ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1640475
The relationship between the timing of lung surgery and postoperative pulmonary complications in patients after SARS-CoV-2 infection: A prospective cohort study
Provisionally accepted
- 1Affiliated Hospital of Yangzhou University, Yangzhou, China
- 2First Affiliated Hospital of Soochow University, Suzhou, China
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Background: Patients with a positive test for SARS-CoV-2 prior to elective surgery early in the pandemic have an elevated risk of perioperative mortality and pulmonary complications. Post-SARS-CoV-2 infection, pulmonary sequelae persist beyond the acute stage, necessitating recovery periods spanning months or even longer. Our study aimed to explore the correlation between the timing of thoracoscopic lung surgery and postoperative pulmonary complications (PPCs) in patients with a history of SARS-CoV-2 infection.We conducted a prospective cohort study, enrolling patients scheduled for elective thoracoscopic partial lung resection. Participants were categorized into two groups based on the duration since their SARS-CoV-2 infection: 5-10 weeks and 11-16 weeks. A total of 68 patients were included, with 34 in each group. The information about SARS-CoV-2 infection were collected; IL-6 and TNF-α levels at 2 h, 1 d, and 2 d after surgery and the WBC count and CRP level in blood at 1 d and 2 d after surgery were analysed; and PPCs and length of hospitalization were recorded. A logistic regression model was employed to assess the relationship between the timing of lung surgery and PPCs in patients post SARS-CoV-2 infection.Results: Compared with the 5-10-week group, in the 11-16-week group, the levels of IL-6 and TNF-α at 2 h, 1 d, and 2 d after surgery were significantly lower, the WBC count and CRP levels in blood at 1 d and 2 d after surgery were significantly lower, the numbers of PPCs and lung infections were significantly lower, and the length of hospitalization was significantly shorter. Multivariate logistic regression analysis revealed that the time interval from surgery to SARS-CoV-2 infection, persistent preoperative symptoms, preoperative difficulty breathing and WBC count at 1 d after surgery were independent risk factors for PPCs.Patients infected with SARS-CoV-2 who underwent thoracoscopic lung surgery within 5 to 10 weeks after infection had a higher risk of PPCs than those who had surgery at 11 to 16 weeks post-infection.
Keywords: Trial registration: Chinese Clinical Trial Registry, Retrospectively registered, Full date of first registration: 17/05/2023, Registration number: ChiCTR2300071539 SARS-COV-2, lung surgery, Postoperative pulmonary complications, COVID-19, prospective cohort study
Received: 03 Jun 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Yang, Li, Duan, Ji and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianyou Zhang, Affiliated Hospital of Yangzhou University, Yangzhou, China
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