Wait 6 weeks for surgery after Covid, says ICMR

PUNE: Recovered Covid patients opting for non-urgent or elective surgeries are being asked by surgeons to go for repeat RT-PCR/antigen tests as part of pre-operative protocols. However, experts from Indian Council of Medical Research (ICMR) and the national task force for Covid-19 have advised against repeating Covid tests within 102 days of recovery, citing presence of “non-viable dead-virus particles” that stay in the body for a while.These virus remnants cannot transmit the illness but can cause a false positive test result. The experts said surgeons should consider performing a non-urgent surgery on a Covid-recovered patient only after six weeks of recovery to ensure faster healing and convalescence post-surgery. “At present, Covid reinfection is confirmed only after 102 days of diagnosis. So, retesting within this time frame is not advisable,” said infectious diseases expert Sanjay Pujari, a member of the task force.“Also, a minimum period of six weeks prior to non-urgent surgery is recommended for Covid-recovered patients who were symptomatic. As for emergency surgeries in recovering or recovered patients, these must be done immediately with due precautions,” Pujari said. He, however, added that if a patient experiences recurrence of Covid symptoms, re-testing and consultation with an infectious disease expert can be considered.Experts said a Covid-recovered patient’s preoperative risk assessment should be “individualised”, by factoring in surgical intensity, co-morbidities and the risk-benefit ratio if procedure is delayed. “Residual symptoms such as fatigue, shortness of breath and chest pain are common in patients who have had Covid. These symptoms can be present for more than 60 days after diagnosis,” Pujari said.Covid may also have long-term effects on heart function. A thorough preoperative evaluation, scheduled well ahead of surgery with special attention on cardiopulmonary systems, should be considered in patients who have recovered and especially in those with residual symptoms, according to the guidelines issued by the American Society of Anaesthesiology (ASA).President of Poona Surgical Society, Sanjay Kolte said, “Retesting recovered patients within 102 days from Covid diagnosis only adds to anxiety and is a wastage of money. Importantly, surgeons should adopt universal precautions while performing elective surgery rather than insisting on RTPCR reports.”Suggested wait times· Four weeks for an asymptomatic patient or someone who has recovered from only mild, non-respiratory symptoms· Six weeks for a symptomatic patient (including cough, shortness of breath) who did not require hospitalisation· Eight to 10 weeks for a symptomatic patient who is diabetic, immunocompromised, or was hospitalized with Covid· Twelve weeks for a patient who was admitted to ICU with Covid-19· No Covid retesting within 102 days· People who’ve recovered from Covid need not take another RT-PCR test to check if they have been reinfected· There is a possibility of a swab test returning a positive result after detecting non-viable remnants of the virus, even after the infection has cleared the system, an ICMR study has clarified· Non-viable virus remnants are dead particles that can no longer infect or transmit the illness· But if one tests positive 102 days after the first Covid episode, it can be considered as a case of new infection, provided there was a negative molecular test in the interim, the ICMR has said

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