Partial COVID-19 vaccination associated with reduction in postoperative mortality and SARS-CoV-2 infection - 11/10/22

Doi : 10.1016/j.amjsurg.2022.03.038

Nikhil K. Prasad ^a,^b, Brian R. Englum ^a, Minerva Mayorga-Carlin ^a,^b, Douglas J. Turner ^b,^a, Shalini Sahoo ^a,^b, John D. Sorkin ^c,^d, Brajesh K. Lal ^a,^b,^⁎
^a Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
^b Surgery Service, Veterans Affairs Medical Center, Baltimore, MD, USA
^c Baltimore Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center, Baltimore, MD, USA
^d Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

^∗Corresponding author. Department of Surgery, University of Maryland, 22 South Greene Street, Baltimore, MD, 21201, USA.Department of SurgeryUniversity of Maryland22 South Greene StreetBaltimoreMD21201USA

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Abstract

Background

There are currently no data to guide decisions about delaying surgery to achieve full vaccination.

Methods

We analyzed data from patients undergoing surgery at any of the 1,283 VA medical facilities nationwide and compared postoperative complication rates by vaccination status.

Results

Of 87,073 surgical patients, 20% were fully vaccinated, 15% partially vaccinated, and 65% unvaccinated. Mortality was reduced in full vaccination vs. unvaccinated (Incidence Rate Ratio 0.77, 95% CI [0.62, 0.94]) and partially vaccinated vs. unvaccinated (0.75 [0.60, 0.94]). Postoperative COVID-19 infection was reduced in fully (0.18 [0.12, 0.26]) and partially vaccinated patients (0.34 [0.24, 0.48]). Fully vaccinated compared to partially vaccinated patients, had similar postoperative mortality (1.02, [0.78, 1.33]), but had decreased COVID-19 infection (0.53 [0.32, 0.87]), pneumonia (0.75 [0.62, 0.93]), and pulmonary failure (0.79 [0.68, 0.93]).

Conclusions

Full and partial vaccination reduces postoperative complications indicating the importance of any degree of vaccination prior to surgery.

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Highlights

•	Full vaccination may decrease postoperative COVID‑19 infection, pneumonia, and pulmonary failure.
•	Even partial vaccination reduced postoperative mortality and pulmonary complications.
•	Full vaccination provides better protection against postoperative complications.

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Keywords : COVID-19, Surgery, Postoperative mortality, Postoperative pneumonia, Vaccination