As a result of the coronavirus pandemic, the individual risk-benefit assessment as a basis for medical decisions, for example with regard to scheduled (elective) surgical procedures, was affected and adequate scheduling became an urgent aspect in the lives of many patients. Often, this situation was further complicated by limited surgical capacities prevailing in many regions of the world. Therefore, a core objective of our pilot course was to address this need and to provide readily accessible information in this context. A concrete point of reference in terms of scientifc content were study results that emerged from the research of the COVIDSurg Collaborative, a global network of surgeons and researchers.

The seminar supported the development of own visualizations by students that convey core insights from this research. In addition, active networking of course participants among each other as well as with international experts from the COVIDSurg Collaborative provided an important methodological starting point to enable deepened and personal insights into the topic.

In the course of six interactive workshop sessions, the participants received an introduction to the basics of visual science communication as well as fundamental aspects of COVIDSurg research - and based on this, developed visualizations step by step in independent project work. Importantly, course participants were ultimately free to choose any topic of their liking, as long as this was appropriate and fitting in a larger thematic context and any appropriate implementation form they wished to use. In the context of special feedback-sessions, we were also supported by the expertise of visualization expert Johanna Barnbeck and Science Notes editor Bernd Eberhart.

With over 15,000 members, the COVIDSurg Collaborative has become one of the largest research networks in the world. It evolved at a rapid pace shortly after the SARS-CoV-2 coronavirus outbreak had been declared a pandemic by the World Health Organization (WHO) in the spring of 2020. Due to the pandemic, numerous new challenges and questions arose for health systems and medical professionals worldwide. Naturally, this also included the care for surgical patients and many urgent questions arose, e.g.: Does a SARS-CoV-2 infection increase the complication risk after s surgical procedures? Are certain patient groups particularly at risk? And if so: Which measures that may be taken have proven effective to reduce these risks?

In order to answer those and other important questions through international collaboration and aiming for joint studies providing reliable results that endorse evidence-based decision-making as quickly as possible, the COVIDSurg Collaborative came together as a globally networked research initiative.

Since the beginning, researchers and physicians at the University of Tübingen have been relevantly involved in the COVIDSurg Collaborative.

For example, led by Prof. Dr. Alfred Königsrainer, Dr. Markus Löffler and Dr. Markus Quante, data from Tübingen have been contributed to three large international studies. The consistent aim of all these efforts has been to gain new knowledge supporting safe patient care in the face of the new challenges posed by the pandemic. An overview of publications provided by the COVIDSurg Collaborative can be found on the initiative's website.

Two key studies that were key for visualizations in our course are summarized with more detail below.

As early as March 2020, Tübingen started contributing data for a first cohort study - and already at the end of May 2020, an international evaluation of these data was published in the renowned journal The Lancet.

This study evaluated data from 1128 patients from 24 countries affected by the pandemic who had been infected with the SARS-CoV-2 coronavirus before or shortly after surgery. The analysis of the data revealed an alarming picture: The overall mortality rate within the first month after surgery was disproportionately high in this patient cohort, amounting to 23.8%. A massive increase in deaths was not only apparent in emergency surgery and major surgical procedures, but comprised also minor procedures and scheduled surgery. Mortality was particularly high in older men (over 70 years of age) and in patients with severe pre-existing conditions such as cancer.

• UKT Press Release
• COVIDSurg Collaborative: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection. An international cohort study. In: Lancet 396 (2020), 27-38; first published May 29, 2020. Accessible online: https://doi.org/10.1016/S0140-6736(20)31182-X.

Due to the initial results of the COVIDSurg cohort study mentioned above, it was clear that surgery had run into a problem during the pandemic: not only had postponements and cancellations of surgeries brought new urgent problems, but a SARS-CoV-2 coronavirus infection posed a clear threat to any affected surgical patient. In order to provide safe surgical care under substantially changed conditions, numerous pressing follow-up questions arose, in particular: When may planned (elective) surgery be resumed without any increased risk following a SARS-CoV-2 infection?

Based on data from more than 140,000 patients (from 1,674 hospitals in a total of 116 countries), the COVIDSurg Collaborative could demonstrate that surgical procedures performed after coronavirus infection are still associated with an increased mortality risk for up to six weeks. Accordingly, patients who tested positive for SARS-CoV-2 have a prolonged risk of severe complications including mortality risk that has more than doubled in the context of surgery compared to similar patients without this risk factor. Importantly, this risk still prevails even without remaining symptoms at the time of surgery. Corresponding results were uniformly determined across all age groups and independent of the severity of concomitant disease, urgency or extent of surgery. These results are therefore directly relevant to patient care in surgery.

• UKT Press Release
• COVIDSurg Collaborative: Timing of surgery following SARS‐CoV‐2 infection. An international prospective cohort study. Anaesthesia 76 (2021), 731–735; first published March 9, 2021. Available online: https://doi.org/10.1111/anae.15458.