Introduction/Background COVID-19 infection leaded to one of the greatest crises affecting the healthcare system worldwide. The aim of the current paper is to analyze the influence of previous COVID-19 infection on the perioperative outcomes of patients submitted to total pelvic exenterations for gynecological malignancies.

Methodology Between July 2021 and April 2022 there were 38 patients submitted to pelvic exenterations for different gynecological malignancies, 11 of these cases presenting a previous history of COVID 19 infection. However, all these 11 patients developed asymptomatic or mild symptomatic disease and did not necessitate hospital admission.

Results Patients with previous history of COVID-19 infection reported a significantly longer length of the surgical procedure (380 minutes versus 300 minutes, p=0,004), a higher intraoperative blood loss (1100 ml versus 600 ml, p=0,002) and a longer intensive care unit stay (5 days versus 2 days, p=0,001). Meanwhile, two of the patients with previous history of COVID-19 infection developed postoperative pneumonia and other three cases developed thrombotic complications while in the control group a single patient developed postoperative thrombotic complications and another one necessitated intensive care readmission due to respiratory dysfunction due to a previous history of asthma

Conclusion These data came to demonstrate that even in cases in which mild forms of COVID-19 infections have been reported, extended surgical procedures such as pelvic exenteration might be associated with a higher risk of perioperative complications.