Surgeons may no longer need to delay elective surgeries for more than two weeks after a positive COVID-19 test.
This is according to a new study published in Annals of Surgery.
The research questions the necessity of extended postponements based on early pandemic guidelines.
In the early days of the pandemic, the American Society of Anaesthesiologists recommended delaying non-urgent surgeries by up to seven weeks following COVID-19 infection, as the virus was associated with increased postoperative complications, including pulmonary issues.
However, many institutions continue to maintain conservative delays despite evolving evidence as COVID-19 subvariants, such as FLiRT and LB.1, drive milder infections.
This new study, led by Ira Leeds, MD, assistant professor of surgery at Yale School of Medicine, analysed over 80,000 veterans affairs patient records from April 2020 to September 2022.
Of these, 16,000 patients had tested positive for COVID-19 before undergoing surgery.
The findings revealed that patients who tested positive for COVID-19 more than two weeks before surgery had similar outcomes to non-infected patients.
Only those who had surgery within two weeks of infection faced higher risks of mortality and postoperative complications, including cardiopulmonary issues, blood clots, and infections.
Ira Leeds said: ‘These findings suggest that the same mandate for postponing surgery that was necessary before isn’t supported by the most recent evidence.’
He noted that routine delays in the pandemic’s early phases were based on societal guidelines to mitigate COVID-related risks.
When later waves of COVID-19 eased in severity, surgeons had little guidance on whether weeks-long delays were still protecting patients, especially those with mild or asymptomatic infections.
However, with the virus’s evolving nature and milder variants, prolonged postponements may unnecessarily delay patient care.
This suggests that the older guidelines no longer align with the current COVID-19 landscape, and updating policies could prevent unnecessary delays while still safeguarding patients' health.
The study challenges continued caution and calls for re-evaluating surgical timelines in light of the pandemic’s current phase.
It offers evidence that previous guidelines for delaying surgery are no longer beneficial to patients – preventing them from receiving timely care while providing no further protection from COVID-related complications.
Dr Leeds added: ‘If someone is being hospitalised for COVID a week before their surgery, and they can wait a couple of weeks, then, yes, they should. But anything more than two weeks was not associated with better surgical outcomes.’
