Recommendations to delay elective surgery following COVID-19 infection

The Australian and New Zealand College of Anaesthetists (ANZCA) has released new guidelines on surgical patient safety and COVID-19.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. Guidelines published in February 2022 recommend that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting. A recent study examined the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. It was found that where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection (including asymptomatic infection), and patients with ongoing symptoms at 7 weeks may benefit from further delay.

Below are the recommendations from the Australian National COVID-19 Clinical Evidence Taskforce: guidelines for the clinical care of people with COVID-19:

Timing of surgery following COVID-19 infection

Conditional recommendation against

Do not routinely perform elective surgery within eight weeks of recovery from acute illness, following a diagnosis of SARS-CoV-2 infection, unless outweighed by the risk of deferring surgery, such as disease progression or clinical priority.

Informed consent and, where deemed necessary, shared decision-making with a valid substitute decision-maker, should include discussion about the potential increased risk of surgery following a diagnosis of COVID-19 and in the presence of post-acute COVID-19 symptoms.

Conditional recommendation

For people undergoing elective surgery following a diagnosis of SARS-CoV-2 infection, consider carrying out multisystem preoperative assessment in consultation with a unit familiar with the assessment of people recovering from COVID-19.

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