Recent COVID Doesn’t Seem to Raise Surgery Risks

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If a positive COVID test has forced you to postpone elective surgery, here’s some good news.

Once recovered from the virus, fully vaccinated patients have no greater odds for post-surgery complications than patients who were never infected, according to a new study.

“Current guidelines recommend avoiding elective surgery until seven weeks after a COVID-19 illness, even if a patient has an asymptomatic infection,” said lead author Dr. Sidney Le, who conducted the research as a fellow with the Kaiser Permanente Division of Research.

“But as the pandemic continues, there is concern that delaying surgeries could cause more harm than benefit to some patients,” he said in a health system news release. “If we are able to identify certain patients who can proceed with surgery despite a recent coronavirus infection, that would be a big relief to health systems and their patients.”

Le is now a surgeon at the University of California, San Francisco.

Co-author Dr. Bradley Cohn said the findings should be welcome news for hospitals that have had to make last-minute changes if a surgery patient tests positive for COVID.

“We have been delaying up to 10% of our surgeries, or canceling them on short notice because previous evidence suggested we could be putting patients at increased risk from the stress of surgery in combination with COVID-19 illness,” said Cohn, chairman of Perioperative Medicine for the Permanente Medical Group.

During the pandemic, surgeons and anesthesiologists have had to rely on guidelines established before vaccines were available, he said.

“There was a tremendous gap in the literature on what the risk to patients might be in the current environment, in the context of an increasingly vaccinated population,” Cohn said in the release.

At least one other study, published earlier this year, has examined the effect of COVID vaccination on post-surgery complication rates.

For the new study, researchers analyzed records for nearly 229,000 Kaiser Permanente surgeries between January 2020 and February 2022. Of those, 4.8% involved cases of COVID in the weeks before or after the procedure.

The rate of complications after surgery was about 5% — both for patients who were fully vaccinated and had COVID-19 within four weeks before their procedure, and those who did not.

Researchers said guidelines for elective surgery could, therefore, be loosened, particularly for patients who had asymptomatic or mild COVID-19, taking into account vaccination status and if general anesthesia is being used.

Longer delays could still be necessary for patients with severe COVID or persistent symptoms, Le said.

“We are proud to bring current data to critically important questions that inform the delivery of surgical care, though we recognize that the pandemic is a scientific roller coaster: the virus itself, the context in which it is spread, and treatments all changing,” Le said. “These questions will need to be revisited over and over again with contemporary data and rapid analysis.”

The findings were published July 15 in the Annals of Surgery.

More information

For more on COVID-19, visit the U.S. Centers for Disease Control and Prevention.

SOURCE: Kaiser Permanente, news release, July 19, 2022

Source: HealthDay

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