The Coronavirus pandemic has affected all aspects of daily life, and the ease of which it spreads poses a great risk not only in daily life, but especially those in hospitals. Because of this high risk ideally you should hold off your surgery until the situation is under better control. But unfortunately, that is not always possible and surgery may be unavoidable. This latest blog series talks about what to expect in your surgical experience and some things that you should consider during these times.
In Part 1 we talk about certain changes in the healthcare system and risk factors that you should consider to help determine whether or not your surgery should be postponed.
*Disclaimer: Your individual hospital, state, city or county may have individual guidelines regarding which surgeries can proceed. Please check with your surgeon or hospital regarding these policies and whether surgery is safe at this time.
1. Risk of COVID-19 Infection
The highest, obvious risk factor is the contraction of coronavirus since your hospital may be treating or have treated COVID-19 patients. Hospitals on a whole are considered vectors for the transmission of viruses and bacteria and strict precautionary measures are taken by hospitals to reduce infections but precautions must be taken by surgical patients. At any step along the surgical process, a patient may be at risk from contracting COVID-19.
Spread of COVID-19
The virus itself is spread through respiratory droplets when a person talks, coughs or sneezes. Many infected people are asymptomatic, and may not even know they are infected or unaware they are infecting others. Wearing a mask when staff enter your room, or while you are around others during the peri-operative process will help greatly decrease the risk of spreading or contracting the virus [1].
Risk of Severe Illness Increases with Age
The risk of severe, symptomatic illness increases dramatically with age. 8 in 10 COVID-19 Related deaths have been in adults 65 years and older [1] .
People With Underlying Medical Conditions [1]
It has been observed that certain people with additional medical conditions are at higher risk from severe illness, especially those that may be immunocompromised. Underlying medical conditions that may place a patient at higher risk include:
o Cancer
o Chronic Kidney Disease
o COPD
o Post-Organ Transplant
o Obesity (BMI >30)
o Serious heart conditions: heart failure, coronary artery disease, etc
o Sickle cell disease
o Type 2 Diabetes
o See here for full CDC list
2. Limited Post-op Services
After surgery one of the most important phases begin and that is recovery. Many times patients will need additional help at home such as a home health aide, visiting nurses to check on the wound/dressings as well as physical/occupational therapy. Sometimes if patients do not progress after surgery as quickly as anticipated, a rehab facility may be an additional option. All of these services have been affected by COVID-19 in one way or another. There may be more difficulty in obtaining services in a timely manner after surgery, and you may need more help than originally anticipated from family or friends.
3. Increased Risk of Postoperative Death in COVD-19 Patients
Patients going for surgery in this situation must consider that there can be an increased risk of death after surgery if they are COVID-19 positive. A study [2] showed that patients undergoing surgery after contracting coronavirus have increased risk of post-operative death. Researchers found that amongst SARS-CoV-2 infected patients who underwent surgery, mortality rates approach those of the sickest patients admitted to intensive care after contracting the virus in the community. If you do test positive pre-op, it would be advised to postpone your surgery by at least 2 weeks or until you have a negative test.
4. Lifesaving Intervention
Despite the COVID-19 risk some of the medical and surgical procedures are inevitable and patients cannot do without undergoing them. This may be due to the necessity of certain treatments that cannot be interrupted or the procedure may save the life of a patient. For these procedures be sure to have your operative game plan fully laid out to avoid any bumps in the road.
Conclusion
COVID-19 has made health care very difficult and complicated procedures like surgeries are even more difficult to manage. Knowing the risks and precautions can help the patients going for surgeries to take care of them. We have discussed some of the risk factors which must be kept in mind and discussed with your medical team. Right Device is here to ensure your operative game plan is ready prior to surgery so that even in these uncertain times you will have the best outcome.
Check out Part 2 to see how your operative experience will change with COVID-19.
Right Device is here to ensure your operative game plan is ready prior to surgery. Sign up today to access our surgery database! Join our Patient Partner Program as well as speak with someone who has had the exact same surgery or with an Orthopedic/Spine Nurse Practitioner or Medical Device Specialist today!
References
University of Birmingham. (2020, May 29). COVID-19 patients who undergo surgery are at increased risk of postoperative death. ScienceDaily. Retrieved July 20, 2020 from www.sciencedaily.com/releases/2020/05/200529190739.htm
COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. The Lancet, 2020; DOI: 10.1016/S0140-6736(20)31182-X
Paul S Myles, Salome Maswime. Mitigating the risks of surgery during the COVID-19 pandemic. The Lancet, 2020; DOI: 10.1016/S0140-6736(20)31256-3
