INTRODUCTION: This study evaluates COVID-19 related patient risk, when undergoing management within one of the largest specialist centres in Europe, which rapidly implemented national COVID-19 safety guidelines METHOD: A prospective cohort study was undertaken in all patients who underwent surgical (n = 1429) or non-operative (n = 191) management during the UK COVID-19 pandemic peak (April-May 2020);all were evaluated for 30-day COVID-19 related death A representative sample of elective/trauma/burns patients (surgery group, n = 729) were selected and also sub-analysed within a controlled cohort study design Comparison was made to a random selection of non-operatively managed (non-operative group, n = 100) or waiting list (control group, n = 250) patients These groups were prospectively followed-up and telephoned from the end of June (control group) or at 30 days post-first assessment (non-operative group)/post-operatively (surgery group) RESULTS: Complex general (9 2%, 136/1483) or regional (5 0%, 74/1483) anaesthesia cases represented 14 2% (210/1483) of operations undertaken There were no 30-day post-operative (0/1429)/first assessment (0/191) COVID-19 related deaths Neither the three sub-speciality plastic surgery, or non-operative groups, displayed increases in post-operative/first assessment symptoms in comparison to each other, or to control The proportion of COVID-19 positive tests were: 7 1% (1/14) (non-operative), 5 9% (2/34) (burns) and 3 0% (3/99) (trauma);there were however no significant differences between these groups, the elective (0%, 0/54) and control (0%, 0/24) groups (p = 0 236) CONCLUSION: We demonstrate that even heterogeneous sub-speciality patient groups, who required operative/non-operative management, did not incur an increased COVID-19 risk compared to each other or to control These highly encouraging results were achieved with described, rapidly implemented service changes that were tailored to protect each patient group and staff
St Andrew's COVID-19 surgery safety (StACS) study: Elective plastic surgery, trauma & burns