The severe acute respiratory syndrome (SARS-CoV-2) Virus that causes Coronavirus disease 2019 (COVID-19) was identified in Wuhan, Hubei province of China in December 2019 by the Chinese Center for Disease and Prevention from the throat swab of a patient(1). The Coronavirus infection mainly affects the respiratory system and is presented with fever, dry cough, and difficulty of breathing, and lately, the patient may deteriorate associated with pneumonia and acute respiratory distress syndrome(2–5).
World Health Organization (WHO) situational report revealed that there were more than 20 million laboratory-confirmed cases and 700 thousand deaths globally as of August13, 2020(6). The American region accounted for the highest number of cases and deaths which was 10 million and 400 thousand respectively(6). The European region accounted for the second-highest confirmed cases and death which were more than 3 million confirmed cases and 200 thousand deaths. Though the COVID-19 pandemic has emerged in the Western Pacific region, China, Hwan city, the number of infected cases, and deaths was the lowest as compared to the American and European regions(6). The number of laboratory-confirmed cases and deaths in the African region was the lowest for the last couple of months but the rate of spreading in this region is increasing at an alarming rate and expected to be very high in the next couple of months if it continues as this rate(6–8).
The last couple of months’ reports in Ethiopia were very low but there were many cases in short periods which is approximately 1000 cases and 10 deaths per day. It is estimated that the number even may be very high because the diagnosis is limited only in big cities.
The challenge of COVID-19 is very high globally due to a lack of proven treatment and the complexity of its transmission (9–13). However, the impact is more catastrophic for low and middle-income countries because of very poor health care system, high illiteracy and low awareness of the disease and its prevention, lack of skilled health personnel, scarce Intensive Care Unit, a limited number of mechanical ventilators, and prevalence of co-morbidities/infection along with malnutrition(8, 13–15).
Epidemiological studies showed that patients with co-morbidities including (Asthma, COPD, Tuberculosis, Pneumonia, Acute respiratory distress syndrome (ARDS), Diabetes mellitus, hypertension, renal disease, hepatic disease, and cardiac disease), history of smoking, and history of substance use, male gender and age greater than 60 years were more likely to die or develop undesirable outcomes(16–19).
The outcomes of patients with coronavirus infection undergoing surgery are very variable. Studies revealed that in-hospital mortality of patients with COVID-19 was very high which varied from 1% 52% of the hospitalized patient(20, 21).
Body of evidence showed that patients visiting the health institution during the COVID-19 pandemic decrease significantly despite requiring medical care which affects significantly the non-COVID-19 patients’ hospital admission(22–26).
The COVID-19 pandemic imposes a significant challenge on health care delivery along with economic, social, and mental health crisis (8–11, 23, 27–36).
Surgery during the COVID-19 outbreak is too challenging to the patient, health care workers, and non-COVID-19 patients(27, 28, 31, 37–40) particularly for low and middle-income countries where the limping health care systems were broken with low testing capacity, sub-optimal postoperative care, lack of anesthesia machine filters and limited personal protective equipment(41–44).
Evidence revealed that mortality of patients hospitalized with COVID-19 was very high which is strongly associated with the presence of comorbidities, smoking, and substance use (16, 18, 27, 32, 39, 45–47).
Some studies showed that perioperative mortality of patients with COVID-19 was very high(23, 25, 39, 48–50) while some studies failed to identify significant mortality among patients with COVID-19 undergoing surgical procedures(21, 47, 51, 52).
Investigating the global prevalence and determinants of perioperative outcomes among patients with COVID-19 undergoing a surgical procedure is very important to reduce patient mortality and morbidity through varies strategies including but not limited to the provision of alternative non-surgical intervention for a moderate and severe case, increasing the number of ICU beds, mechanical ventilator, skilled professionals, and integrated monitors and reducing possible risk factors. Therefore, this systematic review and Meta-Analysis aimed to provide global evidence on the prevalence and determinants of perioperative outcomes among patients with COVID-19 undergoing surgical procedures.