Surgery Can Be Done Sooner with Vaccinated Patients After COVID

Surgery performed shortly after a patient recovers from COVID-19 is not connected to higher risks if they are fully immunized against the SARS-CoV-2 virus

Current recommendations¹ advise postponing elective surgery for at least seven weeks after testing positive for COVID-19. The research that served as the foundation for these recommendations was conducted at a time when immunization rates were still low. A recent study² found that if people are fully vaccinated against SARS-CoV-2, surgical procedures done soon after a patient recovers from COVID-19 and are not linked to higher risks.

The study authors used data from patients who underwent scheduled surgery at a large, integrated health system from January 1, 2018, to February 28, 2022, They conducted a retrospective cohort study in order to determine how COVID-19 vaccination status may modify risk associated with surgery after COVID-19 infection. According to the interval between COVID-19 positivity and the date of surgery, a total of 228,913 patients were divided into five groups, with 4.8% of them having COVID-19 before or after surgery.

There was no discernible difference in the adjusted rate of perioperative complications between the early post-COVID-19, mid-post-COVID-19, and late post-COVID-19 groups among patients who had received the entire COVID-19 vaccine compared to the pre-COVID-19 group. Patients in the early post-COVID-19 group who were not fully vaccinated at the time of infection and who underwent surgery under general anesthesia experienced a considerably higher rate of perioperative problems than those in the pre-COVID-19 group. And patients who were not fully immunized at the time of COVID-19 infection and who did not undergo general anesthesia did not have a higher risk of developing perioperative problems than fully immunized groups.

These data are a significant step toward proving that fully immunized patients with a recent mild COVID-19 infection might safely undergo a scheduled surgery without the need for further postponement, once their symptoms have subsided, as hospitals and health systems continue to expand services to accommodate patients who have postponed surgical procedures because of the pandemic. With this, hospitals may be able to reduce the amount of time before surgery thanks to the findings, eliminating some delays and reducing surgical backlogs brought on by the pandemic. It will be critical to continue carefully tracking surgical techniques and outcomes as well as particular considerations for special patient categories, especially obstetric and pediatric patients, in light of the continual changes we are seeing in virus evolution, newer therapies, and declining immunity.

1. El-Boghdadly, K., Cook, T. M., Goodacre, T., Kua, J., Blake, L., Denmark, S., McNally, S., Mercer, N., Moonesinghe, S. R., & Summerton, D. J. (2021). SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 76(7), 940–946. https://doi.org/10.1111/anae.15464

2. Le, S. T., Kipnis, P., Cohn, B., & Liu, V. X. (2022). Covid-19 vaccination and the timing of surgery following Covid-19 infection. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000005597