COVID-19 Vaccination and the Timing of Surgery Following COVID-19 Infection

Le, Sidney; Kipnis, Patricia; Cohn, Bradley; Liu, Vincent X

doi:10.1097/sla.0000000000005597

Cited by 31 publications

(26 citation statements)

References 31 publications

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“…8 Evidence demonstrates a more than three times greater incidence of PPCs in patients with COVID-19 as long as six weeks before surgery; 8,9 however, this risk and timing may be dependent on patients' vaccination status and anesthesia type. 10 Evidence supports postponing nonurgent procedures in patients with COVID-19. 9,11 The American Society of Anesthesiologists recommends that elective surgery be postponed until patients are not infectious and have recovered from COVID-19.…”

Section: Covid-19 Considerationsmentioning

confidence: 97%

“…As a respiratory infection, the effect of COVID‐19 on surgical patients is a key concern for perioperative teams 8 . Evidence demonstrates a more than three times greater incidence of PPCs in patients with COVID‐19 as long as six weeks before surgery; 8,9 however, this risk and timing may be dependent on patients’ vaccination status and anesthesia type 10 . Evidence supports postponing nonurgent procedures in patients with COVID‐19 9,11 .…”

Section: Covid‐19 Considerationsmentioning

confidence: 99%

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Preventing Postoperative Pulmonary Complications

Croke¹

2022

AORN Journal

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Section: Covid-19 Considerationsmentioning

confidence: 97%

Section: Covid‐19 Considerationsmentioning

confidence: 99%

Preventing Postoperative Pulmonary Complications

Croke¹

2022

AORN Journal

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“…Given the rapid development and dissemination of COVID-19 vaccines, vaccination status represents an additional factor that must be considered prior to the development of stronger recommendations on the appropriate timing of surgery after COVID-19 infection. Le et al performed a retrospective cohort study of 229,913 patients investigating this question [ 35 ]. They found no difference in perioperative complication rates between fully vaccinated and COVID-negative patients at any timepoint (RR 0.66, 0.74, 1.00 for patients having surgery 0–4 weeks, 4–8 weeks, ≥ 8 weeks after infection, respectively).…”

Section: Timing Of Surgery Following Sars-cov-2 Infection and The Rol...mentioning

confidence: 99%

Management of the Normal and Difficult Pediatric Airway: Unique Challenges in the Time of COVID-19

et al. 2023

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Purpose of Review This review focuses on the challenges faced by acute care healthcare workers in the management of the normal and difficult pediatric airway during the COVID-19 pandemic and how these protocols and practices evolved during the pandemic. The current state of knowledge on timing of surgery and anesthesia is also discussed. Recent Findings In the early days of the pandemic, information about the SARS-CoV-2 virus and disease process was scarce. Governmental, healthcare, and professional organizations created several guidelines to protect invaluable healthcare workers from the contagious virus while also delivering appropriate care to children with COVID-19. With the emergence of new studies and the deployment of new life-saving COVID-19 vaccines and other therapies, these guidelines evolved. The use of aerosol containment devices such as aerosol boxes and flexible barrier techniques was found to be ineffective in reliably containing virus particles while posing potential harm to both healthcare workers and patients. Also, the definition of aerosol-generating and dispersing medical procedures was vastly broadened. To date, use of appropriate personal protection equipment and COVID-19 vaccination are the most effective ways to protect healthcare workers and safely manage children infected with SARS-CoV-2 who require airway intervention. Summary Evidence-based public health measures and appropriate personal protective equipment remain the best way to protect both healthcare workers and patients. As the virus and population evolve and COVID-19 vaccines become more widely available, clinicians must be willing to adapt to the emerging evidence of their impact on how safe pediatric perioperative care is delivered.

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“…Notably, preprocedure asymptomatic screening has also been proposed as a patient-specific risk assessment for postoperative complications. An increase in such complications following current or recent (within 8 weeks) SARS-CoV-2 infection has been described, [1][2][3][4][5] but these studies have largely included data obtained before widespread COVID-19 vaccination, availability of effective therapies, and population immunity. Also, these studies may not have included or stratified risk for asymptomatically infected patients, may not have distinguished risk by surgery type or indication, and may have been confounded by factors such as patient comorbidities, indication for surgery, and frailty.…”

Section: Executive Summarymentioning

confidence: 99%

Asymptomatic screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) as an infection prevention measure in healthcare facilities: Challenges and considerations

Talbot

Hayden

Yokoe

et al. 2022

Infect. Control Hosp. Epidemiol.

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Executive summary Testing of asymptomatic patients for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) (ie, “asymptomatic screening) to attempt to reduce the risk of nosocomial transmission has been extensive and resource intensive, and such testing is of unclear benefit when added to other layers of infection prevention mitigation controls. In addition, the logistic challenges and costs related to screening program implementation, data noting the lack of substantial aerosol generation with elective controlled intubation, extubation, and other procedures, and the adverse patient and facility consequences of asymptomatic screening call into question the utility of this infection prevention intervention. Consequently, the Society for Healthcare Epidemiology of America (SHEA) recommends against routine universal use of asymptomatic screening for SARS-CoV-2 in healthcare facilities. Specifically, preprocedure asymptomatic screening is unlikely to provide incremental benefit in preventing SARS-CoV-2 transmission in the procedural and perioperative environment when other infection prevention strategies are in place, and it should not be considered a requirement for all patients. Admission screening may be beneficial during times of increased virus transmission in some settings where other layers of controls are limited (eg, behavioral health, congregate care, or shared patient rooms), but widespread routine use of admission asymptomatic screening is not recommended over strengthening other infection prevention controls. In this commentary, we outline the challenges surrounding the use of asymptomatic screening, including logistics and costs of implementing a screening program, and adverse patient and facility consequences. We review data pertaining to the lack of substantial aerosol generation during elective controlled intubation, extubation, and other procedures, and we provide guidance for when asymptomatic screening for SARS-CoV-2 may be considered in a limited scope.

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COVID-19 Vaccination and the Timing of Surgery Following COVID-19 Infection

Cited by 31 publications

References 31 publications

Preventing Postoperative Pulmonary Complications

Preventing Postoperative Pulmonary Complications

Management of the Normal and Difficult Pediatric Airway: Unique Challenges in the Time of COVID-19

Asymptomatic screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) as an infection prevention measure in healthcare facilities: Challenges and considerations

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