TY - JOUR
T1 - SARS-CoV-2 vaccination modelling for safe surgery to save lives
T2 - data from an international prospective cohort study
AU - Nepogodiev, Dmitri
AU - Simoes, Joana F.F.
AU - Li, Elizabeth
AU - Glasbey, James
AU - Picciochi, Maria
AU - Kamarajah, Sivesh K.
AU - Gujjuri, Rohan
AU - Bhangu, Aneel
AU - Maryam, A.
AU - Azab, Mohammed A.
AU - Zahran, Mohammed A.
AU - Abdelaziz, Areej A.
AU - Aamir, Junaid
AU - Rahman, Norhafiza Ab
AU - Zaid, Muna Aba
AU - Abaalkhail, Muath
AU - Ababneh, Adnan
AU - Ababneh, Hazim
AU - Ababneh, Laila
AU - Ababneh, Roba
AU - Alonso, Rafael Abad
AU - Gurumeta, Alfredo Abad
AU - Abad-Motos, Ane
AU - Abaker, Mussab
AU - Abary, Ryan Rainiel
AU - Abass, Adam
AU - Abate, Emmanuele
AU - López, Cristina Barrena
AU - Brunet-Garcia, Aina
AU - Álvarez, Ana Centeno
AU - Díaz-Feijoo, Berta
AU - Espin-Basany, Eloy
AU - Espinosa-Bravo, Martin
AU - Ferrari, Giovanni
AU - García, Elena García
AU - García-López, Daniel
AU - Romero, Maria Gómez
AU - González-Suárez, Susana
AU - Hirche, Christoph
AU - Lemma, Francesco
AU - Lopez, Manuel
AU - Gomez, Patricia Lopez
AU - Nguyen, Anh
AU - Pellino, Gianluca
AU - López, Francisco Pérez
AU - Rodriguez, Natalia
AU - Sánchez-Cabús, Santiago
AU - Sole-Sedeno, Josep M.
AU - Vilallonga, Ramon
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85142233442&partnerID=8YFLogxK
U2 - 10.1093/bjs/znab101
DO - 10.1093/bjs/znab101
M3 - Article
C2 - 33761533
AN - SCOPUS:85142233442
SN - 0007-1323
VL - 108
SP - 1056
EP - 1063
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 9
ER -
