Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.

SARS-CoV-2 vaccination modelling for safe surgery to save lives. Data from an international prospective cohort study / Bartolucci, Piero; Brachini, Gioia; Bruzzaniti, Placido; Chiappini, Ambra; Chiarella, Vito; Ciccarone, Fabio; Cicerchia, PIERFRANCO MARIA; Cirillo, Bruno; DE TOMA, Giorgio; DI BARTOLOMEO, Alessandro; Familiari, Pietro; Fiori, Enrico; Fonsi, Giovanni Battista; Franco, Giorgio; Frati, Alessandro; Giugliano, Marco; Iannone, Immacolata; LA TORRE, Filippo; Lapolla, Pierfrancesco; Leonardo, Costantino; Marruzzo, Giovanni; Meneghini, Simona; Mingoli, Andrea; Prucher, GIAN MARCO; Ribuffo, Diego; Salvati, Marta; Santoro, Antonio; Sapienza, Paolo; Scafa, ANTHONY KEVIN; Simonelli, Lucilla; Zambon, Martina; Fiorelli, Silvia; Menna, Cecilia; D'Annunzio, Simone; DE NUNZIO, Cosimo; Ibrahim, Mohsen; Loffredo, Chiara; Massullo, Domenico; Rocco, Monica; Pelli, Massimiliano; Teodonio, Leonardo; Tubaro, Andrea; Rendina, Erino Angelo; Dmitri, Nepogodiev; Aneel, Bhangu; Picotti, Veronica; Picchetto, Andrea. - In: BRITISH JOURNAL OF SURGERY. - ISSN 0007-1323. - 108:9(2021), pp. 1056-1063. [10.1093/bjs/znab101]

SARS-CoV-2 vaccination modelling for safe surgery to save lives. Data from an international prospective cohort study

BARTOLUCCI Piero;BRACHINI GIOIA;BRUZZANITI PLACIDO;CHIAPPINI AMBRA;CHIARELLA VITO;CICCARONE FABIO;CICERCHIA PIERFRANCO MARIA;CIRILLO BRUNO;DE TOMA Giorgio;DI BARTOLOMEO ALESSANDRO;FAMILIARI PIETRO;FIORI ENRICO;FONSI Giovanni Battista;FRANCO Giorgio;FRATI ALESSANDRO;GIUGLIANO MARCO;IANNONE IMMACOLATA;LA TORRE Filippo;LAPOLLA PIERFRANCESCO;LEONARDO Costantino;MARRUZZO GIOVANNI;MENEGHINI SIMONA;MINGOLI Andrea;PRUCHER GIAN MARCO;RIBUFFO Diego;SALVATI MARTA;SANTORO Antonio;SAPIENZA Paolo;SCAFA ANTHONY KEVIN;SIMONELLI Lucilla;ZAMBON MARTINA;FIORELLI Silvia;Menna Cecilia;Simone D’Annunzio;Cosimo De Nunzio;Ibrahim Mohsen;Loffredo Chiara;Massullo Domenico;Rocco Monica;Pelli Massimiliano;Teodonio Leonardo;Tubaro Andrea;Erino Angelo Rendina;Picotti Veronica
Membro del Collaboration Group
;
Picchetto Andrea
2021

Abstract

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.
2021
adolescent; adult; aged; COVID-19; COVID-19 vaccines; comorbidity; elective surgical procedures; female; humans; male; middle aged; postoperative complications; preoperative period; prospective studies; SARS-COV-2; vaccination; young adult
01 Pubblicazione su rivista::01a Articolo in rivista
SARS-CoV-2 vaccination modelling for safe surgery to save lives. Data from an international prospective cohort study / Bartolucci, Piero; Brachini, Gioia; Bruzzaniti, Placido; Chiappini, Ambra; Chiarella, Vito; Ciccarone, Fabio; Cicerchia, PIERFRANCO MARIA; Cirillo, Bruno; DE TOMA, Giorgio; DI BARTOLOMEO, Alessandro; Familiari, Pietro; Fiori, Enrico; Fonsi, Giovanni Battista; Franco, Giorgio; Frati, Alessandro; Giugliano, Marco; Iannone, Immacolata; LA TORRE, Filippo; Lapolla, Pierfrancesco; Leonardo, Costantino; Marruzzo, Giovanni; Meneghini, Simona; Mingoli, Andrea; Prucher, GIAN MARCO; Ribuffo, Diego; Salvati, Marta; Santoro, Antonio; Sapienza, Paolo; Scafa, ANTHONY KEVIN; Simonelli, Lucilla; Zambon, Martina; Fiorelli, Silvia; Menna, Cecilia; D'Annunzio, Simone; DE NUNZIO, Cosimo; Ibrahim, Mohsen; Loffredo, Chiara; Massullo, Domenico; Rocco, Monica; Pelli, Massimiliano; Teodonio, Leonardo; Tubaro, Andrea; Rendina, Erino Angelo; Dmitri, Nepogodiev; Aneel, Bhangu; Picotti, Veronica; Picchetto, Andrea. - In: BRITISH JOURNAL OF SURGERY. - ISSN 0007-1323. - 108:9(2021), pp. 1056-1063. [10.1093/bjs/znab101]
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