Perioperative SARS-CoV-2 screening and comparison of immunoglobin values, a retrospective study

Aims: The SARS-CoV-2 pandemic has posed significant challenges to perioperative management, particularly in the context of preoperative screening and immune response evaluation. Various methods, including polymerase chain reaction (PCR) tests, immunoglobulin (Ig) level assessments, chest X-rays, and computerized tomographies, have been employed to mitigate risks. This study aims to explore the differences in immune responses, particularly Ig levels, between vaccinated and non-vaccinated individuals undergoing surgery during the pandemic. Methods: During the study period, data from 656 patients who underwent elective or urgent surgery were collected. Among these, only 86 patients had complete and reliable data on vaccination status and immunoglobulin G (IgG) and immunoglobulin M (IgM) levels. Patients with missing or incomplete information were excluded. The final 86 patients were grouped as follows: non-vaccinated and non-infected (NVNI), non-vaccinated but previously infected (NVI), and individuals who received two doses of the Biontech mRNA vaccine (B). The study compared IgG and IgM levels among these three groups. Results: Patients in group B were significantly older than those in groups NVNI and NVI (mean age: 43.5±13.0 years vs. 30.0±13.2 years and 38.0±18.8 years, respectively; p<0.05). Ig G levels were highest in group B (median: 4641.2 AU/ml, IQR: 13137±14502), followed by group NVI (median: 345.5 AU/ml, IQR: 3236±8082), and were lowest in group NVNI (median: 2.4 AU/ml, IQR: 4.1±5.5) (p<0.05 for all comparisons). Similarly, Ig M levels were significantly higher in group B (median: 0.38 AU/ml, IQR: 0.91±1.40) than in groups NVI (median: 0.28 AU/ml, IQR: 0.61±0.93) and NVNI (median: 0.05 AU/ml, IQR: 0.18±0.29) (p<0.05), while there was no significant difference in Ig M levels between groups NVI and NVNI (p>0.05). Conclusion: Vaccination enhances the immune response, leading to significantly higher IgG levels compared to nonvaccinated individuals, regardless of prior infection. However, some vaccinated individuals did not achieve protective antibody levels. Further research is needed to assess the clinical implications of these findings.