Patients are at increased risk of dying after surgery if they have Covid-19, according to a new study.
It recommends postponing all non-critical surgery during the pandemic.
The research led by the University of Birmingham found that people with SARS-CoV-2 - the virus that causes the Covid-19 disease - experience "substantially worse postoperative outcomes than would be expected for similar patients who do not have SARS-CoV-2 infection."
For coronavirus patients who had surgery, the number of deaths are almost as high as those of the sickest patients admitted to intensive care after catching Covid-19 in the community.
The most risky operations were major surgery such as hip surgery or colon cancer surgery (26.9% death rate ) and then emergency surgery (25.6%).
Mortality rates were higher in men (28.4%) than in women (18.2%), and in patients aged 70 or over (33.7%) compared with those aged under 70 (13.9%).
Other risk factors included severe pre-existing medical problems, cancer surgery, major procedures or emergency surgery.
Report co-author Aneel Bhangu, Senior Lecturer in Surgery at the University of Birmingham, said: "We would normally expect mortality for patients having minor or elective surgery to be under 1%, but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3%) and elective surgery (18.9%).
"These mortality rates are greater than those reported for even the highest-risk patients before the pandemic.
"Men aged 70 and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed."
Post-operative pulmonary complications occurred in 51% of coronavirus patients who underwent surgery.
These complications included conditions such as pneumonia, acute respiratory distress syndrome, or requiring unexpected ventilation.
Report co-author Dmitri Nepogodiev, Research Fellow at the University of Birmingham commented "Worldwide an estimated 28.4 million elective operations were cancelled due to disruption caused by Covid-19.
"Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital.
"There's now an urgent need for investment by governments and health providers in to measures to ensure that as surgery restarts patient safety is prioritised.
"This includes provision of adequate personal protective equipment (PPE), establishment of pathways for rapid preoperative SARS-CoV-2 testing, and consideration of the role of dedicated 'cold' surgical centres."
The findings of the university-led NIHR Global Research Health Unit on Global Surgery have been published in The Lancet.
Researchers examined data for 1,128 patients from 235 hospitals.
Countries participating in the study were: Algeria, Azerbaijan, Belgium, Croatia, Denmark, Egypt, France, Germany, Greece, Ireland, Israel, Italy, Jordan, Libya, Mexico, Netherlands, Pakistan, Portugal, Spain, Sudan, Switzerland, Turkey, United Kingdom and United States.
