SCIRehab Project Series: The Speech Language Pathology Taxonomy

Introduction: Outcomes research for speech language pathology (SLP) interventions for acute traumatic spinal cord injury (SCI) rehabilitation in the US is difficult because of the lack of a treatment classification system (taxonomy).

Objective: To describe a taxonomy developed by speech language pathologists (SLPs) to examine the effects of SLP interventions on SCI rehabilitation outcomes.

Methods: The SCIRehab study uses practice-based evidence, a rigorous observational methodology that examines treatment processes without specifying or requiring specific therapeutic interventions. Speech language pathology lead clinicians and researchers at 6 US SCI centers developed a detailed SLP taxonomy documentation process that is comprehensive of SLP interventions for patients with SCI.

Results: The SLP taxonomy consists of 7 intervention categories that address deficits (speech production for patients with artificial airway, motor speech and voice, swallowing, cognitive-communication, and communication) and the associated exercises and tasks that patients perform. Time is recorded for each category, and supplementary information focuses on cueing needs and family involvement that helps to describe and guide intervention selection. The SCIRehab project is enrolling 1,500 patients with acute traumatic SCI at 6 inpatient rehabilitation facilities.

Conclusions: Speech language pathology taxonomy information is being captured for the SCIRehab patients who are referred for SLP services; this may be the first attempt to document the many details of the SLP rehabilitation process for patients with SCI in the US.     

Hyperbilirubinemia with mild COVID-19 patient: A case report

Introduction and importanceIncreased total serum bilirubin rarely reported in mild COVID-19 patients. It occurs mostly in severe cases, particularly in those who have liver diseases and admitted to an intensive care unit. The main cause of increased liver biochemistries in Covid-19 patients related to used drugs, the presence of the ACE2 receptor in the liver, and robust inflammatory response. However, limited studies available regarding to jaundice in COVID19 patients.Case presentationHere we present a case of hyperbilirubinemia in a mild asymptomatic COVID-19 patient, the patient was diagnosed by RT-PCR three days prior to presentation fever, dark urine, and of acute onset of jaundice. The patient was diagnosed by physical examination and laboratory findings, and treated successfully by high-quality natural honey.Clinical discussionA recent studies of COVID-19 increased total serum bilirubin have been reported, mostly after the appearance of the COVID-19 symptoms. The case in the current study was a 48-year-old male patient who was diagnosed with mild COVID-19 three days prior to presentation. After 2 days increased total serum bilirubin.ConclusionHoney is a natural medicine to treat Jaundice in mild COVID-19 patients. However, significant data on larger studies are still lacking to decide. Our case guides for the clinical treatment of conjunctival icterus in mild COVID-19 patients.     

Patient Satisfaction for Telehealth Physical Therapy Services Was Comparable to that of In-Person Services During the COVID-19 Pandemic

Background

The COVID-19 pandemic has transformed the practice of physical therapy (PT), from a model based on in-person delivery to one that includes telehealth. However, research is needed to assess value, patient satisfaction, and clinical outcomes in the delivery of telehealth PT.

Purposes

We sought to compare patient satisfaction with in-person and telehealth PT and to determine the factors—such as age, gender, or insurance payer—that contributed to patient satisfaction scores.

Methods

Patients between the ages of 18 and 90 years who received outpatient PT at our institution were texted a patient satisfaction survey. Surveys were sent to patients who received in-person PT from January 1 to May 8, 2020, and to patients who received telehealth PT from April 21 to May 8, 2020. Patients’ age, gender, insurance payer, and written comments were also collected. Kruskal-Wallis tests were used to compare survey scores between groups. χ-squared tests were used to compare categorical patient characteristics between groups.

Results

In total, 12,345 surveys were sent out. We included completed surveys from 1147 patients in the analysis. Of these, 33% identified as male and 67% as female, mean age was 60.3 years, 58% had commercial insurance, 36% had Medicare, 3% had Medicaid, 2% had no-fault/worker’s compensation, and 1% had international insurance. The question of satisfaction was answered by 1074 patients. No statistical difference in satisfaction was seen in age or gender groups. Satisfaction differed by insurance type, but when analysis excluded patients with international insurance, there was no difference between groups. In-person PT patients reported higher satisfaction in achieving treatment goals, as rated on a 1-to-5 scale (4.7 ± 0.6), than telehealth PT patients (4.6 ± 0.6), although it is unclear if this result is clinically meaningful. There was no significant difference in the remaining follow-up questions.

Conclusion

We found no overall difference in patient satisfaction between those receiving in-person PT and those receiving telehealth PT. This was true for initial and follow-up visits, with the exception of two categories: the “ability of scheduling an appointment” and “progress towards attaining your treatment goals.” However, the clinical significance of these two exceptions is questionable. Ongoing research is indicated to evaluate the efficacy of telehealth PT while identifying the best patients and conditions for use during non-crisis times. Future studies should determine the effect of telehealth PT on patient-reported outcome measures, function, and value.

     

Post covid-19 invasive pulmonary Aspergillosis: A case report

Introduction and importanceSeveral complications after corona viral infection-19 (COVID-19) have been reported. The study aims is to present a case with post-covid-19 pulmonary fungal infection with antifungal resistance characteristics.Case presentationA 50-year-old male presented with hemoptysis, dyspnea, cough, fever, and rigor for 4-month duration. Three weeks before this complaint, he had cured of COVID-19. Investigations showed multiple ill-defined cavitary lesions involving the left upper lobe. The patient underwent a left upper lobectomy. The post-operative period was uneventful.Clinical discussionAll studies of COVID-19 fungal infections reported occurrence during the COVID-19 infection, mostly 14 days after the appearance of COVID-19 symptoms. The case in the current study was a 50-year-old patient, who was previously diagnosed with COVID-19 for a period of 4 months. After a few days from his recovery, the patient developed dyspnea, cough, fever, and rigor again.ConclusionPulmonary aspergillosis is a serious complication of COVID-19 patients that may not respond well to medical therapy. Pulmonary resection is the last and effective strategy to control the disease.     

Delivering Telerehabilitation to COVID-19 Inpatients:A Retrospective Chart Review Suggests It Is a Viable Option

Background

Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists’ contact with patients when possible. Telehealth has been viewed as “electronic personal protective equipment” during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients.

Purpose

Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program.

Methods

We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques.

Results

Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home.

Conclusions

Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.

     

The Royal College of surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients

BackgroundThe current COVID-19 pandemic has placed enormous strain on healthcare systems worldwide. Understanding of COVID-19 is rapidly evolving. Pneumonia associated with COVID-19 may lead to respiratory failure requiring mechanical ventilation. The rise in patients requiring mechanical ventilation may lead to an increase in tracheostomies being performed in patients with COVID-19. Performing tracheostomy in patients with active SARS-CoV-2 infection poses a number of challenges.MethodsThese guidelines were written following multidisciplinary agreement between Otolaryngology, Head and Neck Surgery, Respiratory Medicine and the Department of Anaesthetics and Critical Care Medicine in the Royal College of Surgeons in Ireland. A literature review was performed and a guideline for elective tracheostomy insertion in patients with COVID-19 proposed.ConclusionThe decision to perform tracheostomy in patients with COVID-19 should be undertaken by senior members of the multidisciplinary team. Steps should be taken to minimise risks to healthcare workers.     

Clinical Experience with COVID-19 at a Specialty Orthopedic Hospital Converted to a Pandemic Overflow Field Hospital

Background

COVID-19, the illness caused by the novel coronavirus, SARS-CoV-2, has sickened millions and killed hundreds of thousands as of June 2020. New York City was affected gravely. Our hospital, a specialty orthopedic hospital unaccustomed to large volumes of patients with life-threatening respiratory infections, underwent rapid adaptation to care for COVID-19 patients in response to emergency surge conditions at neighboring hospitals.

Purposes

We sought to determine the attributes, pharmacologic and other treatments, and clinical course in the cohort of patients with COVID-19 who were admitted to our hospital at the height of the pandemic in April 2020 in New York City.

Methods

We conducted a retrospective observational cohort study of all patients admitted between April 1 and April 21, 2020, who had a diagnosis of COVID-19. Data were gathered from the electronic health record and by manual chart abstraction.

Results

Of the 148 patients admitted with COVID-19 (mean age, 62 years), ten patients died. There were no deaths among non-critically ill patients transferred from other hospitals, while 26% of those with critical illness died. A subset of COVID-19 patients was admitted for orthopedic and medical conditions other than COVID-19, and some of these patients required intensive care and ventilatory support.

Conclusion

Professional and organizational flexibility during pandemic conditions allowed a specialty orthopedic hospital to provide excellent care in a global public health emergency.

     

Perioperative Nonsteroidal Anti-Inflammatory Agents in the COVID-19 Orthopedic Patient

Background

SARS-CoV-2 infection can cause serious complications beyond lung injury and respiratory failure, including sepsis, cardiovascular injury, renal failure, coagulation abnormalities, and neurologic injury. Widely used medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) have been flagged as having the potential to cause harm in the context of COVID-19. It is unknown if the benefits of NSAID use in the orthopedic population will outweigh the potential risks of increased morbidity in COVID-19 orthopedic patients.

Methods

We conducted a narrative review of the use of NSAIDs in the orthopedic patient with COVID-19, focusing on the effects of NSAIDs on the inflammatory process, the role of NSAIDs in orthopedics, and the associations between NSAID use and complications of pneumonia.

Results

We found that it may be appropriate to consider NSAID use in otherwise healthy orthopedic patients with COVID-19 and significant pain.

Conclusions

In this context, we recommend that NSAIDs be used at the lowest effective dose for the shortest duration possible in orthopedic patients with COVID-19. However, pending further data and based on the concerns outlined in this review, we recommend avoiding NSAIDs in orthopedic patients with significant comorbidities and those who are undergoing major orthopedic surgery.

     

Transmission of infection among health care personnel performing surgical tracheostomies on COVID-19 patients

BackgroundStaff and patient safety are of paramount importance while performing a surgical tracheostomy (ST) during the corona virus disease (COVID-19) pandemic. The aim was to assess the incidence of COVID-19 infection among the healthcare personnel (HCP) performing ST on COVID-19 patients.MethodsOne hundred and twenty-two HCP participating in 71 ST procedures performed at our institution between 26th March 2020 and 27th May 2020 were identified. A COVID-19 health questionnaire was distributed among staff with their consent. Data related to the presence of COVID-19 symptoms (new onset continuous cough, fever, loss of taste and/or loss of smell) among HCP involved in ST as well as patient related data were collected.ResultsOf the HCP who responded, eleven (15%,11/72) reported key COVID-19 symptoms and went into self-isolation. Ten members from this group underwent a COVID-19 swab test and three tested positive. Only one HCP attended hospital for symptomatic treatment, none required hospitalisation. Sixty percent (43/72) of the responders had a COVID-19 antibody test with a positive rate of 18.6% (8/43).Among the patients undergoing a ST, 67% (37/55) required a direct intensive care unit (ICU) admission; the mean age was 58 years (29–78) with a male preponderance (65.5%). The median time from intubation to ST was 15 days (range 5–33,IQR = 9). The overall mortality was 11% (6/55).ConclusionsST can be carried out safely with strict adherence to both, personnel protective equipment and ST protocols which are vital to mitigate the potential transmission of COVID-19 to the HCP.     

Clinical characteristics of deceased hemodialysis patients affected by COVID-19

Background

The recent outbreak of Coronavirus Disease 2019 (COVID-19) is a public health emergency of international concern. In China, Wuhan, Hubei Province was the epicenter. The disease is more severe in patients with high comorbidities and dialysis patients fall into this category.

Methods

In this report, we reviewed the whole course of the epidemic emerged in the HD center of Wuhan NO.1 Hospital by 28 February 2020. We compared the differences on the epidemiological characteristics and clinical features between patients surviving from COVID-19 and patients who died.

Result

In this hospital, at time of the present report, 627 patients were on chronic hemodialysis and the prevalence of affected cases was 11.8% (74/627).The median age of the COVID-19-positive patients was 63 years (range 31–88), with an almost even gender distribution (females accounted for 54.4%).The most frequent presenting symptom was cough (41.9%), followed by fatigue (24.2%), fever (17.2%) and dyspnea (14.8%); 22.4% of the cases were and asymptomatic. Fourteen of the 74 patients died (19%), as for presenting symptoms, cough was more frequent in patients who died (P?<?0.05). Surviving patients had higher levels of phosphate and albumin, and lower levels of C-reactive protein (CRP). Chest CT scan was positive in all cases, including in asymptomatic ones, and revealed in about three fourths of the cases bilateral (76.2%) lesions; in each lung lesions were multiple in about half of the cases of the cases (52.3%). After diagnosis, median time to death was 7 days in the 14 patients who died, with a range between 4 and 18 days.

Conclusion

This preliminary, single Center study identifies hemodialysis patients as a population at high risk of severe, and deadly COVID-19 infection. While classic baseline clinical conditions, including age, kidney disease and gender, are not significantly associated with survival in COVID-19 infected hemodialysis, our study also suggests a significant association between risk of and death, poor nutritional status and less than optimal metabolic balance.

     

Patients After Orthotopic Heart Transplantation With COVID-19: Are We Fast Enough With Vaccinations?

BackgroundPatients after orthotopic heart transplantation (HTx) are especially susceptible to infections owing to permanent need for immunosuppression. Vaccinations against COVID-19 have been available since January 2021 and are recommended in organ recipients.AimThe aim of this study was to analyze COVID-19 susceptibility and mortality in HTx and number of patients with COVID-19 previously vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Patients and MethodsWe analyzed a whole cohort of 552 patients after HTx who were SARS-CoV-2 positive and remained under surveillance of the transplantation center during March 2020 to September 2021.ResultsAmong 552 patients after HTx, 10 were COVID-19 survivors prior to transplantation and 103 had SARS CoV-2 infection after transplantation.Mean age of patients with COVID-19 was 55.6 (±14) years, and mean time from transplantation to SARS-CoV-2 infection was 2856 (±2596) days (range, 16-9569 days; interquartile range, 397-4763 days). Among the patients who were COVID-19 positive, 15 were asymptomatic, 10 died, and 51 infections occurred in the era of vaccinations.In the group of patients who were positive for COVID-19 in 2021, 6 received only a single dose of the mRNA vaccine and 3 were vaccinated twice. Among the vaccinated patients with COVID-19, 2 died of severe COVID-19: 1 after a single dose and 1 after 2 standard doses of the vaccine.ConclusionWe observed high susceptibility to SARS-CoV-2 infection in the group of patients after HTx. The majority of patients infected in 2021 did not received the vaccine. Vaccination does not fully protect against severe COVID-19 in patients after HTx.     

Positive COVID-19 Diagnosis Following Primary Elective Total Joint Arthroplasty: Increased Complication and Mortality Rates

BackgroundThis study analyzed complication rates following primary elective total joint arthroplasty (TJA) in patients who subsequently contracted COVID-19.MethodsA large national database was queried for adult patients who underwent primary elective TJA in 2020. Patients who contracted COVID-19 after total knee arthroplasty (TKA) or total hip arthroplasty (THA) underwent 1:6 matching (age [±6 years], sex, month of surgery, COVID-19-related comorbidities) to patients who did not. Differences between groups were assessed using univariate and multivariate analyses. Overall, 712 COVID-19 patients were matched to 4,272 controls (average time to diagnosis: 128-117 days [range, 0-351]).ResultsOf patients diagnosed <90 days postoperatively, 32.5%-33.6% required COVID-19-driven readmission. Discharge to a skilled nursing facility (adjusted odds ratio [aOR] 1.72, P = .003) or acute rehabilitation unit (aOR 4.93, P < .001) and Black race (aOR 2.28, P < .001) were associated with readmission after TKA. Similar results were associated with THA. COVID-19 patients were at increased risk of pulmonary embolism (aOR 4.09, P = .001) after TKA and also periprosthetic joint infection (aOR 4.65, P < .001) and sepsis (aOR 11.11, P < .001) after THA. The mortality rate was 3.51% in COVID-19 patients and 7.94% in readmitted COVID-19 patients compared to 0.09% in controls, representing a 38.7 OR and 91.8 OR of death, respectively. Similar results were observed for TKA and THA separately.ConclusionPatients who contracted COVID-19 following TJA were at greater risk of numerous complications, including death. These patients represent a high-risk cohort who may require more aggressive medical interventions. Given the potential limitations presently, prospectively collected data may be warranted to validate these findings.     

Multilevel diabetic foot revascularization in COVID 19 patient: Case report

IntroductionCoronavirus 2019 (COVID-19) has been associated with endothelial dysfunction. This hypercoagulable state coming from the endothelial injury pones COVID-19 patients to a higher risk for thrombosis. COVID 19 diabetic patients are more exposed to peripheral vascular disease progression. Multilevel peripheral arterial disease is the main cause of critical limb ischemia. Vascular interventions are required to increase distal blood flow and reduce the risk of amputation.Presentation of caseWe report a case of complex revascularization in a diabetic patient with aggressive right foot lesions evolution after COVID-19 infection. The patient presenting a Peripheral arterial ischemic involving the infrarenal aorta, iliac, femoral. The simultaneous intervention consisted of an endovascular aortic stent-graft placement and angioplasty of femoral artery.DiscussionDiabetes is a risk factor of severity and deaths in patients infected with pulmonary viruses. In our experience, COVID 19 virus can accelerate the ulcers generation and progression in diabetic patient. Hybrid interventions can be performed simultaneously or staged with benefit given by the complementary role of endovascular and surgical treatments. In the reported case, a complex simultaneous treatment in a patient presenting Multilevel peripheral arterial disease in association to COVID 19 infection was feasible in the same operation.ConclusionHybrid procedures are safe with high degree of efficacy in terms of revascularization, reduced morbidity and shorter intensive care. In our experience, the use of a hybrid procedure is technically feasible and allowed the treatment of complicated diabetic COVID-19 patient with a good outcome.     

Allogeneic Kidney Transplantation After COVID-19: A Case Report

BackgroundPatients undergoing organ transplantation are immunosuppressed and already at risk of various diseases. We report about a patient who underwent ABO-incompatible kidney transplantation after coronavirus disease 2019 (COVID-19) without a recurrence of infection.Case ReportA 68-year-old woman presented with end-stage renal failure owing to primary autosomal dominant polycystic kidney disease; accordingly, hemodialysis was initiated in September 2020. Her medical history included bilateral osteoarthritis, lumbar spinal stenosis, hypertension, and hyperuricemia. In mid-January 2021, she contracted severe acute respiratory syndrome coronavirus 2 infection from her husband. Both of them were hospitalized and received conservative treatment. Because their symptoms were mild, they were discharged after 10 days. The patient subsequently underwent ABO-incompatible kidney transplantation from her husband who recovered from COVID-19 in March 2021. Before kidney transplantation, her COVID-19 polymerase chain reaction test was negative, confirming the absence of pre-existing COVID-19 immediately before the procedure. Computed tomography revealed no pneumonia. Initial immunosuppression was induced by administering tacrolimus, mycophenolate mofetil, methylprednisolone, basiliximab, rituximab, and 30 g of intravenous immunoglobulin. Double-filtration plasmapheresis and plasma exchange were performed once before ABO-incompatible kidney transplantation. The renal allograft functioned immediately, and the postoperative course was normal without rejection. COVID-19 did not recur. In addition, her serum creatinine levels and renal function had otherwise remained stable.ConclusionLiving kidney transplantation was safely performed in a patient with COVID-19 without postoperative complications or rejection. During the COVID-19 pandemic, the possibility of severe acute respiratory syndrome coronavirus 2 infection during transplantation surgery must be considered.     

Subcutaneous emphysema and spontaneous pneumomediastinum in non-intubated COVID-19 patient: Presenting unusual case report

Introduction and importanceIn non-intubated COVID-19 patients, subcutaneous emphysema and spontaneous pneumomediastinum (SPM) remain rarely, with incidence rates of 3.0 and 1.2 per 100,000, respectively; nevertheless, the occurrence of these conditions in COVID-19 patients is unclear. Up to date only few cases have been reported. The mechanism of pneumomediastinum in non-intubated COVID-19 patients remains unclear.Case presentationHere we present a 63-year-old male with subcutaneous emphysema, and spontaneous pneumomediastinum with a 1-day history of chest pain and productive cough, without chills and dyspnea. The patient was diagnosed by nasopharyngeal RT-PCR, Chest CT, and laboratory findings. The patient successfully treated by given double (mask and nasal) oxygen therapy, antibacterial (moxifloxacin tablet 400 mg) every 24 h for 7 days, followed by antiviral (lopinavir tablet 400 mg) twice daily for 6 days and corticosteroid treatments as well as steroid therapy (methylprednisolone 40 mg) daily for 8 days. Subcutaneous emphysema treated by supraclavicular slit-like incision (3 cm) bilaterally and milking of skin from face, neck, shoulders and chest done for three days for subcutaneous emphysema but regarding the pneumomediastinum we did only follow up of the patient.Clinical discussionSpontaneous pneumomediastinum and subcutaneous emphysema are rare clinical finding in non-intubation of COVID-19 patients but frequently common in patients with coronavirus acute respiratory distress syndrome (COV-ARDS), or intubated COVID-19. In the present paper, subcutaneous emphysema and spontaneous pneumomediastinum occurred at the same time, with no past history of pulmonary diseases, and smoking of the patient. The only reason of this patient was high-pressure repetitive cough.ConclusionThe authors declared that COVID-19 infection leading to subcutaneous emphysema and spontaneous pneumomediastinum in non-intubated COVID-19 patients. Our case revealed that oxygen therapy, bed rest, analgesic, and supraclavicular slit-like incision best option for treat subcutaneous emphysema (SE) and spontaneous pneumomediastinum (SPM).     

Recent COVID-19 infection is associated with increased mortality in the ambulatory surgery population

BackgroundThe effect of COVID-19 infection on post-operative mortality and the optimal timing to perform ambulatory surgery from diagnosis date remains unclear in this population. Our study was to determine whether a history of COVID-19 diagnosis leads to a higher risk of all-cause mortality following ambulatory surgery.MethodsThis cohort constitutes retrospective data obtained from the Optum dataset containing 44,976 US adults who were tested for COVID-19 up to 6 months before surgery and underwent ambulatory surgery between March 2020 to March 2021. The primary outcome was the risk of all-cause mortality between the COVID-19 positive and negative patients grouped according to the time interval from COVID-19 testing to ambulatory surgery, called the Testing to Surgery Interval Mortality (TSIM) of up to 6 months. Secondary outcome included determining all-cause mortality (TSIM) in time intervals of 0–15 days, 16–30 days, 31–45 days, and 46–180 days in COVID-19 positive and negative patients.Results44,934 patients (4297 COVID-19 positive, 40,637 COVID-19 negative) were included in our analysis. COVID-19 positive patients undergoing ambulatory surgery had higher risk of all-cause mortality compared to COVID-19 negative patients (OR = 2.51, p < 0.001). The increased risk of mortality in COVID-19 positive patients remained high amongst patients who had surgery 0–45 days from date of COVID-19 testing. In addition, COVID-19 positive patients who underwent colonoscopy (OR = 0.21, p = 0.01) and plastic and orthopedic surgery (OR = 0.27, p = 0.01) had lower mortality than those underwent other surgeries.ConclusionsA COVID-19 positive diagnosis is associated with significantly higher risk of all-cause mortality following ambulatory surgery. This mortality risk is greatest in patients that undergo ambulatory surgery within 45 days of testing positive for COVID-19. Postponing elective ambulatory surgeries in patients that test positive for COVID-19 infection within 45 days of surgery date should be considered, although prospective studies are needed to assess this.