Timing of elective surgery and risk assessment after SARS-CoV-2 infection: 2023 update A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Federation of Surgical Specialty Associations, Royal College of Anaesthetists and Royal College of Surgeons of England

Guidance for the timing of surgery following SARS-CoV-2 infection needed reassessment given widespread vaccination, less virulent variants, contemporary evidence and a need to increase access to safe surgery. We, therefore, updated previous recommendations to assist policymakers, administrative staff, clinicians and, most importantly, patients. Patients who develop symptoms of SARS-CoV-2 infection within 7 weeks of planned surgery, including on the day of surgery, should be screened for SARS-CoV-2. Elective surgery should not usually be undertaken within 2 weeks of diagnosis of SARS-CoV-2 infection. For patients who have recovered from SARS-CoV-2 infection and who are low risk or having low-risk surgery, most elective surgery can proceed 2 weeks following a SARS-CoV-2 positive test. For patients who are not low risk or having anything other than low-risk surgery between 2 and 7 weeks following infection, an individual risk assessment must be performed. This should consider: patient factors (age; comorbid and functional status); infection factors (severity; ongoing symptoms; vaccination); and surgical factors (clinical priority; risk of disease progression; grade of surgery). This assessment should include the use of an objective and validated risk prediction tool and shared decision-making, taking into account the patient's own attitude to risk. In most circumstances, surgery should proceed unless risk assessment indicates that the risk of proceeding exceeds the risk of delay. There is currently no evidence to support delaying surgery beyond 7 weeks for patients who have fully recovered from or have had mild SARS-CoV-2 infection.

Automated summary

Guidance for the timing of surgery following SARS-CoV-2 infection has been updated to reflect the impact of vaccination, less severe variants, recent evidence, and the need for safe access to surgery. Screening for SARS-CoV-2 is recommended for patients experiencing symptoms within 7 weeks of planned surgery. Elective surgery should generally be avoided within 2 weeks of a SARS-CoV-2 diagnosis. For low-risk patients recovering from SARS-CoV-2, most elective surgery can proceed 2 weeks after a positive test, while an individual risk assessment is necessary for higher-risk patients within 2 to 7 weeks of infection.