Perioperative SARS-CoV-2 infection significantly increases the risk of postoperativecomplications and mortality, while also exerting long-lasting impacts on multiple organsand systems. Due to the curtailment or cessation of non-emergency surgeries during theinitial phase of the pandemic, there is a lack of evidence regarding the optimal timingand medium- to long-term postoperative outcomes of surgical intervention in breast cancerpatients with prior SARS-CoV-2 infection, particularly after vaccination. We aim toinvestigate whether prior SARS-CoV-2 infection increases the risk of postoperativeadverse outcomes in breast cancer patients and determine the optimal timing for surgicalintervention during the pandemic, as well as to longitudinally assess the evolution ofpostoperative adverse outcomes within one year after COVID-19 and identify associatedrisk factors.
This study employs a prospective cohort design with longitudinal and matched
characteristics, focusing on breast cancer patients who underwent surgery after
recovering from SARS-CoV-2 infection. Patients were stratified by the time of surgery
relative to COVID-19 diagnosis. The Inverse Probability of Treatment Weighting (IPTW)
method was used to match a control group (COVID-19 negative) based on patient, tumor, and
surgical factors in order to compare composite indicators (including death, pneumonia,
thrombosis, cardiac complications, and unplanned hospitalization) for evaluating the
optimal timing of surgery. We investigated the longitudinal evolution of postoperative
adverse outcomes and identified the relevant risk factors through logistic regression
analysis.
Other: Preoperative resolved COVID-19
We observed postoperative outcomes only in patients who had or did not have COVID-19
before surgery, without any additional intervention.
Inclusion Criteria:
- Breast cancer patients who underwent surgery after recovering from SARS-CoV-2
infection
- Breast cancer patients who had never been infected with SARS-CoV-2 before surgery
Exclusion Criteria:
- Distant metastasis
- Pregnancy-associated breast cancer
- Incomplete follow-up information
Fujian Medical University Union Hospital
Fuzhou, Fujian, China
Chuan Wang, Study Chair
Fujian Medical University Union Hospital