Postoperative complications remain a significant challenge in visceral surgery, particularly among patients with chronic diseases, altered immune status, or acute viral infections. This study examines the incidence, risk factors, and clinical impact of postoperative complications in three patient cohorts: the general population, patients with chronic inflammatory diseases (such as Crohn's disease and ulcerative colitis) under immunosuppressive therapy, and patients with active SARS-CoV-2 infection. The analysis focuses on surgical complications including anastomotic leakage, wound infections, postoperative ileus, thromboembolic events, and organ-specific complications. In patients with altered immune status, complication rates were higher, with specific risks associated with immunosuppressive therapy and active systemic inflammation. In SARS-CoV-2-infected patients, pulmonary complications and mortality rates were significantly elevated, particularly in emergency surgeries. The findings emphasize the importance of tailored perioperative management, including risk stratification and optimized surgical techniques, to minimize complication rates and improve patient outcomes.