Thoracic Surgery Outcomes for Patients with Coronavirus Disease 2019 (COVID-19)

Chang, Stephanie H.; Chen, David; Paone, Darien; Geraci, Travis C.; Scheinerman, Joshua; Bizekis, Costas; Zervos, Michael; Cerfolio, Robert J.

Objective As the COVID-19 pandemic continues, appropriate management of thoracic complications from COVID-19 needs to be determined. Our objective is to evaluate which complications occur in patients with COVID-19 require thoracic surgery, and report early outcomes. Methods This study is a single-institution retrospective case series at New York University Langone Health Manhattan campus evaluating patients with confirmed COVID-19 infection who were hospitalized and required thoracic surgery from March 13th—July 18th, 2020. Results From March 13th—August 8th, 2020, 1,954 patients were admitted to our hospital for COVID-19. Of these patients, 13 (0.7%) required thoracic surgery. Two (15%) patients required surgery for complicated pneumothoraces, five (38%) patients underwent pneumatocele resection, one (8%) patient had an empyema requiring decortication, and five (38%) patients developed a hemothorax that required surgery. Three (23%) patients died after surgery, nine (69%) patients were discharged, and one (8%) patient remains in the hospital. No healthcare providers converted to COVID-19 positive after the surgeries. Conclusions Given the 77% survival rate, with a majority of patients already discharged from the hospital, thoracic surgery is feasible for the small percent of patients hospitalized with COVID-19 who underwent surgery for complex pneumothorax, pneumatocele, empyema, or hemothorax. Our experience also supports the safety of surgical intervention for healthcare providers who operate on patients with COVID-19.