Brief Clinical Report: PDF OnlyCOVID-19 Outbreak and Surgical Practice Unexpected Fatality in Perioperative PeriodAminian, Ali MD*; Safari, Saeed MD†; Razeghian-Jahromi, Abdolali MD‡; Ghorbani, Mohammad MD†; Delaney, Conor P. MD*Author Information *Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH †Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran ‡General Surgery Private Practice, Tehran, Iran. email@example.com. Article Information Author Contributions: Dr Safari and Dr Razeghian-Jahromi had full access to all of the data in the study and takes responsibility for the integrity of the data. Concept and design: All authors Acquisition and interpretation of data: Safari, Razeghian-Jahromi, Ghorbani Drafting of the manuscript: Aminian Critical revision of the manuscript: All authors Conflicts of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. None was directly related to the study. Funding/Support: None reported. Annals of Surgery: March 26, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/SLA.0000000000003925 Free PAP Metrics Abstract Little is known about surgical practice in the initial phase of coronavirus disease 2019 (COVID-19) global crisis. This is a retrospective case series of 4 surgical patients (cholecystectomy, hernia repair, gastric bypass, and hysterectomy) who developed perioperative complications in the first few weeks of COVID-19 outbreak in Tehran, Iran in the month of February 2020. COVID-19 can complicate the perioperative course with diagnostic challenge and a high potential fatality rate. In locations with widespread infections and limited resources, the risk of elective surgical procedures for index patient and community may outweigh the benefit. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.