- A new study suggests that those who have been diagnosed with COVID-19 should wait at least 7 weeks before undergoing surgery to avoid a higher risk of postoperative death.
- Death rates during the 30 days after surgery were 1.5 percent among those who had not developed COVID-19, and 4 percent among patients who had surgery within 4 weeks of diagnosis.
- That rate dropped to 3.6 percent for those having surgery 5 to 6 weeks after surgery, and 1.5 percent among those having surgery 7 to 8 weeks after developing COVID-19.
A new study suggests that those who have been diagnosed with COVID-19 should wait at least 7 weeks before undergoing surgery to avoid a higher risk of postoperative death.
Led by researchers from the University of Birmingham in the United Kingdom, the team looked at data from more than 140,000 patients who underwent surgery at more than 1,600 hospitals in 116 countries in October 2020.
Death rates during the 30 days after surgery were 1.5 percent among those who had not developed COVID-19, and 4 percent among patients who had surgery within 4 weeks of infection.
That rate dropped to 3.6 percent for those having surgery 5 to 6 weeks after surgery, and 1.5 percent among those having surgery 7 to 8 weeks after developing COVID-19.
Published March 9 in the medical journal Anaesthesia, the numbers were consistent across elective and emergency surgery, age groups, fitness level, and whether the operation was considered major or minor.
Evaluating the risk on a case-by-case basis
After 7 weeks, researchers found patients with ongoing COVID-19 symptoms had a 6 percent death rate, compared with 2.4 percent of those whose symptoms stopped and 1.3 percent of those who were asymptomatic.
“Decisions regarding delaying surgery should be tailored for each patient, since the possible advantages of delaying surgery for at least 7 weeks following SARS-CoV-2 diagnosis must be balanced against the potential risks of delay,” said study author Aneel Bhangu, from the University of Birmingham, in a statement.
Dr. William Li, the co-founder and medical director of the Angiogenesis Foundation, told Healthline it’s unclear why more postoperative danger comes at 7 weeks.
“But we know that COVID affects blood vessels, which are critical for healing and overall recovery from surgery,” Li said. “It also causes inflammation through an autoimmune phenomenon, as well as nerve damage and more. All of these problems make recovery from surgery more challenging, especially the vascular problems.”
Dr. Terry Fouts, a senior clinical advisor for Denver-based surgical care provider BridgeHealth, told Healthline the surgical decision depends on so many factors still being discovered.
“The decision to go forward with surgery depends on things like comorbidity, severity of the infection, and duration of the illness, which may be different for everybody,” Fouts said.
“Some people could just have pulmonary symptoms, or some people might have permanent heart damage, while others could have prolonged brain damage. So, whether and when surgery is appropriate after COVID-19 needs to be determined on a case-by-case basis.”
Doctors are still learning about COVID-19
Fouts told Healthline the disease is still surprising doctors.
“You have the people that get it and get over it, and then you have what we call the long haulers. These are people that have months and possibly years of side effects, especially cardiopulmonary, but even central nervous system brain issues after they’ve had this infection,” Fouts said. “That’s coming to light simply because now we have a year’s experience with this darn thing.”
That evolving information is why doctors recommend monitoring other activities during recovery.
“If they’ve had COVID and they essentially have bounced back and are feeling pretty good, then they can proceed with normal activities,” Dr. Andrew Ordon, a Los Angeles-based plastic surgeon and co-host of the talk show “The Doctors,” told Healthline. “We know that exercise is so important for everything, including the immune system to keep it strong, so long as you’re not having respiratory problems related to COVID-19.”
Ordon said doctors are still learning things like whether COVID-19 stays dormant in the brain or the gastrointestinal tract.
“We talk about the loss of smell and taste, we’ve talked about… COVID (discolored) toes… mental health issues and poor sleep relating to COVID,” Ordon said. “We will probably see more of these of things that may persist. Be your best health advocate; listen to your body. If you feel something that’s unusual that you haven’t felt before, make sure to talk to your doctor.”
He added, “Do everything you can to keep your immune system at its peak — eat right, get sleep, exercise.”