Acceptance and Status of Complete Preoperative COVID-19 Vaccination for Prevention of Major Postoperative Complications

YOVA NURELYA MAP, Dr. Med. dr. Indwiani Astuti; dr. Sumadi Lukman Anwar, Ph.D., Sp.B.Subsp.Onk(K)

2023 | Skripsi | S1 KEDOKTERAN

Latar Belakang : Pandemi coronavirus disease 2019 (COVID-19) menyebabkan banyak perubahan drastis dalam praktik medis, salah satunya adalah dampak pada praktik bedah. Hal ini menimbulkan masalah mengenai keselamatan pasien kanker dengan imunosupresi yang akan menjalani operasi elektif. Ini disebabkan karena SARS-CoV-2 yang sangat menular dapat menimbulkan risiko bagi kesehatan pasien selama dan setelah operasi. Dengan perkembangan terbaru vaksin SARS-CoV-2, beberapa penelitian telah dilakukan untuk menilai apakah vaksinasi COVID-19 sebelum operasi dapat mencegah perkembangan komplikasi pasca operasi terkait COVID-19. Tujuan : Studi ini bertujuan untuk menilai apakah vaksinasi COVID-19 dosis lengkap sebelum operasi bermanfaat dalam mengurangi infeksi COVID-19 pasca operasi dan komplikasi pasca-operasi dalam populasi subyek pasien operasi kanker. Metode : Studi ini adalah studi lanjutan dari hasil studi kohort prospektif yang telah dilakukan, subyek adalah pasien kanker yang akan melalui operasi elektif. Karakteristik pasien dasar termasuk usia, jenis kelamin, tempat tinggal, asuransi kesehatan, jenis operasi yang direncanakan, dan diagnosis klinis diambil dari catatan medis elektrik. Sebelum operasi, data penerimaan vaksin peserta dan status vaksinasi COVID-19 dikumpulkan. Setelah menjalani operasi, sampel akan dipantau secara prospektif hingga 30 hari untuk mengamati apakah mereka mengalami komplikasi bedah besar dan/atau infeksi COVID-19. Variabel akan dikategorikan dan dianalisis menggunakan analisis univariat, bivariat dan multivariat. Hasil : Dari 355 subjek, 1,7% telah divaksinasi lengkap dengan vaksin COVID-19, dan 95,5% berperilaku positif terhadap vaksin sehingga bersedia divaksinasi. Setelah dipantau secara prospektif pasca operasi, 3,9% subjek mengalami infeksi COVID-19 dan 2,8% mengalami komplikasi pasca operasi besar. Berdasarkan analisis bivariat menggunakan uji Fisher's Exact, didapatkan nilai p > 0,999 untuk variabel independen status vaksinasi COVID-19 terhadap infeksi COVID-19 pasca operasi serta terhadap komplikasi mayor pasca operasi. Kesimpulan : Tidak ada asosiasi yang signifikan dari status vaksinasi terhadap COVID-19 dan infeksi COVID-19 pasca operasi atau komplikasi utama lainnya. Ada korelasi yang signifikan antara usia dan penerimaan vaksinasi.

Background : The coronavirus disease 2019 (COVID-19) pandemic has contributed to drastic alterations within medical practices, one of which is an impact on surgical practices. This brings up the issue regarding the safety of the immunosuppressed cancer patients undergoing elective surgery, as the highly infective status of SARS-CoV-2 may pose a risk to the wellbeing of the patients during and after surgery. With the most recent developments of SARS-CoV-2 vaccines, some studies have been conducted to assess whether preoperative COVID-19 vaccination could prevent the development of COVID-19 related postoperative complications. Objective : The study is aimed to assess whether a complete dose of COVID-19 vaccination prior to surgery is beneficial in preventing postoperative COVID-19 infection and any associated major post-surgery complications among cancer surgery patients. Methods : This study is a follow-up research based on the results of a previous prospective cohort study involving cancer patients undergoing elective surgery. Baseline patient characteristics including age, sex, residence, medical cost, type of planned surgery, and clinical diagnosis are extracted from electric medical records. Prior to surgery, data on the participants acceptance and status of COVID-19 vaccination is collected. After undergoing surgery, the sample will be prospectively monitored for up to 30 days to observe whether they have developed major surgical complications and/or COVID-19 infection. Variables will be categorized and analyzed using univariate, bivariate and multivariate analysis. Results : Out of 355 subjects, 1,7% is completely vaccinated with a COVID-19 vaccine, and 95,5% had a positive behavior toward vaccines and thus were willing to be vaccinated. After being prospectively monitored post-surgery, 3,9% of subjects developed COVID-19 infection and 2,8% developed major postoperative complications. Based on bivariate analysis using Fisher's Exact test, a p-value > 0,999 is received for the independent variable COVID-19 vaccination status toward postoperative COVID-19 infection as well as toward major postoperative complications. Conclusion : There is no significant correlation between COVID-19 vaccination status and postoperative COVID-19 infection or any major complications. There is a significant correlation between age and vaccination acceptance.

Kata Kunci : COVID-19, operasi kanker, penerimaan vaksin, vaksinasi pra operasi, komplikasi pasca operasi