key: cord-0025684-byg32f3p authors: nan title: Impact of Bacillus Calmette-Guérin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection date: 2022-01-08 journal: BJS Open DOI: 10.1093/bjsopen/zrab131 sha: 0c6140f45665d0754e96508280ea318350b3fc67 doc_id: 25684 cord_uid: byg32f3p There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality. cent) patients were male and 524 (21.9 per cent) were aged 70 years or older ( Table S1 ). The BCG vaccine had been administered to 1649 (69.0 per cent) patients, of whom 1518 (63.5 per cent) had received it at least 15 years before surgery. Patients who had received a BCG vaccination were younger than patients who had not been vaccinated (70 years of age or older: 16 versus 35 per cent (P < 0.001)), had lower ASA (grades III-V: 30 versus 51 per cent (P < 0.001)), and were more likely to have surgery for benign conditions (71 versus 60 per cent; P < 0.001). There were no significant differences in the rates of emergency surgery, major surgery, or timing of SARS-CoV-2 infection between the groups. Of the 2391 patients, 759 (31.7 per cent) developed PPC. The 30-day mortality was 11.1 per cent (n ¼ 265). Although rates of PPC were significantly lower in patients who had previously been vaccinated against BCG than those who did not (29 versus 38 per cent; P < 0.001) ( Table 1) , this did not persist on adjusted analysis (odds ratio (OR) 0.98, 95 per cent c.i. 0.79-1.22; P ¼ 0.3) ( Table 1) . There were no significant differences in 30-day mortality rates in previously BCG-vaccinated patients versus unvaccinated patients (10 versus 13 per cent; P ¼ 0.062), which remained on adjusted analysis (OR 1.25, 95 per cent c.i. 0.92-1.69; P ¼ 0.156) ( Table 1) . Full models are presented in Tables S2 and S3. Stratified analysis performed by timing of vaccination demonstrated that patients who were vaccinated 15 years previously or longer were less likely than patients vaccinated less than 15 years Lä nsi-Pohja Central Hospital Lopez Muralles I (Hospital General De Enfermedades Echeverría-Dá vila G (Hospital General Szent Borbá la Kó rhá z Ospedale per gli Infermi di Gianni' A (Fondazione IRCSS Ca' Granda -Ospedale Maggiore Guglielmo Da Saliceto Ospedale di Circolo e Fondazione Macchi Hospital Raja Permaisuri Bainun Hospital Enche' Besar Nayen Sainz de la Fuente A (Hospital Español Van den den Broek WT Antonius Ziekenhuis den Boer FC (Zaans Medisch Centrum Jinnah post graduate medical center Cancer Foundation Hospital The Children's Hospital & The Institute of Child Health Lahore Hospital De Especialidades Pediatricas Css Isaacs Beron R (Hospital Regional Rafael Hernandez Css Hospital de Clínicas, II Cá tedra de Clínica Quirú rgica Caballero Sarabia VD (Arzobispo Loayza National Hospital Huamá n E (Hospital Guillermo Kaelin de la Fuente Egoá vil E (Hospital Emergencia Ate Vitarte Hospital II-2 Tarapoto Hospital de Braganc¸a Hospital De Cascais -Dr Clinica Chirurgie I, Spitalul Clinic Judetean de Urgenta Jazan University -King Fahd Central Hospital -Sabia General Hospital -Baish General Hospital Saudi Arabia) Al Ayed A (King Salman Armed Forces Hospital Glisovic Jovanovic I (Clinic for Orthopaedic Surgery and Traumatology Lax-Pé rez R, Sá nchez-Robles M, COVIDSurg Collaborative | 9 Gonzá lez-Valverde FM, Ferná ndez-Ferná ndez PV, Sá nchez-Rodríguez C Nicolá s-Ló pez T, Alconchel F (Hospital Clínico Universitario Virgen de la Arrixaca (IMIB-Arrixaca) Guzmá n I (Hospital Santa Bá rbara Morera Ocó n FJ Sangü esa MJ (Hospital Arnau De Vilanova Liv Hospital Gö ksoy B (Sehit Prof.Dr. _ Ilhan Varank Training and Research Hospital Al Jalila Children's Speciality Hospital Latifa Women and Children Hospital Antrim Area Hospital, Northern Health and Social Care Trust Birmingham Children's Hospital Siddaiah N (Royal Orthopaedic Hospital Bristol Royal Hospital for Children Lancashire Teaching Hospitals NHS Foundation Trust Russell's Hall Hospital COVIDSurg Collaborative | 11 Royal Hospital for Sick Children The Leeds Teaching Hospitals NHS Trust Shackcloth M (Liverpool Heart and Chest Hospital The Walton Centre NHS Foundation Trust Evelina London Children's Hospital Nunoo-Mensah JW (King's College Hospital Cardiac Unit, St Bartholomew's Hospital The Whittington Hospital Macclesfield District General Hospital Hospitals NHS Foundation Trust Rotherham District General Hospital Southport and Formby District General Hospital King's Mill Hospital Teaching Hospitals NHS Trust Saint Mary's Medical Center-Essentia Health Le Bonheur Children's Hospital Callahan MP (NewYork-Presbyterian / Columbia University Medical Center Memorial Sloan Kettering Cancer Center Seattle Children's Hospital Bacille Calmette-Guerin induces NOD2-dependent nonspecific protection from reinfection via epigenetic reprogramming of monocytes BCG-induced trained immunity: can it offer protection against COVID-19? Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study COVID-19-related absence among surgeons: development of an international surgical workforce prediction model Disclosure. The authors declare no conflict of interest. Supplementary material is available at BJS Open online.