Elective surgeries post-COVID diagnosis

ABC7’s The More in the Morning team spoke with Dr. Michael K. Kim, Board-Certified Plastic Surgeon, to talk about when it’s okay for you to have an elective surgery done after you test positive for COVID-19. If you have an elective surgery coming up but you’ve recently tested positive for COVID-19, Dr. Kim said there’s no exact timeframe to wait. But, he said studies have found that if you have a procedure done with general anesthesia soon after having COVID, it nearly doubles your death rate within 30 days after the surgery.

The Bottom Line: Studies suggest that elective surgeries should be delayed, when possible.

What is the definition of "Elective Surgery?"

The definition of elective surgery is “a surgical, therapeutic or diagnostic procedure that can be performed at any time or date between the surgeon and patient. Below is a guideline for suggested wait times from the date of COVID-19 diagnosis to surgery.

  • Four weeks for an asymptomatic patient or recovery from only mild, non-respiratory symptoms.
  • Six weeks for a symptomatic patient (e.g., cough, dyspnea) who did not require hospitalization.
  • Eight to 10 weeks for a symptomatic patient who is diabetic, immunocompromised, or hospitalized.
  • Twelve weeks for a patient who was admitted to an intensive care unit due to COVID-19 infection.

A growing number of studies have shown a substantial increased risk in post-operative death and pulmonary complications for at least six weeks after symptomatic and asymptomatic COVID-19 infection. Additionally, elective surgeries for adults who are immuno-compromised, diabetic, or have a history of hospitalization should be deferred eight to 10 weeks after diagnosis. Those with a history of intensive care hospitalization should be deferred 12 weeks.

Brief Overview of the studies

Several small studies, including one published in The Lancet, have suggested patients with positive COVID-19 test results may experience worse outcomes and increased chance of dying after surgery. A large international study, published in Anaesthesia, showed that keeping surgery on hold for at least seven weeks after a positive coronavirus test was associated with lower mortality risk compared with no delay.

The most recent study on this topic was published in JAMA Network Open in April and compared 5,470 surgical patients with positive COVID-19 test results (within six weeks) to 5,470 patients with negative results. There were more than double the number of deaths reported in the COVID-19-positive group versus the group with negative results.

The connection between COVID-19 infection and surgical complications seems logical given how research suggests a link between COVID-19 infection and inflammation. It’s not only the surgical procedure but the anesthesia as well that can exacerbate inflammation in the body.

Learn More About Dr. Michael K. Kim

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