Surgical Outcomes in Pediatric Patients Testing Positive for SARS-CoV-2

Introduction: In this study we aimed to determine surgical outcomes of pediatric patients undergoing surgery with perioperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Methods: We examined all patients 18 years old and younger who underwent surgery at a children's hospital and tested positive for SARS-CoV-2 within 1 week before or after their procedure. Age-matched control patients who underwent similar procedures over the past ten years were included in a 3:1 ratio. The primary outcome of our study was 7- and 30-day mortality rates. Secondary outcomes in our study were postoperative pulmonary complications, specifically unexpected ventilation, pneumonia, or acute respiratory distress syndrome. Other outcomes included postoperative hospital stay, ICU admission, and readmission for surgical complications. Results: Our study included 43 procedures performed on 39 patients who tested positive for SARS-CoV-2 and underwent surgery from March 1, 2020 to December 31, 2020. No 7- or 30-day mortality events were observed in any patients. Pulmonary complications were observed in 3 out of 43 (7%) surgeries performed on patients with perioperative SARS-CoV-2 diagnosis, and no pulmonary complications were observed in 124 surgeries performed on patients without SARS-CoV-2 diagnosis (p=.003). SARS-CoV-2 diagnosis did not affect length or occurrence of postoperative hospital stay, ICU admission, and readmission for surgical complications. Abnormal preoperative chest x-ray and preoperative blood pressure were also associated with pulmonary complications in additional analyses (p=.02 and.01, respectively). Conclusion: Our results indicate that pediatric patients undergoing surgery with perioperative SARS-CoV-2 diagnosis may be at increased risk for pulmonary complications.