Retrospective cohort study evaluates postoperative complications in patients after thyroidectomy, indicating COVID-19 does not increase risk.
IntroductionThe postoperative impact of recent COVID-19 infection on patients undergoing thyroidectomy remains unclear. This study evaluates the 90-day postoperative outcomes in patients with recent COVID-19 compared to those without.MethodsA retrospective cohort study was conducted using a large multi-institutional database. Adult patients who underwent total thyroidectomy or thyroid lobectomy were divided into 2 cohorts: those with a documented COVID-19 infection within 7 weeks before surgery and those without. Propensity score matching (1:1) was performed to balance age, sex, race, comorbidities, vaccination status, indications for surgery, and surgical procedure performed. Postoperative complications within 90 days were assessed, including hypocalcemia, dysphonia, recurrent laryngeal nerve (RLN) injury, hematoma, surgical site infection (SSI), venous thromboembolism (VTE), pulmonary embolism (PE), pneumonia, acute myocardial infarction (MI), and cerebral infarction. Risk ratios (RRs) with corresponding 95% confidence intervals (CIs) were calculated.ResultsAfter matching, 581 patients were included in each cohort with similar age (50 vs 49 years) and sex distribution (75.6% vs 74.2% female). COVID-19 vaccination rates were comparable between groups (24.9% vs 27.5%). Thyroidectomy-specific complications were not significantly different. Hypocalcemia occurred in 10.2% of the COVID-19 cohort vs 7.2% (RR: 1.41, CI: 0.96-2.05), RLN injury in 3.3% vs 2.4% (RR: 1.36, CI: 0.69-2.68), and dysphonia in 7.4% vs 4.6% (RR: 1.59, CI: 0.99-2.54). COVID-19-related complications were rare. Pulmonary embolism occurred in 2.6% of COVID-19 patients, while all other events were reported as <10 in each group.ConclusionCOVID-19 infection was not associated with an increased risk of major postoperative complications following thyroidectomy.
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