COVID

ASSESSMENT

Data Gathering

  • Previous diagnosis of COVID

    • Dates​

    • Symptoms (respiratory, cardiac, thromboembolic)

    • Treatments (outpatient, inpatient, ICU)

  • Persistent symptoms of COVID

  • Date(s) of COVID vaccination

MANAGEMENT

  • No previous infection or infection >90 days ago: nasopharyngeal PCR test ideally ≤3 days prior to the procedure

  • Infection ≤90 days ago: do not retest unless symptoms suggestive of re-infection

Duration of Isolation [ASA/APSF Statement]

  • 10 days after symptom onset (10-20 days if severe symptoms or immunocompromised [active chemotherapy, within 1 year of stem cell or solid organ transplant, untreated HIV with CD4 <200, primary immunodeficiency disorder, or treated with prednisone >20 mg/d for >14 days]

  • Afebrile 24 hours (without fever-reducing meds)

  • Symptoms improved

Surgical Delay After Infection (from date of diagnosis) [ASA/APSF Statement]

Timelines not absolute and must factor in acuity of surgery and individual patient factors

  • 4 WEEKS: Asymptomatic infection or infection with mild, non-respiratory symptoms 

  • 6 WEEKS: Symptomatic infection NOT requiring hospitalization 

  • 8-10 WEEKS: Symptomatic infection requiring hospitalization or in a patient with diabetes or immunocompromise (active chemotherapy, within 1 year of stem cell or solid organ transplant, untreated HIV with CD4 <200, primary immunodeficiency disorder, or treated with prednisone >20 mg/d for >14 days)

  • 12 WEEKS: Symptomatic infection requiring ICU care

Surgical Delay After Vaccination [RCS of England Statement]

  • No data - only a statement from the Royal College of Surgeons of England:

    • "Non-urgent elective surgery can also take place soon after vaccination. There is some rationale for separating the date of surgery from vaccination by a few days (at most 1 week) so that any symptoms such as fever might be correctly attributed to the consequences of either vaccination or the operation itself."​

  • This statement is congruent with the practices of many healthcare systems in the US​