Anesthesia and surgery for positive COVID‐19 asymptomatic pediatric patients: How long should we wait?

Geng‐Ramos, Giuliana; Cronin, Jessica; Challa, Chaitanya; Brennan, Marjorie; Matisoff, Andrew; Delaney, Meghan; Campos, Joseph; Rana, Sohel; Wyson, Brenna; Pestieau, Sophie

The worldwide spread of the novel SARS-CoV-2 coronavirus (COVID-19) led to significant challenges for healthcare institutions. Our institution implemented guidelines to protect perioperative staff and patients from exposure to COVID-19, including pre-procedural testing.1 Patients who tested positive SARS-CoV-2 had their elective procedure postponed and quarantined as per Center for Disease Control and Prevention (CDC) guidelines.2 A test-based strategy is no longer recommended by the CDC for COVID-19 patients to come off isolation. 2 Instead, patients can be cleared from isolation precautions using time and symptom-based criteria. However, there is limited data addressing the role of re-testing and appropriate scheduling of procedures after a positive test in an asymptomatic patient.3 Following a positive test, our institution delayed surgery and re-tested the patient requiring a negative test result to proceed with elective procedures. We herein describe the patterns of laboratory values of COVID-19 positive patients with a focus on those who we define as "persistently positive" to elucidate a safe pathway to bring patients to surgery.