Preoperative assessment for scheduling surgery during the coronavirus disease pandemic

Abstract

On Mar 11, 2020, the World Health Organization declared coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a pandemic. Because COVID-19 has a pre-symptomatic period of up to 2 weeks, SARS-CoV-2 infection has continued to spread. Some individuals with SARS-CoV-2 infection have a severe clinical course, while most individuals have mild or moderate symptoms. Because SARS-CoV-2 is transmitted via droplets and secretions, anesthesiologists have higher risks of infection, especially during airway management. Therefore, general anesthesia requiring airway management can be a challenging procedure for anesthesiologists. During the pandemic, many elective surgeries have been postponed or cancelled in most affected countries. Recently, the number of elective surgeries is gradually recovering from the effect of the COVID-19 pandemic, and hence, safe clinical practice and protocols to prevent SARS-CoV-2 transmission to medical staff should be established. This mini-review focuses on the preoperative assessment and decision with regard to scheduling surgery in elective and emergency cases during the COVID-19 pandemic. A standardized questionnaire and algorithm regarding COVID-19 should be used to assess surgical patients preoperatively as it increases the reproducibility and accuracy of the decision whether to proceed with surgery.

Keywords: Anesthesia; COVID-19; SARS-CoV-2; Surgery.

Fig. 1

Preoperative assessment of patients undergoing scheduled surgery. Adapted from Velly et al. 2020 [13]. Abbreviations: COVID-19 coronavirus disease, CT computed tomography, PCR polymerase chain reaction, SARS-CoV-2 severe acute respiratory syndrome coronavirus 2

Fig. 2

Preoperative assessment of patients undergoing emergency surgery. Adapted from Velly et al. 2020 [13]. Abbreviations: COVID-19 coronavirus disease, PCR polymerase chain reaction, SARS-CoV-2 severe acute respiratory syndrome coronavirus 2