Τhe impact of COVID-19 infection on incidence of surgical site infection: Α systematic review

Introduction: The Coronavirus disease 2019 (COVID-19) placed unprecedented pressure on the healthcare system. COVID-19 is highly contagious, and the severity of cases varies. For this reason, extensive measures have been taken to prevent the spread of the infection in hospitals. According to the Centers for Disease Control and Prevention (CDC), COVID-19 has greatly affected the incidence of healthcare-associated infections, including surgical site infections (SSIs).

Aim: The investigation of the impact of COVID-19 on the incidence of SSI.

Methods: A systematic review of the literature was conducted in the international electronic database "PubMed" with the keywords: "COVID-19", "surgical site infection*", "SSI" and in the Greek electronic database “IATROTEK-online” with the keywords: "surgical site infections" and "COVID-19”, without time limit for the publication of scientific papers. On PubMed, the keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in English and Greek language, were conducted on animals, and were case studies, editorials, and letters to the editor.  

Results: Of the 32 scientific papers retrieved, seven were included in the systematic review. In 5 of the participating studies, the incidence of SSIs during the COVID-19 pandemic period was decreased by 30.7% to 100% compared with the period before the pandemic due to the increased use of personal protective equipment and the implementation of site-specific protocols concerning the management of patients preoperatively, intraoperatively and postoperatively. In one of the remaining studies, the incidence of SSIs did not change during the COVID-19 pandemic period, while in the other, the incidence increased.

Conclusions: The increased use of personal protective equipment and the implementation of site-specific protocols concerning the management of patients preoperatively, intraoperatively, and postoperatively, due to the COVID-19 pandemic, has led to a reduction in incidence of SSIs.

Keywords: COVID-19, surgical site infection, personal protective equipment, incidence