dean, Miguel Ruiz-Marin, Rory Houston, Mario Trompetto, David Chrastek, Vasileios Kouritas, Maria Cannoletta, Francesco Rosato, Manish V Kaushal, Paulo Matos Costa, Hannah H Elkadi, Jack R Johnstone, Esmee Irvine, Maria R Alvarez, Carlo Corbellini, Gowtham S Venkatesan, Olga Mateo-Sierra, Carolina Martínez-Pérez, Javier Serrano González, Miguel Ángel Hernández Bartolomé, David Díaz Pérez, María Gutiérrez Samaniego, Pablo Galindo Jara, Neil Sharma, Neil J Smart, Deborah S Keller, and [missing] COVIDsurg Collaborative. 2020. “Mortality and Pulmonary Complications in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection : An International Cohort Study.” LANCET 396 (10243): 27–38. doi:10.1016/s0140-6736(20)31182-x.
Vancouver
1.
Nepogodiev D, Bhangu A, Glasbey JC, Li E, Omar OM, Simoes JF, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection : an international cohort study. LANCET. 2020;396(10243):27–38.
IEEE
[1]
D. Nepogodiev et al., “Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection : an international cohort study,” LANCET, vol. 396, no. 10243, pp. 27–38, 2020.
@article{8673787,
  abstract     = {{Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection.

Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation.

Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047).

Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery.}},
  author       = {{Nepogodiev, Dmitri and Bhangu, Aneel and Glasbey, James C and Li, Elizabeth and Omar, Omar M and Simoes, Joana FF and Abbott, Tom EF and Alser, Osaid and Arnaud, Alexis P and Bankhead-Kendall, Brittany K and Breen, Kerry A and Cunha, Miguel F and Davidson, Giana H and Di Saverio, Salomone and Gallo, Gaetano and Griffiths, Ewen A and Gujjuri, Rohan R and Hutchinson, Peter J and Kaafarani, Haytham MA and Lederhuber, Hans and Löffler, Markus W and Mashbari, Hassan N and Minaya-Bravo, Ana and Morton, Dion G and Moszkowicz, David and Pata, Francesco and Tsoulfas, George and Venn, Mary L and Cox, Daniel and Roslani, April C and Alakaloko, Felix and de Vries, Jean-Paul PM and Aaraj, Mahmoud A and Abbott, Tom EF and Abbott, Sarah J and Abdalla, Mutwakil OM and Abdelaal, Ahmed S and Ademuyiwa, Adesoji O and Aherne, Thomas M and Ali, Osman M and Alkadeeki, Ghadah Z and Almeida, Ana C and Alrahawy, Mahmoud M and Ambler, Graeme K and Alameer, Ehab and Andreani, Stefano M and De Andrés-Asenjo, Beatriz and Antonanzas, Leyre Lopez and Aoun, Salah G and Ashoush, Fouad M and Augestad, Knut Magne and Avellana, Rocio B and Ayeni, Funbi A and Ayorinde, John OO and Babu, Bheemanakone H and Baig, Mirza MAS and Bajomo, Oreoluwa M and Baker, Olivia J and Baker, Markus P and Baldwin, Alexander J and Ban, Vin Shen and Baron, Ryan D and Barranquero, Alberto G and Barry, Conor P and DI Bartolomeo, Alessandro and Bass, Gary A and Bath, Michael F and Batjer, H Hunt and Beamish, Andrew J and Belgaumkar, Ajay P and Bence, Matthew N and Benson, Ruth A and Bernal-Sprekelsen, Juan Carlos and Bhama, Anuradha R and Bhavaraju, Avi V and Biffl, Walter L and Blundell, Chris M and Boddy, Alexander P and Borgstein, Alexander BJ and Bosanquet, David C and Bosch, Karen D and Bouhuwaish, Ahmad EM and Bozkurt, Mehmet A and Brathwaite, Collin EM and Brown, Benjamin C and Brown, Oliver D and Brown, Allison K and Buarque, Igor Lima and Bueno-Cañones, Alejandro D and Bulugma, Mustafa R and Burke, Joshua R and Byrne, Matthew HV and Cagigal-Ortega, Elima P and Callcut, Rachael A and DI Candido, Francesca and Canova, Michaela E and Carlos, William J and Caruana, Edward J and Cato, Liam D and Catton, Andrew B and Ceretti, Andrea Pisani and Chase, Thomas JG and Chiara, Francesco Di and Chowdhury, Abeed H and Chung, Eric A and Cicerchia, Pierfranco M and Clough, Ethan CS and Coleman, Natasha L and Collins, Chris G and Collins, Michelle L and Colonna, Emily T and Comini, Lara V and Coughlin, Patrick A and Cruzado, Laura Fernández-Gomez and Davidson, Brian R and Davies, Richard J and Davies, Emma J and Davis, Niall F and Dawson, Brett E and Dean, Benjamin JF and Delgado, Maria Garcia-Conde and Diaz, Jose J and Dickson, Kathryn E and Diez-Alonso, Manuel M and Dixon, Jan R and Doe, Matthew J and Drake, Thomas D and Drake, Frederick T and Duffy, John P and Dunne, Declan FJ and Dunne, Naomi JM and Durán-Muñoz-Cruzado, Virginia M and Durst, Alexander ZE and Eardley, Nicola J and Edwards, John G and Elfallal, Ahmed H and Elfiky, Mahmoud MA and Elliott, Jessie A and Emile, Sameh H and Emslie, Katy M and Endorf, Frederick W and Engel, Jamie L and Enjuto, Diego T and Etchill, Eric W and Evans, Jonathan P and Fahey, Brian A and Faria, Carlos S and Feo, Carlo V and Ferguson, Henry JM and Fernandez, Beatriz Dieguez and Fernandez, Andres Garcia and Fernández, Antonio J and Fernández-Pacheco, Borja Camacho and Fitzgerald, J Edward and Fonsi, Giovanni B and Font, Roser Farré and Fowler, Amy L and Fretwell, Kenneth R and Fructuoso, Lorena Sanchon and Fusai, Giuseppe K and Garcia, Miguel Hernandez and Garcia-Ureña, Miguel Angel and Gill, Charn K and Gisbertz, Suzanne S and Del Giudice, Roberto and Giuffrida, Maria Carmela and Di Giuseppe, Matteo and Gómez, María Fanjul and Griffiths, Ewen A and Guariglia, Claudio A and Hainsworth, Alison J and Hall, Bria J and Hall, James RW and Hammond, John S and Haqqani, Maha H and Harrison, Ewen M and Hazelton, Joshua P and van Heinsbergen, Maarten and Hill, Arnold DK and Hing, Caroline B and Hirji, Sameer A and Ho, Michael WS and Holbrook, Charlotte M and Holme, Thomas J and Hopkins, James C and Hopkinson, David N and Hossain, Fahad S and Hudson, Victoria E and Hughes, Jane L and Hwang, E. Shelley and Ibrahim, Mohamed AH and Isolani, Simone M and Jenkinson, Michael D and Jenny, Hillary E and Jeyaretna, Deva S and Jones, Robert P and Jones, Andrew P and Jonker, Pascal KC and Jönsson, Maria L and Joyce, Doireann P and Kalkwarf, Kyle J and Kamarajah, Sivesh K and El Kassas, Mohamed and Kavanagh, Dara O and Keatley, James M and Khalefa, Mohamed A and Khan, Jim S and Kirmani, Bilal H and Kisiel, Aaron P and Kouris, Spyros Marinos and Kowal, Mikolaj R and Labib, Peter L and Larkin, John O and Lauscher, Johannes C and Leclercq, Wouter KG and Ledesma, Frances SJ and Leite-Moreira, André M and Leung, Elaine YL and Lewis, Sophia E and Lima, Maria João and Lin, Daniel J and Liu, Helen H and Lowery, Aoife J and Lozano, Saida Martel and Luney, Catriona R and Maia, Mariana Magalhães and Mariani, Nicolò M and Marino, Marco V and Marra, Angelo A and Marsh, Christopher L and Martin, Robert CG and McCluney, Simon J and McIntyre, Robert C and Mckay, Siobhan C and McKevitt, Kevin L and Meagher, Ashley D and Mehdi, Mohammad Q and Mehigan, Brian J and Gonzalez-De Miguel, Melania and De Miguel-Ardevines, Maria-Carmen and Mills, Sarah J and Mohan, Helen M and Moir, John AG and Monson, John RT and Monteiro, Joana M and Montella, Maria T and Montesinos, Cristina Soto and Morgom, Marwa M and Moura, Francisco S and Muguerza, Jose M and Murphy, Suzanne H and De Nardi, Paola and Naumann, David N and Neary, Paul C and Neely, David TA and Ng-Kamstra, Joshua S and Ngu, Albert WT and Nguyen, Truong A and Nita, George E and Nunes, Quentin M and Nygaard, Rachel M and O'Meara, Lindsay B and O'Neill, John R and Okafor, Barbara U and Olson, Steven A and Oo, Aung Y and Ormazabal, Pablo Collera and Osorio, Alexander L and Pachl, Max J and Parry, James T and Patel, Panna K and Pérez-Sánchez, Luis E and Pevidal, Ana Nogues and Pezzuto, Anna P and Philp, Matthew M and Pinkney, Thomas D and Pollok, Joerg M and Povey, Meical G and Poza, Alfredo Alonso and Rajgor, Amarkumar D and Rao, Jagan N and Raptis, Dimitri A and Rice, Henry E and Ridgway, Paul F and Rivas, Ana Munoz and Rodriguez-Sanjuan, Juan C and Rogers, Luke J and Da Roit, Anna and Rollett, Rebecca A and Romera, Jose L and Rooney, Siobhan M and Roxo, Vanessa I and Le Roy, Bertrand and Rubio, Eduardo E and Ruiz, Carolina Castro and Ruiz, Manuel Losada and Ryan, Éanna J and Saad, Abdel Rahman and Saeed, Samerah A and Salama, Hiba A and Salamah, Abdulrauf A and Sampietro, Gianluca M and Sarma, Diwakar R and Schaffer, Kathryn B and Schnitzbauer, Andreas A and Scurrah, Rachel J and Serevina, Olivia L and Serralheiro, Pedro A and Sewards, Joseph M and Shackcloth, Michael J and Shaw, Abigail V and Sheel, Andrea RG and Sica, Giuseppe S and De Simone, Veronica and Singh, Aminder A and Singh, Rabindra P and Skelly, Brendan L and Smith, Henry G and Sohail, Amir H and Spalding, Duncan R and Springford, Laurie R and Ssentongo, Anna E and Steinkamp, Pieter J and Stevens, Kent A and Stewart, Grant D and Stylianides, Nicholas A and Sullivan, Tom BB and Taher, Ahmed SA and Tamimy, Muhammad S and Tang, Alethea M and Tebala, Giovanni D and Tejero-Pintor, Francisco J and Thaha, Mohamed A and Thomas, Amy J and De Toma, Giorgio and La Torre, Filippo and Torres, Antonio J and Townshend, David N and Trout, Isobel M and Tucker, Sarah C and Ubhi, Harmony K and Vega, Viviana A and Velmahos, George C and Velopulos, Catherine G and Viswanath, Yirupaiahgari KS and Vivas, Alfredo A and Wade, Ryckie G and Wadley, Martin S and Wall, Joshua JS and Walters, Andrew M and Warren, Oliver J and Weerasinghe, Chamindri K and Wilkin, Richard JW and Williams, Katherine J and Winter, Stuart C and Wormald, Justin CR and Wright, Franklin L and Xyda, Souzana E and Young, Alastair L and Youssef, Mina MG and Yousuf, Farhat B and El Youzouri, Hanan and Zappa, Marco A and Abate, Emmanuele and Abdalaziz, Hossam and Abdelkarim, Mostafa and Abdou, Hossam and Aboelkassem-Ibrahim, Ahmad and Abuown, Ala and Acebes-Garcia, Fernando and Acharya, Metesh and Adamina, Michel and Addae-Boateng, Emmanuel and Aftab, Raiyyan and Agarwal, Arnav and Aguilar, José and Ahmed, Yousra and Aitken, Emma and Al-Azzawi, Marwa and Al-Embideen, Somya and Al-Masri, Mahmoud and Al-Najjar, Hani and Al-Sukaini, Ahmad and Alam, Ruhina and Alderson, Derek and Aliyeva, Zumrud and Aljanadi, Firas and Almasri, Murad and Alonso-Ortuño, Paula and Altintoprak, Fatih and Amira, Gamal and Amjad, Rabbia and Anania, Gabriele and Andabaka, Tatjana and Angelou, Dimitrios and Annamalai, Seethalakshmi and Annessi, Valerio and Anthoney, James and Anwar, Sibtain and Anwer, Mariyah and Aragon-Chamizo, Juan and Ardito, Antonella and Arigoni, Michele and Armao, Teodora and Arminio, Armando and Armstrong, Lara and Arnaud, Alexis and Asaad, Peter and Ashcroft, James and Ashmore, Christopher and Asqalan, Ahmad and Asti, Emanuele and Aubry, Emmanuelle and Aytac, Erman and Ayuso-Herrera, Esther and Baeza, Melody and Bailon-Cuadrado, Martin and Bakmaz, Bernarda and Baldi, Caterina and Baldini, Edoardo and Baldo, Stefano and Ballabio, Michele and Baloyiannis, Ioannis and Baltazar, Gerard and Bàmbina, Fabrizio and Bandiera, Alessandro and Barlow, Emma and Barmasse, Roberto and Barmpagianni, Christina and Baronio, Gianluca and Barra, Fabio and Bartsch, Anne-Marie and Basgaran, Amedra and Basha, Amr and Bashkirova, Varvara and Bastazza, Marco and Baumber, Rachel and Belcher, Elizabeth and Belvedere, Angela and Benítez-Linero, Inmaculada and Bergeat, Damien and Bernasconi, Matteo and Bhalla, Ashish and Bhutiani, Neal and Bianco, Federica and Bisagni, Pietro and Blake, Iain and Blanco-Colino, Ruth and Blazquez-Martin, Alma and Boal, Matthew and Bonavina, Luigi and Bonavina, Giulia and Bond-Smith, Giles and Booth, Karen and Borges, Filipe and Borghi, Felice and Bouchagier, Konstantinos and Bourke, Grainne and Boyle, Emily and Brachini, Gioia and Brain, Jessie and Brar, Amanpreet and Breckles, Lisa and Bretagnol, Frédéric and Brixton, Genevieve and Bruzzaniti, Placido and Bueser, Teofila and Burnside, Nathan and Caballero, Albert and Calcerrada-Alises, Enrique and Callahan, Miriam and Camarero, Enrique and Campagnaro, Tommaso and Campanelli, Michela and Candiani, Massimo and Cantalejo-Diaz, Miguel and Cao, Han and Capelli, Patrizio and Capizzi, Vita and Carcano, Giulio and Carissimi, Francesca and Carlini, Massimo and Carlucci, Michele and Carmichael, Heather and Carrasco, Milagros and Carrillo, Mariana and Carvello, Michele and Casati, Massimiliano and Castoro, Carlo and Catalan, Vanesa and Cavaleiro, Salomé and Cellerino, Paola and Centinaio, Giovanna and Cernei, Cristina and Cerro, Cristina and Cervellera, Maurizio and Chakrabortee, Sohini and Chamberlain, Stephanie and Chan, Jeffrey and Chang, Grace and Chaudhry, Dauod and Chebaro, Alexandre and Chen, David and Chetty, Govind and Chia, Zoe and Chiappini, Ambra and Chiarugi, Massimo and Chidambaram, Swathikan and Chiozza, Matteo and Cholewa, Hanna and Chong, Clara and Choolani-Bhojwani, Ekta and Christoforidis, Dimitri and Chui, Karen and Chung, Choyin and Cirillo, Bruno and Citterio, Davide and Clermidi, Pauline and Coccolini, Federico and Colletti, Gaia and Compagnoni, Bruno and Concepción-Martín, Vanesa and Confalonieri, Marco and Connolly, Hannah and Conso, Christel and Conti, Luigi and Cooper, Zara and Cordera, Fernando and Corral, Javier and Costa, Marta and Costanzi, Andrea and Cotsoglou, Christian and Cozza, Valerio and Cuming, Tamzin and Curtis, Miles and Cuschieri, Joseph and D'Agruma, Michele and D'Andrea, Giancarlo and Daliya, Prita and Dare, Oliver and Darko, Ebenezer and Day, Andrew and Dehal, Ahmed and Dehart, Dustin and Delgado-Oliver, Eduardo and Denning, Max and Desai, Anant and Desender, Liesbeth and Dester, Sara and Díaz-García, Alberto and Diaz-Peña, Patricia and Dousset, Bertrand and Doussot, Alexandre and Duchateau, Nicolas and Duff, Sarah and Dunning, Joel and Duque-Mallen, Victoria and Dziakova, Jana and Egan, Bridget and Egan, Richard and El-Ali, Abess and Elfeki, Hossam and Elhadi, Muhammed and Eljareh, Mohammed and Elkady, Ramy and Elkhafeefi, Fatimah and Elmore, Ugo and Elmoslemany, Tarek and Emmerson, Oliver and Enemosah, Ibrahim and English, Camilla and English, William and Escartin, Jorge and Estaire-Gomez, Mercedes and Evans, Luke and Evans, Jessica and Exley, Rebecca and Fabbri, Nicoló and Falco, Giuseppe and Familiari, Pietro and Fancellu, Alessandro and Farik, Shebani and Farrell, Tony and Fehervari, Matyas and Fell, Adam and Fernandez-Camuñas, Angel and Fernández-Marín, Reyes and Fernández-Martínez, María and Ferrara, Francesco and Ferrari, Guglielmo and Ferrero, Simone and Findlay, Laura and Fiore, Marco and Fiori, Enrico and Flatman, Michael and Flindall, Ian and Flor, Blas and Fontana, Tommaso and Ford, Samuel and Ford, David and Forlani, Stefano and Francone, Elisa and Frattaruolo, Colomba and Frio, Federico and Gagliano, Annalisa and Gagliardi, Filippo and Gahunia, Sukhpreet and Gaino, Francesca and Gala, Tanzeela and Galfrascoli, Elisa and Galimberti, Luca and Gallagher, Phoebe and Galleano, Raffaele and Galván-Pérez, Armando and Gammeri, Emanuele and Ganau, Mario and Garcés-García, Raúl and Garulli, Gianluca and Gascon-Ferrer, Isabel and Gattolin, Andrea and Gaujoux, Sebastien and Gentilli, Sergio and Georgiades, Fanourios and Ghanbari, Amir and Ghosh, Dhruv and Giacometti, Marco and Giblin, Anna-Victoria and Gilbert, Catherine and Giménez, Clara and Giorgakis, Emmanouil and Gipponi, Manuel and Glen, Paul and Goatly, Giles and Gobatti, Davide and Godbole, Chintamani and Gohil, Kajal and Gómez, Marcos and Gomez-Rosado, Juan-Carlos and Gonullu, Emre and Gonzalez-Gonzalez, Enrique and Gordini, Luca and Gracia, Isabel and Gracia-Roche, Carlos and Granieri, Stefano and Green, Susanna and Grivon, Manuela and Grove, Thomas and Guaglio, Marcello and Guaitoli, Eleonora and Guglielmi, Alfredo and Guha, Soumya and Gustavino, Claudio and Habeeb, Amir and Hagger, Robert and Hakmi, Hazim and Halkias, Constantine and Hall, Claire and Hampton, Matthew and Handa, Siddhartha and Hansen, Laura and Haq, Iram and Harky, Amer and Harries, Rhiannon and Harrison, Joseph and Hasan, Raashad and Hawari, Mohammad and Hawkin, Paul and Hebblethwaite, Bethany and Henriques, Susana and Heritage, Emily and Hernandez-Juara, Pilar and Herrero-Lopez, Maria and Hervieux, Erik and Heyd, Bruno and Higgs, Simon and Hitchman, Louise and Ho, Beatrice and Hogan, Aisling and Hölzle, Frank and Hossain, Tanvir and Hurt, Libor and Hutchinson, Peter and Iacob, Giulio and Iannone, Immacolata and Ibrahim, Sherif and Iovino, Domenico and Isik, Arda and Jafarova, Sevda and Jamil, Tahir and Jayaraju, Ullas and Jenner, Edward and Jimenez-Higuera, Elisa and Jimeno, Jaime and Jones, Mark and Judkins, Nicholas and Kalavrezos, Nicholas and Kalidindi, Venugopala and Kalkat, Maninder and Kamal, Mona and Kamphues, Carsten and Kang, Chong and Kara, Yasin and Karam, Edward and Karim, Ahmed and Kashora, Florence and Kearney, David and Khajuria, Apoorva and Khan, Umul and Khan, Azam and Khatri, Chetan and Kinnaman, Gabriel and Kinross, James and Kler, Aaron and Klimopoulos, Serafeim and Kocataş, Ali and Kolias, Angelos and Königsrainer, Alfred and Konsten, Joop and Kontovounisios, Christos and Kourdouli, Amar and Krishnan, Emily and Kristinsson, Sverrir and Kruijff, Schelto and Kudsk-Iversen, Søren and Kufeji, Dorothy and Kugler, Nadav and Kulkarni, Rugved and Kurihara, Hayato and Laface, Letizia and Lakkis, Zaher and Lami, Mariam and Landaluce-Olavarria, Aitor and Lapolla, Pierfrancesco and Lawani, Ismail and Lawday, Samuel and Lázaro, André and Lecolle, Katia and Leventoglu, Sezai and Li, Zoe and Liew, Ignatius and Lisi, Giorgio and Lizzi, Vincenzo and Lo, Terence and Lomiento, Daniele and Longhi, Marco and Lostis, Emilie and Lostoridis, Eftychios and Loubani, Mahmoud and Lowy-Benoliel, Alejandro and Lucianetti, Alessandro and Luke, Louis and Lunevicius, Raimundas and Luraghi, Marco and Lye, George and Mabrouk, Islam and Macchi, Alberto and MacDonald, Luisa and Machairas, Nikolaos and Madonini, Marco and Magowan, Drew and Maisonneuve, Emeline and Majkowska, Agata and Majkowski, Lawrence and Mak, Jason and Malabarba, Stefano and Malerba, Michele and Mannan, Syed and Manson, Joanna and Mansuri, Ahmer and Mantoglu, Baris and Manu, Nichola and Maqsood, Afnan and Marano, Alessandra and Marchbank, Adrian and Marcos-Santos, Pablo and Marrano, Enrico and Martin, Janet and Martin, Emmeline and Martin, Guy and Martin-Albo, Lorena and Martín-Román, Lorena and Martinelli, Fabio and Martínez-dePaz, Fernando and Martinez-German, Antonio and Martinez-Pinedo, Carlos and Martins, Ricardo and Marwan, Hisham and Marzi, Federica and Mathieu, Pierre and Matute-Najarro, Maria-Soledad and Maw, Andrew and Mazingi, Dennis and Mazzaferro, Vincenzo and McCanny, Andrew and McKenzie, Katherine and McLarty, Nicola and McPherson, Iain and Medina, Esther and Mediratta, Saniya and Medone, Marzia and Mehra, Gautam and Mele, Simone and Melero-Cortés, Lidia and Mendoza-Moreno, Fernando and Meneghini, Simona and Mercante, Giuseppe and Merdrignac, Aude and Merola, Stephen and Metallidis, Symeon and Michel, Martin and Migliore, Marco and Mihanovic, Jakov and Miller, Douglas and Mingoli, Andrea and Minto, Gary and Mirabella, Antonello and Misra, Nikhil and Mitrasinovic, Stefan and Miu, Victor and Moawad, Nader and Mochet, Sylvie and Modabber, Ali and Mohammad, Adam and Mohan, Midhun and Moliner-Sánchez, Carmen and Mongelli, Francesco and Monteleone, Michela and Montuori, Mauro and Moore, Rachel and Mora-Guzmán, Ismael and Morales, Xavier and Morales, Dieter and Morelli, Luca and Morelli, Lucia and Morgan, Richard and Morris, Chris and Mortini, Pietro and Mosca, Angelo and Motter, Dema and Moug, Susan and Mukherjee, Samrat and Najdy, Manhal and Nakas, Apostolos and Namazov, Ilgar and Naredla, Pradyumna and Nasef, Emmhamed and Nassa, Heeam and Nath, Rahul and Navarro-Sánchez, Antonio and Nazarian, Scarlet and Negri, Giampiero and Nehra, Deepika and Neil-Dwyer, Jason and Neri, Jacopo and Newton, Katy and Nikaj, Herald and Niquen, Milagros and Nobile, Sara and Nogueiro, Jorge and Ntirenganya, Faustin and Nugent, Michael and Núñez, Jordi and Ocaña, Juan and Okechukwu, Valentine and Oliva-Mompean, Fernando and Oliveira, Ana and Ollat, Didier and Onos, Lavinia and Osagie-Clouard, Liza and Osman, Khabab and Ottolina, Jessica and Ourieff, Jared and Outani, Oumaima and Oyewole, Bankole and Ozben, Volkan and Pacheco-Sanchez, David and Padilla-Valverde, David and Pai, Madhava and Paiella, Salvatore and Paisley, Samuel and Palini, Gianmarco and Palmeri, Matteo and Panahi, Pedram and Parente, Alessandro and Parlanti, Daniele and Parmar, Chetan and Pascual, Angela and Patel, Mahul and Pathak, Abhijit and Patil, Sangram and Pattyn, Piet and Peckham-Cooper, Adam and Pedrazzani, Corrado and Pellino, Gianluca and Peluso, Chiara and Pereira, André and Pereira-Neves, António and Perez-Diaz, MD and Pérez-González, Marta and Pérez-Saborido, Baltasar and Perivoliotis, Konstantinos and Perkins, Clare and Peros, Georgios and Perotto, Ornella and Perra, Teresa and Petrone, Patrizio and Phenix, George and Picazo, Sara and Picon-Rodriguez, Rafael and Piloni, Martina and Pingarrón-Martín, Lorena and Pinotti, Enrico and Pisanu, Adolfo and Pizzini, Paolo and Pockney, Peter and Podda, Mauro and Podolsky, Dina and Poggioli, Gilberto and Pompili, Cecilia and Pontari, Michael and Porcu, Alberto and Potter, Ryan and Price, Claire and Pruvot, François-René and Pujol-Muncunill, Roger and Puppo, Andrea and Quante, Markus and Quintana-Villamandos, Begoña and Qureshi, Ali and Radenkovic, Dejan and Rakvin, Ivan and Ramallo-Solís, Irene and Ramcharan, Sean and Ramos, Diego and Ramos-Bonilla, Antonio and Ramzi, Joussi and Rathinam, Sridhar and Rausa, Emanuele and Ravaioli, Matteo and Ravindran, Sharanya and Raymond, Thomas and Razik, Aisha and Redfern, Jennifer and Reguera-Rosal, 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Maria-Pilar and Santora, Thomas and Santoro, Antonio and Santos, Irene and Santos-Sousa, Hugo and Sapienza, Paolo and Sartarelli, Lodovico and Sarveswaran, Janahan and Sasia, Diego and Saudemont, Alain and Saudi-Moro, Sef and Saxena, Shobhit and Saxena, Dolly and Sayasneh, Ahmad and Scalabre, Aurelien and Schache, Andrew and Schiavina, Riccardo and Schineis, Christian and Schreckenbach, Teresa and Scorza, Antonella and Scott, Lucy and Seegert, Sara and Seguin-Givelet, Agathe and Senent-Boza, Ana and Seymour, Keith and Shabana, Amanda and Shah, Karishma and Shah, Jigar and Shah, Preena and Shah, Sujay and Shakir, Taner and Shalaby, Mostafa and Shankar, Sushma and Shaw, Richard and Shehata, Sameh and Shenfine, Amy and Sheridan, Kelda and Sherief, Ahmed and Sherief, Mohamed and Sherif, Mohamed and Shinkwin, Michael and Shu, Sebastian and Siaw-Acheampong, Kwabena and Sileri, Pierpaolo and Singh, Abhinav and Singh, Shailendra and Sinha, Sanjay and Sinha, Deepti and Siragusa, Leandro and Sivaprakasam, Rajesh and Sivayoganathan, Sriharan and Smillie, Robert and Smith, Claire and Smith, Andrew and Smith, Christopher and Sochorova, Dana and Soggiu, Fiammetta and Sohrabi, Catrin and Sohrabi, Catrin and Sohrabi, Catrin and Solari, Francesca and Solli, Piergiorgio and Soreide, Kjetil and Spinelli, Antonino and Spoletini, Domenico and Spriano, Giuseppe and Sravanam, Sanskrithi and Ssentongo, Paddy and Stanger, Sophie and Stavroulias, Dionisios and Steel, Ben and Stella, Marco and Stewart, Robbie and Stringer, Sally and Sulen, Nina and Sundar, Sudha and Sundhu, Matthew and Suri, Avni and Syed, Arooj and Szatmary, Peter and Tabiri, Stephen and Tadross, Daniel and Taglietti, Lucio and Tansey, Rosamond and Tartaglia, Dario and Tawheed, Ahmed and Tayeh, Salim and Teles, Tobias and Testa, Valentina and Tewari, Nilanjana and Thoenissen, Philipp and Thomas, Kane and Thomin, Anne and Thrush, Jessica and Tierney, Sean and Tiwari, Abhinav and Toh, Simon and Toledo, Enrique and Tonini, Valeria and Torkington, Jared and Torquati, Alfonso and Torzilli, Guido and Totty, Joshua and Tourountzi, Paraskevi and Tousidonis, Manuel and Townend, Philip and Townsend, Catherine and Trompeter, Alex and Trotta, Francesco and Truant, Stéphanie and Trujillo-Díaz, Jeancarlos and Tsoulfas, Georgios and Turco, Celia and Turrado-Rodriguez, Victor and Turri, Giulia and Tustin, Harry and Tyler, Jayne and Tzedakis, Stylianos and Tzovaras, George and Uittenbogaart, Martine and Ullah, Ramzan and Urban, Shane and Urbani, Alessia and Usai, Antonella and Vaccarella, Gianpaolo and Valdes-Hernandez, Javier and Valsecchi, Luca and Vashisht, Rajiv and Vázquez-Fernández, Andrea and Venn, Mary and Vera-Mansilla, Cristina and Vergari, Roberto and Vescio, Giuseppina and Vidya, Raghavan and Vieira, Paula and Vijay, Vardhini and Vimalachandran, Dale and Violante, Tommaso and Volpe, Anita and Vovola, Fernanda and Vulliamy, Paul and Wall, Rosemary and Wallwork, Kate and Ward, Alex and Warwick, David and Waseem, Saima and Weaver, Helen and Wells, Fiona and Wen, Jiaxin and West, Raha and Whitehall, Emma and Wild, Laura and Wilkins, Alex and Williams, Gethin and Williams, Matthew and Winnand, Philipp and Wong, Ken and Worku, Dawit and Wright, Naomi and Yalamanchili, Seema and Yershov, Danylo and Yildiz, Alp and Young, Richard and Yurttas, Can and Zadegan, Frederic and Zafar, Noman and Zakaria, Rasheed and Zambon, Martina and Zanini, Nicola and Zarate, Alba and Zerbib, Philippe and Zizzo, Maurizio and Zmora, Oded and Zonta, Sandro and van Berge Henegouwen, Mark I and van der Plas, Willemijn Y and Ali, Inthekab Ali Mohamed and Bakri, Nur Amalina Che and Bauset, Juan Carlos Catalá and Abou Chaar, Mohamad K and Marino Cosentino, Luigi MP and Gómez Díaz, Carlos J and Garcia Galocha, Jose L and de Gheldere, Charles and Ataíde Gomes, Gustavo Mendonça and Beltrán de Heredia, Juan and Blazer III, Dan G and Nugent III, William C and Ali karar, Ali A and Borja De Lacy, F and Blas Laina, Juan luis and Shane Lester, Madan Jha and Liyanage, Aloka S D and Al Maadany, Faraj S and De Marchi, Joshua A and Ramos-De la Medina, Antonio and Mithany, Reda H M and Sanchez del Pueblo, Cristina and van Ramshorst, Gabriëlle and De Salas, Maria Marqueta and De Souza, Anthony C and Dolores Del Toro, M and Archer, James E and Odeh, Abdulrahman and Erridge, Simon and Salem, Hosni Khairy and Jones, Gareth P and Gardner, Anne and Tripathi, Shiva S and Gregg, Anne and Jeganathan, Reuben and Siddique, Muhammad Harris and Lombardi, Celestino P and Martin, Benjamin and Leo, Cosimo Alex and Dass, Debashis and Di Franco, Gregorio and Jiao, Long R and Mari, Giulio Maria and Capitan-Morales, Luis-Cristobal and Connelly, Tara M and Alanbuki, Ammar and De Virgilio, Armando and Schilling, Clare and San Miguel Mendez, Carlos and Kulkarni, Gauri and Nizami, Kulsoom and Walsh, Stewart and Dean, Harry and Ruiz-Marin, Miguel and Houston, Rory and Trompetto, Mario and Chrastek, David and Kouritas, Vasileios and Cannoletta, Maria and Rosato, Francesco and Kaushal, Manish V and Costa, Paulo Matos and Elkadi, Hannah H and Johnstone, Jack R and Irvine, Esmee and Alvarez, Maria R and Corbellini, Carlo and Venkatesan, Gowtham S and Mateo-Sierra, Olga and Martínez-Pérez, Carolina and Serrano González, Javier and Hernández Bartolomé, Miguel Ángel and Díaz Pérez, David and Gutiérrez Samaniego, María and Galindo Jara, Pablo and Sharma, Neil and Smart, Neil J and Keller, Deborah S and COVIDsurg Collaborative, [missing]}},
  issn         = {{0140-6736}},
  journal      = {{LANCET}},
  keywords     = {{General Medicine,CONSENSUS DEFINITIONS}},
  language     = {{eng}},
  number       = {{10243}},
  pages        = {{27--38}},
  title        = {{Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection : an international cohort study}},
  url          = {{http://dx.doi.org/10.1016/s0140-6736(20)31182-x}},
  volume       = {{396}},
  year         = {{2020}},
}

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