(Supplementary Figure 1). Patients underwent surgery in 78 hospitals from 16 countries, predominantly in Italy (n= 44), UK (n= 28) and Spain (n= 20). 112 patients with a previous positive swab were matched to 448 patients with no positive swab. In the propensity score matched model, previous SARS-CoV-2 infection was associated with increased odds of pulmonary complications compared to no infection (10⋅ 7%[12/122] versus 3⋅ 6%[16/448], adjusted odds ratio 3⋅ 84, 95% confidence interval 1⋅ 51-9⋅ 74, p= 0⋅ 004, Supplementary Figure 2). When split by time from swab to surgery, both pulmonary complications and mortality were lowest at least 4weeks after notification of a positive swab test (Table 1). However, 71⋅ 3%(87/122) of patients had surgery within 4 weeks of SARS-CoV-2 infection in this series. There are significant limitations of these data, including risk of selection bias and a small sample size, meaning this data should be considered as exploratory. Until that time, this data provides the first signal that those with a positive SARS-COV-2 swab preoperatively should have their surgery delayed for at least 4 weeks after notification.

Further research is urgently needed to validate these figures in a larger series and explore differences in recovery between asymptomatic SARS-CoV-2 and symptomatic COVID-19. GlobalSurg-COVIDSurg Week is a multi-centre international snapshot study planned for October 2020 and will explore these research questions in detail. At the time of writing there are over 1300 centres registered in 105 countries, with representation across all surgical specialties. The study protocol and registration are available at: globalsurg. org/surgweek/