Sunday, July 4, 2021

Wait six weeks for surgery after COVID, says ICMR

Pune: Recovered Covid patients opting for non-urgent or elective surgeries are being asked by surgeons to go for repeat RT-PCR/antigen tests as part of pre-operative protocols. However, experts from the Indian Council of Medical Research (ICMR) and the national task force for Covid-19 have advised against repeating Covid tests within 102 days of recovery, citing the presence of “non-viable dead-virus particles” that stay in the body for a while, reports Umesh Isalkar.These virus remnants cannot transmit the illness but can cause a false positive test result. The experts said surgeons should consider performing a non-urgent surgery on a Covid-recovered patient only after six weeks of recovery to ensure faster healing and convalescence post-surgery.

Retesting for Covid not advised within 102 days of diagnosis’

At present, Covid reinfection is confirmed only after 102 days of diagnosis. So, retesting within this time frame is not advisable,” said infectious diseases expert Sanjay Pujari, a member of the task force.
“A minimum period of six weeks prior to non-urgent surgery is recommended for Covid-recovered patients who were symptomatic. As for emergency surgeries in recovering or recovered patients, these must be done immediately with due precautions,” Pujari said. He added that if a patient experiences recurrence of Covid symptoms, re-testing, and consultation with an infectious disease expert can be considered.

Experts said that a Covid-recovered patient’s preoperative risk assessment should be “individualized”, by factoring in surgical intensity, comorbidities, and risk-benefit ratio if the procedure is delayed. “Residual symptoms like fatigue, shortness of breath, and chest pain are common in patients who had Covid. These symptoms can be present for more than 60 days after diagnosis,” Pujari said.

Covid may also have long-term effects on heart function. A thorough preoperative evaluation, scheduled well ahead of surgery with special attention on cardiopulmonary systems, should be considered in patients who have recovered and especially in those with residual symptoms, as per norms issued by the American Society of Anaesthesiology.


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