# Impact of prior SARS-CoV-2 infection on perioperative cardiac, pulmonary and neurocognitive complications in older patients: Study protocol for an observative case control study

## TL;DR

This study aims to understand how prior SARS-CoV-2 infection affects post-surgery complications in older patients.

## Contribution

The study is the first to specifically investigate the impact of prior SARS-CoV-2 infection on perioperative complications in older surgical patients.

## Key findings

- The study will analyze the occurrence of delirium and other complications in patients with and without prior SARS-CoV-2 infection.
- Results will provide new insights into how prior infection influences surgical outcomes in older adults.
- 266 patients over 60 undergoing elective surgery will be included in the analysis.

## Abstract

Postoperative delirium is considered a serious complication in older patients. Older patients often suffer from several concomitant diseases. The reduced physical condition can increase the risk of cardiac, pulmonary and neurocognitive complications during and after surgery. SARS-CoV-2 infection primarily affects the respiratory tract but can also damage other organ systems such as the heart and brain. Given the wide range of pulmonary, cardiac and neurocognitive complications caused by SARS-CoV-2, these risks must be given special consideration during planned surgical procedures. Both surgical procedures and anesthesia are risk factors for postoperative complications in themselves. The specific impact of prior SARS-CoV-2 infection on perioperative complications in older patients has not been sufficiently researched. The aim of this study is to understand how a previous SARS-CoV-2 infection influences the occurrence of perioperative complications.

In this case-control study, the data of patients over 60 years of age undergoing elective surgery are analyzed. Subjects are divided into two groups based on their SARS-CoV-2 infection status: those with a documented previous infection and those without. Confirmation of infection will be based on written evidence and anamnestic information. The primary endpoint of the examination is the occurrence of delirium within the first five postoperative days. In addition, further cardiac, pulmonary and neurocognitive complications are recorded in the perioperative period. The occurrence of postoperative delirium is recorded during the daily ward round in the first five days after surgery. The 3DCAM test and the 4AT are used for this purpose. In addition, the CAM-ICU will be used in the intensive care unit. The recruitment will include 266 patients. Statistical analyses will be performed to determine the correlation between a previous SARS-CoV-2 infection and the observed clinical outcomes.

The results of this study will provide new insights into the impact of prior SARS-CoV-2 infection on perioperative complications in older patients undergoing elective surgery.

Deutsches Register Klinischer Studien: DRKS00034861.