COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

Abstract

The COVID-19 pandemic has dramatically affected societies and healthcare systems around the globe. The perioperative care continuum has also been under significant strain due to the pandemic-tasked with simultaneously addressing surgical strains and backlogs, infection prevention strategies, and emerging data regarding significantly higher perioperative risk for COVID-19 patients and survivors. Many uncertainties persist regarding the perioperative risk, assessment, and management of COVID-19 survivors-and the energy to catch up on surgical backlogs must be tempered with strategies to continue to mitigate COVID-19 related perioperative risk. Here, we review the available data for COVID-19-related perioperative risk, discuss areas of persistent uncertainty, and empower the perioperative teams to pursue evidence-based strategies for high quality, patient-centered, team-based care as we enter the third year of the COVID-19 pandemic.

Keywords: APSF, anesthesia patient safety foundation; ARDS, acute respiratory distress syndrome; ASA PS, American society of anesthesiologists physical status; ASA, American society of anesthesiologists; ASC, ambulatory surgery center; Anesthesiology; COVID-19; ECMO, extracorporeal membrane oxygenation; NNV, number needed to vaccinate; PASC, post-acute sequelae of SARS-CoV-2; PEM, post-exertional malaise; PICS, post-intensive care syndrome; POTS, postural orthostatic tachycardia syndrome; PPE, personal protective equipment; PTSD, post-traumatic stress disorder; Perioperative medicine; RCRI, revised cardiac risk index; SARS-CoV-2; Surgical risk; VTE, venous thromboembolism.