CONSENSUS||RECOMMENDATIONS OF THE PORTUGUESE SOCIETY OF ANESTHESIOLOGY FOR THE SCHEDULE OF ELECTIVE PROCEDURES AFTER SARS-CoV-2 INFECTION IN THE NON-OBSTETRIC ADULT POPULATION IN PORTUGAL || MARCH 2022

Abstract

The decision on the timing of an elective procedure after SARS-CoV-2 infection should be multidisciplinary, patient-centered. In assessing the risk/benefit of a postponement, the following should be considered: risk of progression of the underlying pathology; time elapsed after SARS-CoV-2 infection; infectious risk; severity of initial clinical presentation of COVID-19; persistence of symptoms; clinical status and frailty; vaccine status. This information must be discussed and included in the patient's free and informed consent (I C). If there is a clinical suspicion of COVID-19, all elective procedures must be rescheduled, until SARS-CoV-2 infection is excluded (I C). In the case of high-risk contacts, all elective procedures must be rescheduled, for a time later than 14 days after the date of the last exposure (IIa C). In the case of a history of SARS-CoV-2 infection: no elective procedure should be performed during the infectious period (IB) In non-priority elective procedures, it is recommended to postpone the surgery: 7 weeks, in individuals without a complete vaccination schedule and immunocompetent and who recovered from asymptomatic or mild COVID-19 (IIa B); 4 weeks, in individuals with a complete vaccination schedule and immunocompetent and who recovered from asymptomatic or mild COVID-19 (IIa C); Case by case, after 7 weeks, in immunosuppressed individuals or who recovered from moderate or severe or critical COVID-19 (I C); Subsequent postponements should be considered if symptoms persist (I B). In high-priority and high-priority elective procedures, the decision-making on the timing of the procedure must be taken analysing risk/benefit on a case-by-case basis (I C). Vaccination of patients proposed for elective surgery, who do not have a complete primary vaccination and booster vaccination, if eligible by the National Health Authority, should be encouraged. Preferably, the interval between the last inoculation and the procedure should be greater than 14 days (IB). Isolation before an elective procedure is not recommended. High-risk situations of contagion should be avoided (I B).