ArticleAnnals of medicine and surgery (2012)2025
A cross-sectional, retrospective study analyzing the impact of COVID-19 on surgical mortality in Johannesburg, South Africa.
Article in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Various comorbidities are known to exacerbate the risk of surgical mortality with COVID-19 infection. The effect of HIV infection on surgical mortality in the context of COVID-19 has also not been investigated. The aim of our study was to investigate the influence of HIV status on mortality in surgical patients admitted during the COVID-19 pandemic in Johannesburg, South Africa. Material and methods: We reviewed records of patients who were admitted and underwent surgery during the COVID-19 pandemic and died. Data regarding perioperative COVID-19 infection, risk factors, comorbidities, mortality preventability, and contributing factors were extracted. Logistic regression was used to analyze comorbidities associated with COVID-19 infection among surgical mortalities. Results: A total of 404 records of mortalities were found and 25% (82/404) tested positive for COVID-19. 40% Of the mortalities were either potentially preventable or preventable. Comorbidities in patients who were COVID-19-positive surgical mortalities compared to their negative counterparts included smoking in 35% versus 4%, chronic obstructive pulmonary disease (COPD) in 20% versus 3%, and diabetes mellitus in 23% versus 13%, respectively. The odds of being COVID-19 positive in surgical mortalities with hypertension, smoking, and COPD were 1.96 times [OR = 1.96, 95% CI (1.06, 3.59)], 7.78 times [OR = 7.78, 95% CI (3.45, 18.35)], and 3.09 times [OR = 3.09, 95% CI (1.08, 8.95)], respectively. 55% of COVID-19-positive patients who died were HIV positive compared to 31% among the COVID-19-negative group. 26% of HIV-positive patients were on anti-retroviral treatment (ART). 22% of HIV-/COVID-19-coinfected surgical mortalities were not on antiretroviral treatment compared to 9% in the HIV-positive and COVID-19-negative groups. The odds of COVID-19 infection in surgical mortalities who were HIV positive and not on ART was 3.10 [95% CI (1.55, 6.11)]. Conclusion: The rate of COVID-19 infection was higher in HIV-positive patients who died, especially if they were not on ART. Smoking, COPD, and hypertension imparted the largest risk on COVID-19 infection in cases of surgical mortality. These comorbidities likely superimpose the pathological effects of COVID-19 infection, worsening surgical prognosis.
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