Pune: Individualize risk assessment in Covid cured, say doctors

PUNE: Experts have advised against delaying elective (nonurgent) surgeries among the Covid-19 recovered in view of the residual symptoms as it could complicate the pre-existing conditions.
Residual Covid symptoms, are common and may linger for more than 60 days after the diagnosis in the Covid recovered.
A Covid-recovered patient’s pre-operative risk assessment should be individualized, by factoring in surgical intensity, co-morbidities and the risk-benefit ratio, the experts said.

“As per the existing guidelines, not everyone should wait for 4-12 weeks for an elective surgery after recovering from Covid-19. The pre-operative risk assessment cannot be generalized. If an elective surgery is going to ease the complications, it should be considered an essential surgery, if not an emergency one,” said surgeon Sanjay Kolte, president of the Poona Surgical Society.
Delay in seeking medical care for various anal conditions is also being seen very commonly among people. “We are seeing many patients of fistula, who are postponing the advised surgery even after the considerable time after Covid recovery. Fistula has the tendency to branch over a period of time and can get complicated,” said Healing Hands Clinic’s chief proctologist Ashwin Porwal.
Porwal said, “Last week, I came across two such cases. One presented with the extension of the fistula from the scrotum to the abdominal wall. He had to be operated on in an emergency with specialized surgery. Another case was associated with bleeding piles. The patient came with haemoglobin dropped terribly low to six grams per deciliter (g/dl). He was given a blood transfusion and was operated in emergency with laser surgery.”
Experts from the India and the American Society of Anaesthesiology have issued norms for carrying out elective surgeries in Covid recovered. “The guidelines only help surgeons in prioritization of cases. They do not interfere in surgeon’s discretion about scheduling an elective surgery as per the individual patient’s need,” said infectious diseases expert Sanjay Pujari.