Elective surgery after Covid-19: A narrative review of the literature
Abstract
By November 2021, at the time of preparing this article, the disease caused by the new coronavirus (Coronavirus Disease 2019 - COVID-19), declared as a pandemic by the World Health Organization (WHO) on March 11, 2020, had affected more than 128 million people and claimed upwards of 5 million lives. Many of the patients who suffered from this disease will need elective procedures, and this will require knowledge on how to perform the surgery, what tests to order and the extent of preoperative optimization. The objective of this work was to conduct a narrative review of the current evidence regarding time to the performance of an elective procedure in a patient who suffered from COVID-19, the preoperative tests that need to be ordered, and the degree of clinical optimization required according to the complexity of the surgery and individual patient clinical condition. A search was conducted in the Pubmed/Medline, Science Direct, OVID and SciELO databases, as well as in the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) web-based platforms. Although the evidence is still limited, different scientific societies have issued relevant guidelines pertaining to the timing of an elective procedure after COVID-19 infection. For patients who were asymptomatic, the time is 4 weeks after the initial diagnosis of SARS-CoV-2, whereas for symptomatic patients with a mild to moderate course, the time is at least 7 weeks, and 12 weeks if ICU admission was required. There are no guidelines pertaining to preoperative tests or the degree of clinical optimization, although institutional protocols have been developed based on expert consensus on the topic.
References
Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44. doi: http://www.doi.org/10.1038/s41564-020-0695-z
World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. 2021 [citado: 2021 mar. 14]. Disponible en: https://covid19.who.int
Cui J, Li F, Shi ZLi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-92. doi: http://www.doi.org/10.1038/s41579-018-0118-9
Zhou P, Yang X Lou, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. doi: http://www.doi.org/10.1038/s41586-020-2012-7
Cuesen Chen D, Szabla R, Zheng M, Li G, Du P, et al. Broad and differential animal angiotensin-converting enzyme. J Virol. 2020;94(18):1-16. doi: http://www.doi.org/10.1128/JVI.00940-20
El-Boghdadly K, Cook TM, Goodacre T, Kua J, Blake L, Denmark S, et al. 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. Anaesthesia. 2021;1-7. doi: http://www.doi.org/10.1111/anae.15464
Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631-7. doi: http://www.doi.org/10.1002/path.1570
Gheblawi M, Wang K, Viveiros A, Nguyen Q, Zhong JC, Turner AJ, et al. Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res. 2020;1456-74. doi: http://www.doi.org/10.1161/CIRCRESAHA.120.317015
Hu B, Huang S, Yin L. The cytokine storm and COVID-19. J Med Virol. 2021;93(1):250-6. doi: http://www.doi.org/10.1002/jmv.26232
Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med. 2020;383(23):2255-73. doi: http://www.doi.org/10.1056/NEJMra2026131
Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (Stress) cardiomyopathy. N Engl J Med. 2015;373(10):929-38. doi: http://www.doi.org/10.1056/NEJMoa1406761
Lee DW, Gardner R, Porter DL, Louis CU, Ahmed N, Jensen M, et al. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014;124(2):188-95. doi: http://www.doi.org/10.1182/blood-2014-05-552729
Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, et al. Post-acute COVID-19 syndrome. Nature Med. 2021:1-15. doi: http://www.doi.org/10.1038/s41591-021-01283-z
Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021;93(2):1013-22. doi: http://www.doi.org/10.1002/jmv.26368
Doykov I, Hällqvist J, Gilmour KC, Grandjean L, Mills K, Heywood WE. “The long tail of Covid-19” - The detection of a prolonged inflammatory response after a SARS-CoV-2 infection in asymptomatic and mildly affected patients. F1000Res. 2020;9:1349. doi: http://www.doi.org/10.12688/f1000research.27287.2
Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220-32. doi: http://www.doi.org/10.1016/S0140-6736(20)32656-8
Chopra V, Flanders SA, O’Malley M, Malani AN, Prescott HC. Sixty-day outcomes among patients hospitalized with COVID-19. Ann Intern Med. 2021;174(4):576-8. doi: http://www.doi.org/10.7326/M20-5661
Moreno-Pérez O, Merino E, León-Ramírez J, Andrés M, Ramos JM, Arenas-Jiménez J, et al. Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study. J Infect. 2020;82(3): 378-83. doi: http://www.doi.org/10.1016/j.jinf.2021.01.004
Carvalho-Schneider C, Laurent E, Lemaignen A, Laribi S, Flament T, Beau E, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. 2020;(January). Clin Microbiol Infect. 2020;27(2):258-63. doi: http://www.doi.org/10.1016/j.cmi.2020.09.052
Carfì A, Bernabei R, Landi F, for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324(6):603. doi: http://www.doi.org/10.1001/jama.2020.12603
Stahel PF. How to risk-stratify elective surgery during the COVID-19 pandemic ? 2020;1-4. doi: http://www.doi.org/10.1186/s13037-020-00235-9
Barrios Parra A, Prieto Ortiz RG, Torregrosa Almonacid L, Álvarez Tamayo CA, Hernández-Restrepo JD, González Higuera LG, et al. Volver a empezar: cirugía electiva durante la pandemia del SARS-CoV2. Recomendaciones desde la Asociación Colombiana de Cirugía. Rev Colomb Cirugía. 2020;35(2):302-21. doi: http://www.doi.org/10.30944/20117582.656
Lockey S, Nelson D, Kessler M, Kessler J. Approaching “Elective” surgery in the era of COVID-19. HAND Surg Landsc. 2020;46(January):60-4. doi: http://www.doi.org/10.1016/j.jhsa.2020.09.006
American Society of Anesthesiologists and Anesthesia Patient Safety Foundation. Joint Statement on Elective Surgery and Anesthesia for Patients after COVID-19 Infection December. 2020. p. 1-4.
Collaborative, COVIDsurg. Delaying surgery for patients with a previous SARS-CoV-2 infection. Br J Surg. 2020;107:601-2. doi: http://www.doi.org/10.1002/bjs.12050
Almaadany FS, Samadov E, Namazov I, Jafarova S, Ramshorst GHV, Pattyn P, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-COV-2 infection: An international cohort study. Lancet. 2020;396(10243):27-38. doi: http://www.doi.org/10.1016/S0140-6736(20)31182-X
COVIDSurg Collaborative; GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021;76(6):748-58. doi: http://www.doi.org/10.1111/anae.15458.
Jonker PKC, van der Plas WY, Steinkamp PJ, Poelstra R, Emous M, van der Meij W, et al. Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: A Dutch, multicenter, matched-cohort clinical study. Surg (United States). 2021;169(2):264-74. doi: https://doi.org/10.1016/j.surg.2020.09.022
Doglietto F, Vezzoli M, Gheza F, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg. 2020;155(8):691-702. doi: http://www.doi.org/10.1001/jamasurg.2020.2713
Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11):1265-73. doi: http://www.doi.org/10.1001/jamacardio.2020.3557
Centers for Disease Control and Prevention. Interim guidance on duration of isolation and precautions for adults with COVID-19 [internet]. 2021 [citado: 2021 mar. 14]. Disponible en: https://stacks.cdc.gov/view/cdc/102824
Van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM, Okba N, et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun. 2021;12(1):8-13. doi: http://www.doi.org/10.1038/s41467-020-20568-4
Pachand VN, Milner R, Angelos P, Posner MC, Fung JJ, Agrawal N, et al. Medically necessary, time-sensitive procedures: scoring system to ethically and efficiently manage resource scarcity and provider risk during the COVID-19 Pandemic. J Am Coll Surg. 2020;231(2):281-8. doi: http://www.doi.org/10.1016/j.jamcollsurg.2020.04.011
Royal Australasian College of Surgeons. Guidelines on the preoperative diagnostic workup for COVID-19. A rapid review commissioned by Royal Australasian College of Surgeons [internet]. 2020 [citado: 2021 mar. 14]. Disponible en: https://nsfl.health.govt.nz/system/files/documents/pages/guidelines_on_the_preoperative_diagnostic_workup_for_covid-19.pdf
Bui N, Coetzer M, Schenning KJ, O’Glasser AY. Preparing previously COVID-19-positive patients for elective surgery: a framework for preoperative evaluation. Perioper Med. 2021;10(1). doi: http://www.doi.org/10.1186/s13741-020-00172-2
Wajekar A, Solanki S, Divatia J. Pre-anesthesia re-evaluation in post COVID-19 patients posted for elective surgeries: an online, cross-sectional survey. Indian J Surg Oncol. 2021:1-6. doi: http://www.doi.org/10.1007/s13193-021-01347-z
Collaborative, COVIDsurg. Mortality and pulmonary complications in patients udergoing surgery with perioperative SARS-CoV2 infection: an international cohort study. Lancet 2020; 396(10243): 27-38. doi: http://www.doi.org/10.1093/bjsopen/zrab033.003
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331. doi: http://www.doi.org/10.1016/j.eclinm.2020.100331
Downloads
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
