SARS-CoV2 is a deadly virus belonging to the family Corona-viridae, with the primary target pulmonary system, known as the coronavirus pandemic disease (COVID-19). This virus has caused a high death rate of approximately 9,500 deaths as of December 2020. Along this pandemic, the hospital will treat non-emergent conditions in COVID-19 patients require nonemergent surgery. Anesthesiologists have an important role in the anesthesia management in patients with COVID-19 utilization and require airway management. This article explains optimal preoperative evaluation, intraoperative management, and postoperative management of COVID-19 patients. Optimal treatment is expected to minimize complications and the spread of COVID-19 disease. The optimal time for elective surgery should be decided by a multidisciplinary committee that considers the risk of complications either the patient, the disease itself, the surgical procedure, or other alternatives with lower risk. Perioperative management is carried out preoperatively, intraoperatively, and postoperatively. The safety of anesthesiologists using personal protective equipment (PPE) to carry out preoperative evaluations is important. The number of disease severity can use a scoring system, the results of which can be used as a reference for multidisciplinary discussions related to perioperative management plans. General anesthesia can contribute to the spread of disease resulting from the risk of droplets resulting from airway action, so regional anesthesia can be considered to reduce the risk of spread. For this reason, optimal management is needed to reduce risks to patients as well as medical personnel.

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by vascular thrombosis or pregnancy complications with the presence of antiphospholipid antibodies. It is a rare disease affecting 40–50/100,000 population yet responsible for 10%–15% of recurrent pregnancy loss. Diagnosis requires at least one clinical and one laboratory criteria to be met. Perioperative management in obstetric APS underwent cesarean section stressed on the management of anticoagulation and proper choice of anesthesia technique. We report the case of a 21-years-old woman, 39 weeks pregnant, diagnosed with APS since the 8th week of gestation. She had two previous miscarriages and an elevated level of anticardiolipin antibody (aCL IgG: 21 GPL U/ml) with normal aCL IgM and lupus anticoagulant. She was treated with a prophylactic dose of low-molecular-weight heparin (0.4 IU subcutaneous enoxaparin) and oral aspirin 80 mg daily. She presented to the obstetric department and scheduled for an urgent cesarean section. Enoxaparin was held, and the surgery was done with spinal anesthesia. Anticoagulation resumed 12 h after surgery. No complications on the mother and baby were found after 3 days of observation.