Your browser doesn't support javascript.
loading
Omicron, Long-COVID, and the Safety of Elective Surgery for Adults and Children: Joint Guidance from the Therapeutics and Guidelines Committee of the Surgical Infection Society and the Surgery Strategic Clinical Network, Alberta Health Services.
Barie, Philip S; Brindle, Mary E; Khadaroo, Rachel G; Klassen, Tara L; Huston, Jared M.
Afiliación
  • Barie PS; Department of Surgery, Weill Cornell Medicine, New York, New York, USA.
  • Brindle ME; Departments of Surgery and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Khadaroo RG; Surgery Strategic Clinical Network, Calgary Zone, Alberta Health Services, Edmonton, Alberta, Canada.
  • Klassen TL; Surgery Strategic Clinical Network, Calgary Zone, Alberta Health Services, Edmonton, Alberta, Canada.
  • Huston JM; Departments of Surgery and Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Surg Infect (Larchmt) ; 24(1): 6-18, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36580648
Background: Active and recent coronavirus disease 2019 (COVID-19) infections are associated with morbidity and mortality after surgery in adults. Current recommendations suggest delaying elective surgery in survivors for four to 12 weeks, depending on initial illness severity. Recently, the predominant causes of COVID-19 are the highly transmissible/less virulent Omicron variant/subvariants. Moreover, increased survivability of primary infections has engendered the long-COVID syndrome, with protean manifestations that may persist for months. Considering the more than 600,000,000 COVID-19 survivors, surgeons will likely be consulted by recovered patients seeking elective operations. Knowledge gaps of the aftermath of Omicron infections raise questions whether extant guidance for timing of surgery still applies to adults or should apply to the pediatric population. Methods: Scoping review of relevant English-language literature. Results: Most supporting data derive from early in the pandemic when the Alpha variant of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) predominated. The Omicron variant/subvariants generally cause milder infections with less organ dysfunction; many infections are asymptomatic, especially in children. Data are scant with respect to adult surgical outcomes after Omicron infection, and especially so for pediatric surgical outcomes at any stage of the pandemic. Conclusions: Numerous knowledge gaps persist with respect to the disease, the recovered pre-operative patient, the nature of the proposed procedure, and supporting data. For example, should the waiting period for all but urgent elective surgery be extended beyond 12 weeks, e.g., after serious/critical illness, or for patients with long-COVID and organ dysfunction? Conversely, can the waiting periods for asymptomatic patients or vaccinated patients be shortened? How shall children be risk-stratified, considering the distinctiveness of pediatric COVID-19 and the paucity of data? Forthcoming guidelines will hopefully answer these questions but may require ongoing modifications based on additional new data and the epidemiology of emerging strains.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Síndrome Post Agudo de COVID-19 Tipo de estudio: Guideline Límite: Adult / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Surg Infect (Larchmt) Asunto de la revista: BACTERIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Síndrome Post Agudo de COVID-19 Tipo de estudio: Guideline Límite: Adult / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Surg Infect (Larchmt) Asunto de la revista: BACTERIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos