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

COVIDSurg Collaborative; GlobalSurg Collaborative; David Watson; Tim Bright

doi:10.1093/bjs/znab101

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

COVIDSurg Collaborative
, GlobalSurg Collaborative
, David Watson
, Tim Bright

College of Medicine and Public Health

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

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.

Original language	English
Pages (from-to)	1056–1063
Number of pages	8
Journal	British Journal of Surgery
Volume	108
Issue number	9
DOIs	https://doi.org/10.1093/bjs/znab101
Publication status	Published - Sept 2021

Bibliographical note

cited By 16

Keywords

SARS-COV-2
vaccination modelling
preoperative vaccination
elective surgery access

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10.1093/bjs/znab101Licence: In Copyright

Cite this

@article{7ebb0ea4f02347bd90d11c56c394e177,

title = "SARS-CoV-2 vaccination modelling for safe surgery to save lives: Data from an international prospective cohort study",

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.",

keywords = "SARS-COV-2, vaccination modelling, preoperative vaccination, elective surgery access",

author = "\{COVIDSurg Collaborative\} and \{GlobalSurg Collaborative\} and D. Nepogodiev and Simoes, \{J. F. F.\} and E. Li and M. Picciochi and J. Glasbey and Osaid Alser and L. Boccalatte and Calvache, \{Jose Andres\} and Irani Duran and Muhammed Elhadi and Mohammed Elmujtaba and Sameh Emile and Harrison, \{Ewen M\} and Peter Hutchinson and Ingabire, \{Jc Allen\} and Arda Isik and Kamarajah, \{Sivesh K\} and Sharad Karandikar and Kauppila, \{Joonas H.\} and Gabriele Kembuan and Hans Lederhuber and L{\"o}ffler, \{Markus W.\} and Harvinder Mann and Marson, \{Ella J\} and Mclean, \{Kenneth A\} and Emmanuel Munyaneza and Lisa Norman and Omar, \{Omar M\} and Riinu Pius and Peter Pockney and Martin Ruteg{\aa}rd and Stewart, \{Grant D.\} and Taylor, \{Elliott H\} and Venn, \{Mary L.\} and Aneel Bhangu and Waheed-Ul-Rahman Ahmed and Leah Argus and Alasdair Ball and Bywater, \{Edward P\} and Ruth Blanco-Colino and Amanpreet Brar and Daoud Chaudhry and Dawson, \{Brett E\} and Gujjuri, \{Rohan R.\} and Jones, \{Conor S\} and Keatley, \{James M\} and Samuel Lawday and Dmitri Nepogodiev and Riinu Ots and Oumaima Outani and Catherine Shaw and Trout, \{Isobel M\} and Chris Varghese and William Xu and Irida Dajti and Arben Gjata and \{Oussama Kacimi\}, \{Salah Eddine Oussama Kacimi\} and Modolo, \{Maria Marta\} and Daniel Cox and Philip Townend and Felix Aigner and Irmgard Kronberger and Elgun Samadov and Amer Alderazi and Kamral Hossain and Greg Padmore and \{van Ramshorst\}, Gabrielle and Isma{\"i}l Lawani and Anis Cerovac and Samir Delibegovic and Glauco Baiocchi and \{Ata{\'i}de Gomes\}, \{Gustavo Mendon{\c c}a\} and \{Lima Buarque\}, Igor and Muhammad Gohar and Mihail Slavchev and Chukwuemeka Nwegbu and Arnav Agarwal and Janet Martin and Joshua Ng-Kamstra and Maricarmen Olivos and Wenhui Lou and Dong-Lin Ren and \{J- Perez Rivera\}, Carlos and \{Danic Hadzibegovic\}, Ana and Tomislav Kopjar and Jakov Mihanovic and \{Avil{\'e}s Jim{\'e}nez\}, \{Pablo Mijahil\} and Nikolaos Gouvas and Jaroslav Klat and Ren{\'e} Novysedl{\'a}k and Nicolas Amisi and Peter Christensen and Alaa El-Hussuna and Sylvia Batista and Eddy Lincango-Naranjo and \{Ar{\'e}valo Sandoval\}, \{Danilo Alfonso\} and Hailu Dhufera and Samuel Hailu and Mengesha, \{Mengistu Gebreyohanes\} and Arnaud, \{Alexis P\} and Zaza Demetrashvili and Markus Albertsmeier and Acquah, \{Daniel Kwesi\} and Bernard Ofori and Stephen Tabiri and Symeon Metallidis and Georgios Tsoulfas and Maria-Lorena Aguilera-Arevalo and Gustavo Recinos and Tam{\'a}s Mersich and D{\'a}niel Wettstein and Dhruva Ghosh and \{Brouki Milan\}, Peiman and Khosravi, \{Mohammad Hossein\} and Masoud Mozafari and Ahmed Hilmi and Mohan, \{Helen M.\} and Oded Zmora and Gaetano Gallo and Francesco Pata and Gianluca Pellino and Yuki Fujimoto and Naoto Kuroda and Sohei Satoi and \{Abou Chaar\}, \{Mohamad K.\} and Faris Ayasra and Ildar Fakhradiyev and \{Said Hamdun\}, \{Intisar Hisham\} and Jang Jin-Young and Mohammad Jamal and Lina Karout and Aiste Gulla and Fanjandrainy Rasoaherinomenjanahary and Samison, \{Luc Herv{\'e}\} and Roslani, \{April Camilla\} and \{Dur{\'a}n S{\'a}nchez\}, \{Iran Irani\} and Gonzalez, \{Diana Samantha\} and Laura Martinez and Mart{\'i}nez, \{Mar{\'i}a Jos{\'e}\} and Alejandra Nayen and \{Ramos-De la Medina\}, Antonio and Jade Nunez and Nashidengo, \{Pueya Rashid\} and Rakesh Shah and \{Lal Shrestha\}, Ashish and Pascal Jonker and Schelto Kruijff and Milou Noltes and Pieter Steinkamp and Deborah Wright and Lukman Abdur-Rahman and Adesoji Ademuyiwa and Adewale Adisa and Babatunde Osinaike and Justina Seyi-Olajide and Omolara Williams and Emmanuel Williams and Sofija Pejkova and \{Al Balushi\}, Zainab and \{Uzair Qureshi\}, Ahmad and Raza Sayyed and \{Abo Mohsen\}, Mustafa and Abukhalaf, \{Sadi A.\} and Moises Cukier and Hugo Gomez-Fernandez and \{Shu Yip\}, Sebastian and \{Vasquez Ojeda\}, \{Ximena Paola\} and Sacdalan, \{Marie Dione\} and Piotr Major and Jos{\'e} Azevedo and Cunha, \{Miguel F.\} and Ir{\`e}ne Santos and Ahmad Zarour and Eduard-Alexandru Bonci and Ionut Negoi and Sergey Efetov and Viktor Kochetkov and Andrey Litvin and Georges Bucyibaruta and Ntirenganya Faustin and Sosthene Habumuremyi and Alphonsine Imanishimwe and \{Jean de Dieu\}, Haragirimana and Isaie Ncogoza and Ehab AlAmeer and Abdourahmane Ndong and Dejan Radenkovic and Chew, \{Min Hoe\} and Frederick Koh and James Ngu and Arp{\'a}d Panyko and Uros Bele and Ko{\v s}ir, \{Jurij Ale{\v s}\} and Hassan Daoud and \{Minaya Bravo\}, \{Ana Maria\} and Umesh Jayarajah and Dakshitha Wickramasinghe and \{Essa Adam\}, \{Mohammed Elmujtba Adam\} and Malin Sund and Michel Adamina and Gialamas, \{Eleftherios Gialamas\} and Karoline Horisberger and Muhammad Alshaar and Abel Huang and Varut Lohsiriwat and Shane Charles and Haithem Jlassi and Sezai Leventoğlu and Lekuya, \{Herv{\'e} Monka\} and Herman Lule and Slava Kopetskyi and Hayder Alsaadi and Sattar Alshryda and Bankhead-Kendall, \{Brittany Kay\} and Kerry Breen and Kaafarani, \{Haytham M.A.\} and Hassan Mashbari and \{Bonilla Cal\}, Fernando and Hamza Al-Naggar and Mayaba Maimbo and Dennis Mazingi and Tom Abbott and Melika Akhbari and Ruth Benson and Shivam Bhanderi and Bruce Biccard and Edward Caruana and Sohini Chakrabortee and Reema Chapatwala and Ainhoa Costas-Chavarri and Demetriades, \{Andreas K\} and Anant Desai and \{Di Saverio\}, Salomone and Drake, \{Thomas M.\} and John Edwards and Evans, \{Jonathan P.\} and Marco Fiore and Ford, \{Samuel J.\} and Christina Fotopoulou and Alexander Fowler and Kaori Futaba and Ian Ganly and James, \{Harelimana Grace\} and Ewen Griffiths and Alessandro Gronchi and Hyman, \{Gabriella Yael\} and Joseph Incorvia and Ritu Jain and David Watson and Tim Bright",

note = "cited By 16",

year = "2021",

month = sep,

doi = "10.1093/bjs/znab101",

language = "English",

volume = "108",

pages = "1056–1063",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "Oxford University Press",

number = "9",

}

TY - JOUR

T1 - SARS-CoV-2 vaccination modelling for safe surgery to save lives: Data from an international prospective cohort study

AU - COVIDSurg Collaborative

AU - GlobalSurg Collaborative

AU - Nepogodiev, D.

AU - Simoes, J. F. F.

AU - Li, E.

AU - Picciochi, M.

AU - Glasbey, J.

AU - Alser, Osaid

AU - Boccalatte, L.

AU - Calvache, Jose Andres

AU - Duran, Irani

AU - Elhadi, Muhammed

AU - Elmujtaba , Mohammed

AU - Emile, Sameh

AU - Harrison , Ewen M

AU - Hutchinson, Peter

AU - Ingabire, Jc Allen

AU - Isik, Arda

AU - Kamarajah, Sivesh K

AU - Karandikar, Sharad

AU - Kauppila, Joonas H.

AU - Kembuan, Gabriele

AU - Lederhuber, Hans

AU - Löffler, Markus W.

AU - Mann, Harvinder

AU - Marson, Ella J

AU - Mclean, Kenneth A

AU - Munyaneza, Emmanuel

AU - Norman , Lisa

AU - Omar, Omar M

AU - Pius, Riinu

AU - Pockney, Peter

AU - Rutegård, Martin

AU - Stewart, Grant D.

AU - Taylor, Elliott H

AU - Venn, Mary L.

AU - Bhangu, Aneel

AU - Ahmed, Waheed-Ul-Rahman

AU - Argus, Leah

AU - Ball, Alasdair

AU - Bywater, Edward P

AU - Blanco-Colino, Ruth

AU - Brar, Amanpreet

AU - Chaudhry, Daoud

AU - Dawson, Brett E

AU - Gujjuri, Rohan R.

AU - Jones, Conor S

AU - Keatley, James M

AU - Lawday, Samuel

AU - Nepogodiev, Dmitri

AU - Ots, Riinu

AU - Outani , Oumaima

AU - Shaw , Catherine

AU - Trout, Isobel M

AU - Varghese, Chris

AU - Xu, William

AU - Dajti, Irida

AU - Gjata, Arben

AU - Oussama Kacimi, Salah Eddine Oussama Kacimi

AU - Modolo , Maria Marta

AU - Cox, Daniel

AU - Townend, Philip

AU - Aigner, Felix

AU - Kronberger , Irmgard

AU - Samadov, Elgun

AU - Alderazi, Amer

AU - Hossain, Kamral

AU - Padmore, Greg

AU - van Ramshorst, Gabrielle

AU - Lawani, Ismaïl

AU - Cerovac, Anis

AU - Delibegovic, Samir

AU - Baiocchi, Glauco

AU - Ataíde Gomes, Gustavo Mendonça

AU - Lima Buarque, Igor

AU - Gohar, Muhammad

AU - Slavchev, Mihail

AU - Nwegbu, Chukwuemeka

AU - Agarwal, Arnav

AU - Martin, Janet

AU - Ng-Kamstra, Joshua

AU - Olivos, Maricarmen

AU - Lou, Wenhui

AU - Ren, Dong-Lin

AU - J- Perez Rivera, Carlos

AU - Danic Hadzibegovic, Ana

AU - Kopjar, Tomislav

AU - Mihanovic, Jakov

AU - Avilés Jiménez, Pablo Mijahil

AU - Gouvas, Nikolaos

AU - Klat, Jaroslav

AU - Novysedlák, René

AU - Amisi, Nicolas

AU - Christensen, Peter

AU - El-Hussuna, Alaa

AU - Batista, Sylvia

AU - Lincango-Naranjo, Eddy

AU - Arévalo Sandoval, Danilo Alfonso

AU - Dhufera, Hailu

AU - Hailu, Samuel

AU - Mengesha , Mengistu Gebreyohanes

AU - Arnaud, Alexis P

AU - Demetrashvili, Zaza

AU - Albertsmeier, Markus

AU - Acquah, Daniel Kwesi

AU - Ofori, Bernard

AU - Tabiri, Stephen

AU - Metallidis, Symeon

AU - Tsoulfas, Georgios

AU - Aguilera-Arevalo, Maria-Lorena

AU - Recinos, Gustavo

AU - Mersich, Tamás

AU - Wettstein, Dániel

AU - Ghosh , Dhruva

AU - Brouki Milan, Peiman

AU - Khosravi, Mohammad Hossein

AU - Mozafari, Masoud

AU - Hilmi, Ahmed

AU - Mohan, Helen M.

AU - Zmora, Oded

AU - Gallo, Gaetano

AU - Pata, Francesco

AU - Pellino, Gianluca

AU - Fujimoto, Yuki

AU - Kuroda, Naoto

AU - Satoi , Sohei

AU - Abou Chaar, Mohamad K.

AU - Ayasra, Faris

AU - Fakhradiyev, Ildar

AU - Said Hamdun, Intisar Hisham

AU - Jin-Young, Jang

AU - Jamal, Mohammad

AU - Karout, Lina

AU - Gulla, Aiste

AU - Rasoaherinomenjanahary, Fanjandrainy

AU - Samison, Luc Hervé

AU - Roslani , April Camilla

AU - Durán Sánchez, Iran Irani

AU - Gonzalez, Diana Samantha

AU - Martinez, Laura

AU - Martínez, María José

AU - Nayen, Alejandra

AU - Ramos-De la Medina, Antonio

AU - Nunez, Jade

AU - Nashidengo, Pueya Rashid

AU - Shah, Rakesh

AU - Lal Shrestha, Ashish

AU - Jonker, Pascal

AU - Kruijff, Schelto

AU - Noltes, Milou

AU - Steinkamp, Pieter

AU - Wright, Deborah

AU - Abdur-Rahman, Lukman

AU - Ademuyiwa, Adesoji

AU - Adisa, Adewale

AU - Osinaike, Babatunde

AU - Seyi-Olajide, Justina

AU - Williams, Omolara

AU - Williams, Emmanuel

AU - Pejkova, Sofija

AU - Al Balushi, Zainab

AU - Uzair Qureshi , Ahmad

AU - Sayyed, Raza

AU - Abo Mohsen, Mustafa

AU - Abukhalaf, Sadi A.

AU - Cukier, Moises

AU - Gomez-Fernandez, Hugo

AU - Shu Yip, Sebastian

AU - Vasquez Ojeda, Ximena Paola

AU - Sacdalan, Marie Dione

AU - Major, Piotr

AU - Azevedo, José

AU - Cunha, Miguel F.

AU - Santos, Irène

AU - Zarour, Ahmad

AU - Bonci, Eduard-Alexandru

AU - Negoi, Ionut

AU - Efetov, Sergey

AU - Kochetkov, Viktor

AU - Litvin, Andrey

AU - Bucyibaruta, Georges

AU - Faustin, Ntirenganya

AU - Habumuremyi, Sosthene

AU - Imanishimwe, Alphonsine

AU - Jean de Dieu, Haragirimana

AU - Ncogoza, Isaie

AU - AlAmeer , Ehab

AU - Ndong, Abdourahmane

AU - Radenkovic, Dejan

AU - Chew, Min Hoe

AU - Koh, Frederick

AU - Ngu, James

AU - Panyko, Arpád

AU - Bele, Uros

AU - Košir, Jurij Aleš

AU - Daoud, Hassan

AU - Minaya Bravo, Ana Maria

AU - Jayarajah, Umesh

AU - Wickramasinghe, Dakshitha

AU - Essa Adam, Mohammed Elmujtba Adam

AU - Sund, Malin

AU - Adamina, Michel

AU - Gialamas, Eleftherios Gialamas

AU - Horisberger, Karoline

AU - Alshaar, Muhammad

AU - Huang, Abel

AU - Lohsiriwat, Varut

AU - Charles, Shane

AU - Jlassi, Haithem

AU - Leventoğlu, Sezai

AU - Lekuya, Hervé Monka

AU - Lule , Herman

AU - Kopetskyi, Slava

AU - Alsaadi, Hayder

AU - Alshryda, Sattar

AU - Bankhead-Kendall, Brittany Kay

AU - Breen, Kerry

AU - Kaafarani, Haytham M.A.

AU - Mashbari, Hassan

AU - Bonilla Cal, Fernando

AU - Al-Naggar, Hamza

AU - Maimbo, Mayaba

AU - Mazingi, Dennis

AU - Abbott, Tom

AU - Akhbari, Melika

AU - Benson, Ruth

AU - Bhanderi, Shivam

AU - Biccard, Bruce

AU - Caruana, Edward

AU - Chakrabortee, Sohini

AU - Chapatwala, Reema

AU - Costas-Chavarri, Ainhoa

AU - Demetriades, Andreas K

AU - Desai, Anant

AU - Di Saverio, Salomone

AU - Drake, Thomas M.

AU - Edwards, John

AU - Evans, Jonathan P.

AU - Fiore, Marco

AU - Ford, Samuel J.

AU - Fotopoulou, Christina

AU - Fowler, Alexander

AU - Futaba, Kaori

AU - Ganly, Ian

AU - James, Harelimana Grace

AU - Griffiths, Ewen

AU - Gronchi, Alessandro

AU - Hyman, Gabriella Yael

AU - Incorvia, Joseph

AU - Jain, Ritu

AU - Watson, David

AU - Bright, Tim

N1 - cited By 16

PY - 2021/9

Y1 - 2021/9

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.

KW - SARS-COV-2

KW - vaccination modelling

KW - preoperative vaccination

KW - elective surgery access

UR - https://www.scopus.com/pages/publications/85142233442

U2 - 10.1093/bjs/znab101

DO - 10.1093/bjs/znab101

M3 - Article

SN - 0007-1323

VL - 108

SP - 1056

EP - 1063

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 9

ER -

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

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Keywords

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