[How long must be an elective surgery delayed after SARS-COV-2 diagnosis? (Multiple-center regional research)].

Butyrskii, A G; Mikhaylichenko, V Yu; Fomochkin, I I; Sherendak, S A; Golomidov, A N; Aliev, A S; Rumyantseva, M I

OBJECTIVE To determine the optimal postponement period for elective surgery in patients with SARS-COV-2 infection. MATERIAL AND METHODS A multiple-center regional prospective cohort research included patients who underwent elective surgeries in November, 2020. We compared the outcomes in patients with preoperative COVID-19 and those without infection. The primary endpoint was 30-day mortality rate. This parameter was stratified depending on period after COVID-19 diagnosis using logistic regression. RESULTS Preoperative COVID-19 was diagnosed in 32 (4.6%) out of 682 patients. Thirty-day mortality rate in patients without infection was 1.5%. Preoperative coronavirus infection increased mortality rate (odds ratio 20%, 25%, 18.1% and 8.3% for surgery within 0-2, 3-4, 5-6 and 7-8 weeks after infection, respectively). Surgeries after 7-8 weeks ensured the same result as in patients without infection (odds ratio 1.5%). After 7-8-week postponement of elective surgery, patients with COVID-19 and active symptoms had higher mortality rate compared to those without or resolved symptoms (50 vs. 13 vs 6.5%, respectively). CONCLUSION If possible, elective surgery should be delayed for at least 7-8 weeks after COVID-19 diagnosis. In patients with active symptoms in 7-8 weeks after diagnosis of infection, further postponement of surgery is recommended.