What Is SARS-CoV-2 or COVID-19?
Coronavirus is a family of viruses that could cause illnesses, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the common cold. SARS-CoV-2 is an abbreviation of the severe acute respiratory syndrome coronavirus 2. It is the virus that can cause the disease COVID-19 in humans. Initially, a new coronavirus was identified in 2019 as the cause of a disease outbreak that originated in China. New international research was published in the Anesthetists journal that surgery should be delayed for seven weeks once the patient tests positive for SARS-CoV-2. Vaccination is also likely to reduce postoperative pulmonary complications, decreasing intensive care use and overall healthcare costs.
What Is Elective Surgery?
Elective surgery is a surgery that is scheduled in advance because it does not involve a medical emergency. Since it is a non-emergency surgery, it allows the patient and the doctor to decide the best time and place for it. These surgeries are done with advanced planning, for example, cholecystectomy, hernia repair, coronary artery bypass, colonic resection, etc.
Why Should the Patient Wait for Surgery After the Diagnosis of COVID-19?
A new study has suggested that those diagnosed with COVID-19 are expected to wait at least seven weeks before getting the surgery done to avoid a higher risk of postoperative death.
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During the 30th day after surgery, death rates were 1.5 percent among those who had not acquired COVID-19 and 4 percent among patients who had surgery within four weeks of diagnosis.
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But the rates dropped to 3.6 percent for people who had surgery 5 to 6 weeks after surgery and 1.5 percent for people who had surgery 7 to 8 weeks after developing COVID-19.
How Long Should the Patient Wait for the Surgery After COVID-19?
When a patient has tested positive for SARS-CoV-2, the doctor should postpone the elective surgical procedures until the patient is no longer contagious and has been cured of COVID-19.
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A patient may be contagious based upon a CDC non-test-based procedure in mild to moderate cases of COVID-19. The patient should get relieved from fever at least 24 hours without using fever-reducing medications and improving respiratory symptoms. At least it should be ten days after the onset of symptoms or via a CDC non-test-based strategy in severe cases of COVID-19.
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It should be at least ten days and up to 20 days free of symptom onset for immunocompromised patients. At least 24 hours following the resolution of fever without fever-reducing medications, symptoms like cough and shortness of breath should have improved.
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The sufficient recovery of the patient from the physiologic changes from SARS-CoV-2 cannot be considered safe. However, evaluation should include estimating the patient’s exercise potential.
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The timing of elective surgery after improving from COVID-19 uses both the symptom and severity-based levels. The statement involves suggested wait times from the time of onset of COVID-19 diagnosis to surgery as:
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Asymptomatic patients or patients who recovered from only mild, non-respiratory symptoms should wait for at least four weeks.
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Asymptomatic patients with cough and dyspnea who did not need any hospitalization should wait for at least six weeks.
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An asymptomatic individual who is immunocompromised, diabetic, or hospitalized should wait for at least eight to ten weeks.
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And the patients admitted to an intensive care unit due to a COVID-19 infection should wait for at least twelve weeks.
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What Are the Precautions to Be Taken for Elective Surgery Patients With COVID-19?
The CDC has guidance for those exposed to a person with symptomatic COVID-19 during 48 hours before symptoms onset until that person meets the criteria for discontinuing home isolation. These patients should be directed as follows:
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The patient should stay at home until 14 days after the last exposure and maintain a social distance of a minimum of six feet from other people at all times.
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Self-monitor themselves for symptoms by checking the temperature twice a day and watching for shortness of breath, cough, fever, or other signs of COVID-19.
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The patient should not contact people at higher risk for severe illness except if they live in the same house or have the same exposure.
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Follow CDC guidance if symptoms develop.
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Based on these recommendations, a patient enrolled for elective surgery with close contact with someone infected with COVID-19 should have their case admitted for at least 14 days.
What Are Surgeries That Can Be Delayed in the Case of COVID-19?
The COVID-19 Pandemic has impacted health care in many ways. This has frequently led to a long interval in non-urgent surgeries. If you have surgery that is not urgently needed (for example, elective surgery), your surgeon may advise waiting until the Pandemic ends.
Your surgeon may opt to delay an elective surgery to help:
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Preserve your health.
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Restrict the spread of COVID-19 infection.
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To save personal protective equipment (PPE) such as masks and gowns.
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To save the intensive care unit (ICU), hospital beds and other materials needed to attend to hospitalized patients with COVID-19 infection.
For example, a surgery that requires general anesthesia needs a ventilator to help people breathe during the procedures and when these ventilators are required for someone with severe conditions of COVID-19 infection. Nowadays, hospitals and their staff are taking careful steps to keep you safe, which is best for your health if you need surgery.
Each surgery is viewed on an individual basis. Decisions may differ among hospitals and over the country. Some elective or non-emergency surgeries can be postponed without a scheduled date, making you feel worried. Your surgeon will carefully analyze the risks of delay in having the surgery during this Pandemic. Your surgery will only be postponed if it does not put your health at risk or allow your condition to worsen. You and your surgeon will decide the safest path for you, whether moving ahead with the surgery or delaying. Studies have shown that delaying surgery for earlier stage cancer types between 3 and 6 months did not affect survival rates or recurrence rates. There may also be other therapy types that can slow down cancer growth while waiting for the surgery. If you require surgery to treat cancer, your surgeon will analyze factors such as your cancer stage and how fast it grows or spreads. Surgery may be instantly needed for people with some types of cancer.
Conclusion:
Do things that can keep your immune system at its peak, eat healthily, get proper sleep, and exercise to overcome this deadly disease. The decision to go for surgery after COVID-19 depends on the severity of the infection, comorbidity, and duration of the illness, which is different for each person. So when surgery is appropriate after COVID-19 needs to be decided on a case-by-case basis.
