Routine testing for COVID-19 can make surgery safer

A new group of international researchers at The University of Western Australia has found routine testing patients for COVID-19 before major surgery could reduce the risk of respiratory complications and save lives.

The researchers found that using a nasal swab test to confirm that asymptomatic patients were not infected with SARS-CoV-2, was associated with a lower rate of post-operative complications. 

The COVIDSurg Collaborative comprises experts from more than 130 countries with the Australian and New Zealand collaboration led by the Royal Australian College of Surgeons Clinical Trials Network. 

The group has published its findings today in the British Journal of Surgery and is calling for pre-operative swab testing for all patients as part of a broader strategy to continue surgery safely during the pandemic.  

Swab testing gave opportunity for surgeons to identify asymptomatic infected patients and postpone their operation, avoiding the severe risk of COVID-19 complications after surgery. 

Routine testing also helped to prevent cross-infection from patients with no symptoms to other elective surgical patients upon admission to hospital. 

The collaborative has launched a dedicated toolkit to help hospitals and healthcare providers around the world get elective surgery up and running again, after more than 28 million procedures were postponed in the first phase of the global pandemic.

Professor Toby Richards, from the UWA Division of Surgery and Fiona Stanley Hospital, said the findings demonstrated major variation between countries in the application of preoperative testing. 

“Whilst a clear benefit to testing was seen, just one in four patients were screened for infection,” Professor Richards said. “This illustrates the need for global expansion and standardisation of swab testing worldwide.

“Preoperative swab testing should not be considered in isolation, but as part of a broader plan to minimise risks for patients, including setting up COVID-19 free surgical pathways in all hospitals performing elective surgery.”

The COVIDSurg toolkit will support individual hospitals, regions, and countries during a major global reorganisation of surgical services during the pandemic and beyond, by:

• Summarising published data to support safe surgical practice;
• Guiding effective surgical recovery plans; and 
• Creating a five-year vision of safe and effective surgery that addresses global challenges, including shortfalls in access to surgery that existed before the pandemic.

Lead researcher, Dr Jess Vo, from Fiona Stanley Hospital said surgery was an essential part of all health systems. 

“On average, you will undergo three to four operations during your lifetime,” Dr Vo said.

“Surgery remains the cure for most cancers and underpins the treatment of many non-infectious diseases.

“Our new toolkit will help everyone involved in surgical planning over the next 5 years, including providers, healthcare leaders, patients, governments, financers and industry. 

“It addresses global challenges, but is locally adaptable to hospitals and environments with varying access to resources.”