This international, multicenter cohort study of 235 hospitals in 24 countries included all patients undergoing surgery who had a SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality, whereas the main secondary outcome measure was the presence of pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. The analysis included 1128 patients who had surgery between January 1, 2020, and March 31, 2020, of whom 835 (74%) had emergency surgery and 280 (24.8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26%) patients, and 30-day mortality was 23.8%. Pulmonary complications occurred in 51.2% of patients; 30-day mortality occurred in 38% of patients and accounted for 81.7% of all deaths. In adjusted analyses, 30-day mortality was associated with the following: male gender, age 70...

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