Annals Consult Guys - Timing Elective Surgery in a Patient With Positive Results on a Preadmission Test for SARS-CoV-2
Authors: Howard H. Weitz, Geno J. Merli, Avital Y. O’Glasser
Journal: Annals of Internal Medicine (2022)

Web ExclusivesMarch 2022Annals Consult Guys - Timing Elective Surgery in a Patient With Positive Results on a Preadmission Test for SARS-CoV-2FREEHoward H. Weitz, MD, Geno J. Merli, MD, and Avital Y. O’Glasser, MDHoward H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Search for more papers by this author, Geno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Search for more papers by this author, and Avital Y. O’Glasser, MDOregon Health & Sciences University, Portland, Oregon (A.Y.O.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W21-0004 CME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Annals Consult Guys discuss management of patients who test positive for SARS-CoV-2 before scheduled elective surgery with Dr. Avital O’Glasser.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment The Consult GuysJefferson University6 April 2022 Author’s response Dear Dr. Kedlaya: We appreciate your comments and observation. Unfortunately at the current time we do not have evidence to change our perioperative recommendations for the patient with the Omicron variant. We are hopeful to have that evidence soon. We agree with the March 2022 update guideline from the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England that “There is currently no evidence on peri-operative outcomes after SARS-CoV-2 vaccination and the omicron variant. Therefore, previous recommendations that, where possible, patients should avoid elective surgery within 7 weeks of SARS-CoV-2 infection remain, unless the benefit of doing so exceeds the risk of waiting” (ref: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.15699 ). Thank you for following The Consult Guys Dr. Indira KedlayaManipal Hospital, Varthur, Bengaluru, India24 March 2022 Post op risk with SARS CoV2 I think the systemic involvement wih COVID-19 infection during omicron variant in vaccinated individuals is obviously so different than the infection during the other waves and that needed a mention. I hence think that post op risk is probably a lot lower with omicron than with other variants, risk of pulmonary complications, thrombotic complications, etc. So the answer was quite incomplete. I am such a fan of the consult guys, but this session was not up to the mark. Marvin S RabinowitzSt. Elizabeth Hospital Utica NY14 March 2022 Nosocomial Risk This is a no brainer: no. This is an elective surgery and you are considering bringing in a COVID patient into the hospital for an elective procedure. You want to spread COVID on the surgical ward and to the OR staff? Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Oregon Health & Sciences University, Portland, Oregon (A.Y.O.)Disclosures: Drs. Merli and Weitz report that they have no financial relationships or interests to disclose. Dr. O’Glasser reports a speaking honorarium from the Women in Medicine Summit. All relevant financial relationships have been mitigated. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=W21-0004.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Stephanie Chang, MD, MPH, Deputy Editor, reports employment with the Agency for Healthcare Research and Quality, travel compensation from the Guidelines International Network, and participation in the Patient-Centered Outcomes Research Institute methodology committee. Vineet Chopra, MD, MSc, Deputy Editor, reports grants received from the Agency for Healthcare Research and Quality and royalties from UpToDate and Oxford University Press. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he is employed at Johns Hopkins University. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center and consultancy with Boston Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports employment with the Perelman School of Medicine, University of Pennsylvania, and consultancies with the U.S. Food and Drug Administration and the State of Colorado. 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