My patient recently had Covid. When is it safe for them to have surgery and anesthesia?

It's a situation we're confronting weekly--a patient comes to pre-op, and you see "prior Covid positive" in their EMR. Naturally, the next question is, when is it safe for the patient to undergo surgery and anesthesia? It's a question that has immediate clinical relevance but precious little data. The ASA/APSF recently published an updated statement on this question. I'm fairly familiar with this topic because I authored the bulk of the original statement on this question (published Dec. 8, 2020). 

Let's get straight to the main points: 

 1. There's only one major study which looked at the timing of surgery after Covid and its relationship to post-op complication rates. That study showed that 7 weeks seemed to be the inflection point where complications rates were significantly lower. 

 2. However, the study has wide confidence intervals around the 5-6 week mark, which means a 5 to 6- week wait period may be sufficient to decrease post-op complication rates. 

 3. The 7-week period also appeared to apply to asymptomatic patients; this seems a bit questionable based on clinical experience. 

 4. This study was conducted before vaccines and Omicron. 

 5. The net effect of vaccines and Omicron on the issue of timing of surgery after infection and its relationship to post-op complications is entirely unclear. 

Bottom line: there's not enough data to work off of. You'll have to use your best judgment--taking into consideration the patient's age, comorbidities, symptom severity of covid infection, and intensity of the surgical procedure. Here's the link: