The COVID-19 pandemic has had profound effects on the health care workforce; more than 130 million cases of COVID-19 and nearly 3 million deaths have been recorded worldwide as of April 1, 2021.¹ To reduce health care resource utilization and increase the expected need for critical care capacity as COVID-19 cases surged, surgical care was dramatically interrupted, with more than 28 million elective surgeries canceled worldwide.² In response to the major disruptions of surgical care, the Surgical Outcomes Club assembled a 3-part panel to highlight key ways in which the surgical health services research community responded. This Viewpoint serves to disseminate mechanisms for how surgical outcomes researchers can contribute to (1) safely delivering evidence-based surgical care during the pandemic, (2) accelerating the path to health equity in the wake of disparities provoked by the pandemic, and (3) using the unique conditions of the pandemic as a natural experiment to define the future of surgical care delivery.

The need for timely access to population-specific data is critical to the attainment of optimal surgical outcomes and conducting research that can be used to quickly inform surgical care. Leveraging an existing network of collaborating surgeons and anesthetists across more than 80 countries, the COVIDSurg collaborative was quickly launched to provide evidence to guide the delivery of safe surgery in patients with COVID-19. This sophisticated collaborative has been able to stand up multicenter studies, including cohort and pragmatic randomized clinical trials, to address surgical care delivery using patient-level and system-level data, and to facilitate timely dissemination of study findings.³

Aneel Bhangu, MBChB, PhD, and Joana Simões, MBChB, from the University of Birmingham (UK) presented examples of how the COVIDSurg collaborative has informed guidance on optimal use of preoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to prevent poor outcomes in surgical patients and inform guidelines about the timing of surgery. For example, an early cohort study conducted among COVIDSurg collaborative partners in 235 hospitals across 24 countries studied all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery and demonstrated high rates of 30-day mortality (23.8%) and the presence of pulmonary complications in more than half of the surgical patients.² These results helped to inform policies to delay nonurgent surgeries for these patients. Surgical outcomes researchers could and should do more to leverage large, population-based, collaborative data such as these to continue to answer important and timely questions remaining about the effects of COVID on access to and outcomes of surgical care and use this opportunity to examine variation in these important outcomes across health systems to inform clinical decision-making.

COVID-19 大流行对卫生保健人员产生了深远的影响；超过1.3亿案件COVID-19和近3万人死亡在全球已记录为4月1日，2021年¹降低医疗资源的利用率，提高危重容量COVID-19情况下，预期的需求激增，外科护理被严重中断，全球取消了超过 2800 万例择期手术。²为应对外科护理的重大中断，外科结果俱乐部组建了一个由 3 部分组成的小组，以突出外科健康服务研究界做出回应的关键方式。该观点旨在传播有关手术结果研究人员如何为 (1) 在大流行期间安全提供循证手术护理做出贡献的机制，(2) 在大流行引起的差异之后加速实现健康公平的道路，以及 (3) ) 使用大流行的独特条件作为自然实验来定义手术护理的未来。

及时获取特定人群数据的需求对于获得最佳手术结果和开展可用于快速为手术护理提供信息的研究至关重要。利用现有的 80 多个国家/地区的外科医生和麻醉师合作网络，COVIDSurg 合作项目迅速启动，为指导 COVID-19 患者进行安全手术提供证据。这种复杂的合作已经能够支持多中心研究，包括队列和实用随机临床试验，使用患者级和系统级数据解决外科护理提供问题，并促进研究结果的及时传播。³

来自伯明翰大学（英国）的 Aneel Bhangu，MBChB，PhD 和 Joana Simões，MBChB，展示了 COVIDSurg 合作如何为术前严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）检测的最佳使用提供指导的示例以防止手术患者的不良结果并告知有关手术时间的指南。例如，在 24 个国家/地区的 235 家医院的 COVIDSurg 合作伙伴之间进行的一项早期队列研究研究了所有接受手术的患者，这些患者在手术前 7 天内或手术后 30 天内确诊感染了 SARS-CoV-2，并显示 30 天死亡率很高(23.8%) 并且超过一半的手术患者存在肺部并发症。²这些结果有助于为延迟这些患者的非紧急手术的政策提供信息。手术结果研究人员可以而且应该做更多的工作，以利用诸如此类的大型、基于人群的协作数据，继续回答有关 COVID 对获得手术治疗的机会和结果的影响的重要而及时的问题，并利用这个机会检查变异在这些重要的卫生系统结果中，为临床决策提供信息。