Doctors and patients should consider COVID-19 history when planning surgery, according to a new study.
For patients who've had a COVID-19 diagnosis, researchers found significant postoperative problems diminish gradually over time, but risks persist more than a year after the illness.
That time frame is longer than previously known, said the research team from Vanderbilt University Medical Center, in Nashville.
“Compared to previous population studies of this issue, ours is distinguished for tracking surgical outcomes more broadly and using a longer time horizon from COVID diagnosis,” study co-author Dr. Robert Freundlich, an associate professor of anesthesiology and biomedical informatics, said in a university news release.
“As we were midway in our study, based on postoperative pulmonary outcomes one medical society issued a recommendation to delay surgery after COVID-19 by up to 12 weeks in more severe cases of COVID,” Freundlich said.
“Meanwhile, with respect to this range of cardiovascular problems, in our data we were surprised to find a trend of subsiding risk still discernable more than a year after COVID diagnosis,” he added.
To study this, the researchers used health data from nearly 4,000 adult surgical patients who had a previous COVID-19 infection. They underwent surgery between March 2020 and December 2021.
The median length of time between COVID diagnosis and surgery for the study participants was 98 days, meaning for half it was longer.
The investigators analyzed the odds of cardiovascular problems within 30 days of surgery. These included clots such as deep venous thrombosis and pulmonary embolism; strokes, myocardial [heart] injury, acute kidney injury and death.
Rates of these outcomes dropped steeply initially, from about 18% to 10% over the first 100 days after a COVID diagnosis. They then dwindled over the next 10 months, the findings showed, and reached about 8% after 400 days — about 13 months.
This rate of decreasing risk was unaffected by patients' COVID-19 vaccination status.
“In a given patient's case, many considerations can influence when surgery should best occur, and our results provide further indication that doctors and patients would do well to include proximity to COVID in their thinking,” Freundlich said.
The findings were published online Dec. 14 in JAMA Network Open.
The U.S. Centers for Disease Control and Prevention has more on what patients should know before surgery.
SOURCE: Vanderbilt University Medical Center, news release, Dec. 14, 2022
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