Guidance: SARS-CoV-2 infection, COVID-19 and timing of elective surgery

A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Perioperative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England has been published on the SARS-CoV-2 infection, COVID-19 and timing of elective surgery.

The scale of the COVID-19 pandemic means that a significant number of patients who have previously been infected with SARS-CoV-2 will require surgery. Given the potential for multisystem involvement, timing of surgery needs to be carefully considered to plan for safe surgery. The consensus statement uses evidence from a systematic review and expert opinion to highlight key principles in the timing of surgery.

Key Guidance points

  • Emergency surgery, even for a patient without a PCR positive test should proceed with full COVID precautions.
  • For elective or planned surgery, a delay of seven weeks after infection is recommended, including for people who are otherwise asymptomatic (but have had a positive test).
  • There should be an individual assessment and longer preparation time for COVID patients who have recently been treated with steroids or who have had on-going or previously severe COVID symptoms.
  • Timing of surgery following a COVID infection should involve shared decision-making between the patient and their healthcare team – this includes discussions about the risks and benefits of operating, alternatives to surgery, and doing nothing. This is particularly important as the health of many patients may have deteriorated during the pandemic
  • All patients should use the time before their surgery to better prepare for their procedure, e.g. by gradually improving their fitness or by stopping smoking, as this greatly reduces complications after operations, especially if they have other medical problems. It is important that we change the patient’s perception, so they see this period not as waiting time but preparation time.  

Please find the full consensus statement here

Information for patients about the new consensus statement can be found here and on our guidance for patients having an operation during COVID-19 pandemic