Postoperative Surgical Site and Secondary Infections in Colorectal Cancer Patients With a History of SARS-CoV-2: A Retrospective Cohort Study.

BACKGROUND

The outbreak of the COVID-19 pandemic brought unique challenges to the field of healthcare, particularly to the surgical field. This retrospective cohort study aims to compare the risk of surgical site infection (SSI) and secondary infection between colorectal cancer (CRC) patients with a history of COVID-19 infection and those without.

METHOD: A cohort of 200 CRC patients, comprising 100 with a documented history of COVID-19 infection and 100 without, were retrospectively analyzed. Independent sample t-tests for continuous variables, Chi-square tests for categorical variables, and additionally univariate and multivariate binary logistic regression analysis were performed using IBM SPSS Statistics for Windows, Version 29.0.2 (Released 2023; IBM Corp., Armonk, New York, United States). The data were collected from the medical records of patients treated at the Hernia and Colorectal Surgery department of the Second Affiliated Hospital of Dalian Medical University, Dalian, China. Key clinical variables examined included the incidence of SSIs, occurrence of secondary infections, presence of comorbidities such as diabetes and hypertension, and duration of hospitalization.

RESULTS

The comparative analysis yielded compelling differences between CRC patients with a history of COVID-19 infection and those without. The study revealed a significantly higher incidence of SSI (68.8% vs. 31.3%, p=0.003) and secondary infection (70.1% vs. 29.9%, p<0.001) among patients with a history of COVID-19. In the multivariate analysis for SSIs, hypertension (OR = 2.78, 95%CI: 1.03-7.54, p=0.044) and surgical procedure type (open vs. laparoscopic) (OR = 6.04, 95%CI: 1.88-19.43, p=0.003) were found to be significant independent predictors. Patients with a history of COVID-19 had a significantly higher incidence of secondary infections (70.1% vs. 29.9%, p<0.001), with multivariate analysis showing COVID-19 status (OR: 3.053, 95%CI: 1.515-6.154, p=0.002), hypertension (OR: 2.632, 95% CI: 1.154-6.006, p=0.021), and diabetes mellitus (OR: 4.326, 95%CI: 2.029-9.226, p<0.001) as independent risk factors.

CONCLUSION

This study highlights significant insight into SSI rates, secondary infection rates, and clinical characteristics between CRC patients with and without a history of COVID-19 infection. The findings underscore that CRC patients with hypertension who underwent open surgery procedures exhibited a higher susceptibility to SSI. Following CRC patients in combination with comorbidities such as hypertension, diabetes, and a history of COVID-19 infection exhibited higher susceptibility to secondary infections. This study contributes to the evolving understanding of the impact of COVID-19 history on surgical outcomes, providing valuable insight to healthcare providers in optimizing care for CRC patients in the context of this ongoing health crisis.