Influence of COVID-19 on postoperative prognosis and pain management

Yue-Zi Hu, Zai-Long Qin, Wen Tang, Zhao-Lan Hu, Ru-Yi Luo

Abstract

The COVID-19 pandemic has significantly affected healthcare, particularly surgical care. Although short-term effects on surgical outcomes have been examined, understanding of long-term postoperative prognosis and pain management in COVID-19 patients remains limited.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has placed significant strain on healthcare systems worldwide and has led to considerable economic losses [1]. Global adult mortality rates surged during the pandemic in 2020 and 2021, reversing the previously observed decline [2].

Methods

This study was approved by the Medical Ethics Committee of the Second Xiangya Hospital of Central South University (approval number: LYF20240197). Medical records were accessed between 8 October and 30 December 2024 for research purposes.

Results

The study included 52 patients diagnosed with COVID-19 out of 329 patients admitted to the ICU post-surgery, matched with 104 control subjects during the same study period from December 2022 to January 2023.

Discussion

Surgical procedures in patients with COVID-19 were associated with increased rates of blood transfusions, sepsis and hospital mortality, as well as higher SOFA score, longer durations of mechanical ventilation and extended stays in the ICU. Moreover, COVID-19 infection was linked to elevated postoperative pain scores.

Conclusion

This study demonstrated that surgical patients with COVID-19 faced increased risks of blood transfusion, postoperative infection, mortality, prolonged mechanical ventilation in the ICU, and extended ICU stays, along with higher postoperative pain levels.

Citation: Hu Y-Z, Qin Z-L, Tang W, Hu Z-L, Luo R-Y (2026) Influence of COVID-19 on postoperative prognosis and pain management. PLoS One 21(3): e0344211. https://doi.org/10.1371/journal.pone.0344211

Editor: Eyüp Serhat Çalık, Ataturk University Faculty of Medicine, TÜRKIYE

Received: October 5, 2025; Accepted: February 17, 2026; Published: March 9, 2026

Copyright: © 2026 Hu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Due to ethical and legal restrictions related to human participant privacy, the minimal data set underlying the findings of this study cannot be made publicly available. Data are available from the Institutional Review Board of The Second Xiangya Hospital of Central South University for researchers who meet the criteria for access to confidential data (contact: xy2gcphyb@163.com). The authors did not have any special access privileges that others would not have.

Funding: This work was funded by: Natural Science Foundation of Hunan Province (2024JJ5503) awarded to RL, Natural Science Foundation of Hunan Province (2023JJ10088) awarded to ZH, Health Commission of Hunan Province (W20243166) awarded to YH, Open Project of Guangxi Key Laboratory of reproductive health and birth defect prevention (GXWCH-ZDKF-2023-01) awarded to ZH, Natural Science Foundation of Changsha (kq2403082) awarded to RL, National Natural Science Foundation of China (82271379) awarded to ZH, Joint Foundation of Hunan University of Chinese Medicine (2024XYLH053) awarded to YH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors declare no competing interests.