Pre-operative COVID19 and Cardiovascular Complications

When is it safe to have surgery after COVID? Listen as Associate Editor Dr. Jason Carter (Baylor University) interviews lead author Dr. Anai Kothari (Medical College of Wisconsin) and leading expert Dr. Michael Joyner (Mayo Clinic) about the groundbreaking new research study by SenthilKumar et al. that evaluated how pre-operative COVID infection might affect a patient’s risk of post-operative major adverse cardiovascular and cerebrovascular events (MACE) by analyzing data from 457,804 patients within the National COVID Cohort Collaborative (N3C) Data Enclave. In fact, it was a surgical operation in October 2020 that inspired Dr. Kothari and collaborators to consider how the stress of surgery combined with the potential end-organ changes that happen with prior COVID infection would impact surgical outcomes. If patients had a prior history of COVID followed by a subsequent non-emergency surgery, the authors found a 12% increase in overall risk of having a major adverse cardiovascular or cerebrovascular event after surgery. The authors found that most patients had surgery more than 8 weeks after COVID infection. However, if patients had surgery in the first 4 weeks after COVID infection, there was a slight increase in the number of post-surgical MACE. Disease severity had a major impact on post-surgical incidence of MACE. In contrast, vaccination against COVID decreased the risk of MACE without increasing the risk of any post-operative negative outcomes that the group assessed. Listen as these experts discuss surgical timing and the role of COVID vaccines to not only reduce risk of post-surgical MACE for patients but also to protect immunocompromised individuals in the greater population.

Gopika SenthilKumar, Nathaniel B. Verhagen, Salma A. Sheriff, Xin Yang, Carlos E. Figueroa Castro, Aniko Szabo, Brad W. Taylor, Njeri Wainaina, Kathryn Lauer, Jon C. Gould, and Anai N. Kothari on behalf of the N3C Consortium Preoperative SARS-CoV-2 infection increases risk of early postoperative cardiovascular complications following noncardiac surgery Am J Physiol Heart Circ Physiol, published April 25, 2023. DOI: 10.1152/ajpheart.00097.2023