Surgery two weeks after covid infection is safe

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An analysis of data from 3.6 million operations in the UK shows that it is safe to operate on patients two weeks after a positive covid diagnosis, as long as they have recovered. Ciaran McInerney et al present this result in Anaesthesia.

Mortality

After operations performed since corona vaccines became available, the mortality rate was 0.2 percent over a 30-day period. This corresponds reasonably well with the pre-covid mortality: 0.1 percent. The mortality rate for surgeries performed within two weeks of a positive test was 1.1 percent, decreasing to 0.3 percent over a four-week period.

These results are in line with the results of recent research in the US. A retrospective analysis there found that patients who tested positive for Covid-19 and were not vaccinated had a greater risk of postoperative pulmonary complications than vaccinated patients who underwent surgery, regardless of how long it had been since they were positive.

UK and Germany

Other research done before vaccines were available showed that it is better to wait seven weeks after a positive test before operating. Guidelines in the UK and Germany, according to McInerney et al., still recommend postponing elective surgery for up to seven weeks after a SARS-CoV-2 infection. That time interval is also observed in the US, but only for unvaccinated people. The Dutch guideline says: ‘Consider postponing surgery for 14 days after a positive PCR test.’ That recommendation now receives support from McInerney et al

They do acknowledge some limitations to their research. For example, they believe that the results cannot serve as a guideline for policy in patients with a higher risk, for example if they have remained symptomatic after the acute phase of Covid-19, or if they have a poorly functioning immune system.

doi:10.1111/anae.16001

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