634. SURGICAL OUTCOMES OF ESOPHAGEAL CANCER PATIENTS BASED ON PRIOR COVID DIAGNOSIS

Abstract Background Since the Covid pandemic, many studies have been performed to determine the impact of Covid on surgical outcomes. Many researchers have found that prior Covid diagnosis puts surgical patients at higher risk of complication and mortality. The aim of this study is to determine if esophageal cancer patients undergoing esophagectomy are at higher risk based on previous Covid status. Methods The National Cancer Database (NCDB) was queried for all patients who underwent esophagectomy for cancer in 2020. This study was limited to the 2020 database as this was the year that Covid status was added to the NCDB registry. Patients with a Covid history and without a Covid history were compared. Only patients with complete Covid information were included in this study. Peri-operative outcomes including hospital length of stay and 30-day readmission were compared between groups. Wilcoxon rank-sum tests were performed to compare continuous variables between groups and Chi-square/Fisher’s exact tests were performed to compare categorical variables between groups. Results A total of 2387 patients met inclusion criteria, of which 114 (5%) had prior diagnosis of Covid and 2273 (95%) did not have prior Covid. There were no significant differences regarding basic demographics, including age, gender, neoadjuvant therapy, or pathologic staging. Both groups had similar rates of minimally invasive techniques and conversions to open surgery. There was no difference regarding 30-day readmission, however, the Covid group had a statistically longer hospital length of stay, 9 days (IQR 6-15) vs 8 days (IQR 1-11), p=0.007. On logistic regression, Covid was an independent predictor of increased overall length of stay (p=0.045). Conclusion Despite previous evidence that Covid patients may experience more surgical complications than their non-Covid counterparts, this NCDB study of esophageal patients undergoing esophagectomy demonstrated similar baseline demographics and outcomes with the only significant difference being longer hospital length of stay. Further research is necessary to determine risk of previous Covid diagnosis in surgical outcomes.