Surgery should be delayed for seven weeks after a patient tests positive for Covid-19, as surgeries taking place up to six weeks after diagnosis is associated with an increased risk of death, according to a new global study. It was found that patients are more than two-and-half times more likely to die after their operation if done immediately.
Of the 1,40,231 patients in the study, 3,127 had a pre-operative Covid diagnosis, with 55% being symptomatic. Both elective and emergency patients undergoing surgery for any indication were eligible. The researchers found that patients operated 0-6 weeks after the Covid infection diagnosis were at increased risk of postoperative death, as were patients with ongoing symptoms at the time of surgery.
Adjusted 30-day mortality in patients who did not have Covid infection was 1.5%. But this increased in patients with Covid. For those operated within 0-2 weeks and 3-4 weeks the mortality rate was 4% each, and at 5-6 weeks it was 3.6%, while it drastically reduced to 1.5% after 7-8 weeks of Covid diagnosis. These findings were consistent across age groups, differing severity of the patient’s condition, the urgency of surgery, and grade of surgery, and in sensitivity analyses for elective surgery.
“This is one of the largest surgical cohort studies done in the world, and for the first time gives us evidence of least amount of time delay for doing surgery with optimal outcomes. However, while deciding on the surgery, one will also need to balance it with the disease risk to the patient,” Dr Anupama R, head of, department of gynecologic oncology, Amrita Institute of Medical Sciences, Kochi, who was part of the study.