The risk goes up further if the time of surgery is closer to the diagnosis of Covid-19, the study published in medical journal Anaesthesia says. The analysis was based on over 1.4 lakh surgeries conducted in 1,674 hospitals in 116 countries. This included 56 hospitals from India, including All India Institute of Medical Sciences.
Dr Shilpa Sharma, who led the study from AIIMS, told TOI, “While it is a known fact that SARS-CoV-2 infection during surgery increases the mortality risk, this is the first time a study has given evidence about the least amount of time delay in surgeries that would optimise final outcomes.”
“In all, 31 doctors from AIIMS participated in the study. We analysed deaths and pulmonary complications recorded within 30 days in patients who underwent surgery in departments such as paediatric, orthopaedics, cardiothoracic and general surgery and neurosurgery. It showed that patients with current and past history of Covid-19 were at higher risk of post-surgery complications and even death,” added Sharma.
The doctor said that this could be because Covid-19 causes systemic inflammation. “The infection affects the lungs. Administering anaesthesia isn’t easy. Also, most such patients have low immunity and the risk of postoperative infection is high. The decision to delay surgery needs to be balanced by the disease risk to the patient,” she added.
At AIIMS, RT-PCR and CBNAAT tests are carried out routinely to screen all surgical patients. Surgery is delayed for those who test positive, wherever possible, till the patients recover.
The study showed that time of surgery from the diagnosis of Covid-19 was inversely proportional to the risk of death and even pulmonary complications.
Of the 1,40,231 patients who underwent surgery at different hospitals during the study period (October 2020), 3,127 were diagnosed with current or recent history of Covid-19.
The 30-day post-operative mortality in patients who underwent surgery in 0-2 weeks of diagnosis of Covid-19 was 9.1%, 6.9% within 3-4 weeks of the infection, 5.5% within 5-6 weeks of contracting Covid-19, and 2% in those who were operated upon after seven weeks of being infected with the virus.