By Kparobo Ehvwubare
The setting up of ‘COVID-19 free’ hospital areas for patients undergoing surgeries can reduce risk of death from lung infections associated with Coronavirus.
Prof. Adesoji Ademuyiwa, the National Study Lead at College of Medicine, University of Lagos, said in Lagos on Tuesday that this was part of the latest findings by researchers.
Ademuyiwa, who participated in the study, said researchers working together around the world found that patients who had their operation and hospital care in ‘COVID-19 free’ areas had better outcomes.
According to him, the study led by researchers at the University of Birmingham, the COVIDSurg Collaborative, comprise experts from over 130 countries.
He said the group’s findings are contained in the Journal of Clinical Oncology, a leading global cancer research journal, published on Tuesday. The study was funded by a National Institute for Health Research (NIHR), Global Health Research Unit Grant.
It covered adult patients undergoing elective surgery with curative intent for a range of suspected cancers including bowel, gullet, stomach, head and neck, lung, liver, pancreas, bladder, prostate, kidney, womb, cervix, ovarian, breast, sarcoma and brain tumours.
Ademuyiwa said: “I think the implication of this study to us in Nigeria and other low- and middle-income countries is that, we must begin to look at ways to have COVID-19 free dedicated theatres.’’
He said this should be similar to the model used by the Lagos University Teaching Hospital (LUTH), Idi-Araba, during the pandemic.
“It allowed surgeries to continue while COVID-19 positive patients were operated in other dedicated theatre”.
“This global study has now shown that several lives could be saved with such arrangement, and this should be promoted across the different strata of the healthcare system in our country,” he said.
A new global study revealed that COVID-19 free areas improved the safety of surgery by having a strict policy that no patient treated for COVID-19 is mixed with those undergoing surgery.
“COVID-19 free areas were set up, both in smaller independent hospitals and large hospitals with emergency departments.
“For fear that patients may contract COVID-19 in hospital; millions of operations around the world were cancelled during the first wave of the pandemic,’’ it said.
The data included in the study represented a wide variety of different surgeries for patients of all ages, genders and ethnicities.
“As a second wave approaches, more patients face delays. When operations for cancer and other time-dependent are delayed, they can progress to be untreatable.
“This research has shown, for the first time, that hospitals around the world can continue safe surgery by setting up COVID-19 free areas to minimise the risk from the Coronavirus,’’ the study showed.
In his remarks, a Collaborative Lead, Dr Aneel Bhangu from NIHR, Global Health Research Unit on Global Surgery, University of Birmingham, stressed the need for protection of cancer surgery patients from harm.
Bhangu said: “As health providers restart elective cancer surgery, they must look to protect cancer surgery patients from harm by investing in dedicated COVID-19 free hospital areas.
“These can be tailored to the resources available locally, ensuring that patients treated for COVID-19 are not mixed with patients needing surgery.
“However, this represents a significant challenge to many hospitals around the world.
“Governments and hospital providers must help to fund this major international redesign of surgical services and provide protection for patients.
“COVID-19 free areas could save many lives during future waves, by allowing surgery to continue safely despite high rates of infection in the community.”
Also, Dr James Glasbey, another Study Lead at the University of Birmingham, called for major reorganisation of hospital services.
Glasbey said: “Major reorganisation of hospital services to provide COVID-19 free areas for elective surgery must be justified by evidence like this, as it redirects time and resources away from other services.
“We have proved that those efforts are essential in protecting patients undergoing surgery during the pandemic.
“Our data showed that COVID-19 free hospital areas were beneficial when the rate of infection in the community was both low and high.
“We recommend that COVID-19 free areas are set up in all countries currently affected by the pandemic, including those likely to suffer from future waves.
“However, overcoming the challenges of setting up such pathways, including separate hospitals to provide elective surgery, may lead to unintended consequences.
“Consequences for hospitals must be carefully monitored to achieve the best balance of healthcare for patients.”
In the study, researchers examined data from 9,171 patients in 55 countries, across five different continents from the start of the pandemic up the middle of April 2020.
The experts discovered that pulmonary complication (2.2% vs 4.9%) and rates of death after surgery (0.7% vs 1.7%) were lower for patients who had their hospital treatment in ‘COVID-19 free’ areas.
Also, just 27 per cent of patients had their care in these protected areas.
It was estimated that around 2.2 million operations take place in Nigeria each year, of which around 230,000 are for removal of a cancer.