ASO Author Reflections: Leveraging Real-World Data to Guide Surgical Risk Stratification in Patients Recovered from COVID-19

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented and unexpected clinical considerations across multiple treatment settings. This includes determining how, or if, surgical care should be modified in patients undergoing elective surgery after recovering from severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Increasingly, it is being recognized that some patients who recover from an acute SARS-CoV-2 infection develop a persistent, longer-term syndrome (‘‘longCOVID’’) that is associated with an increased risk of thromboembolic events, myocarditis, and pulmonary disorders. Each of these sequelae may modify surgical risk in the perioperative setting. One proposed solution is delaying surgical treatment until the postoperative risk, especially for patients undergoing elective surgery, returns to baseline. Based on data from other viral syndromes and preliminary results from a large, multinational collaborative, initial recommendations ranged from 4 to 7 weeks to delay elective surgery in those recovered from SARS-CoV2. However, for time-sensitive conditions including cancer-related surgery, a shorter postponement period may be required, and quantifying the risk in this population is crucial. PRESENT