Covid's lingering effects can put the breaks on elective surgery

The operation to be performed, patients’ medical conditions and the risk of delaying surgery should all be factored in.“Long covid” patients like Colvin who continue to have debilitating symptoms months after 12 weeks have passed require a more thorough evaluation before surgery, said Dr. Beverly Philip, president of the society.Now that Covid-19 has been brought to heel in many areas and vaccines are widely available, hospital operating rooms are bustling again.“In talking to surgical colleagues, hospitals are really busy now,” said Dr. Avital O’Glasser, medical director of the outpatient preoperative clinic at Oregon Health and Sciences University in Portland. When obtaining patients’ medical history and conducting physical exams, clinicians look for signs of Covid-19 complications that aren’t readily identifiable and determine whether patients have returned to their pre-Covid-19 level of health.The pre-op exam also includes lab and other tests that evaluate cardiopulmonary function, coagulation status, inflammation markers and nutrition, all of which can be disrupted by Covid-19.If the assessment raises no red flags, patients can be cleared for surgery once they have waited the minimum seven weeks since their Covid-19 diagnosis.Originally, the minimum wait for surgery was four weeks, but clinicians pushed it back to seven after the international study was published, O’Glasser said.“We are still learning about covid, and uncertainty in medicine is one of the biggest challenges we face,” said O’Glasser.