Recent COVID Diagnosis is Associated with Serious — Even Lethal — Risk After Elective Arthroplasty
The idea that COVID is associated with problems after surgery was well known, but the risk magnitudes here were shocking
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Smart Practice: Postpone elective arthroplasty surgery for a month after a diagnosis of COVID.
What’s the Claim?
A large-database study using a national COVID-specific database found that patients who underwent elective THA or TKA despite a positive pre-op test for COVID within two weeks of surgery were at much higher risk for serious complications after arthroplasty, including:
- Pneumonia (odds ratio [OR] 2.5 [95% CI 1.4 to 4.2])
- Postoperative myocardial infarction (OR 2.9 [95% CI 1.3 to 6.2])
- Sepsis within 90 days (OR 2.6 [95% CI 1.4 to 4.8])
- 30-day mortality (OR 10.6 [95% CI 5.1 to 22]).
The risks fell away pretty quickly over time, with no COVID-associated risk increases identified in patients who waited more than a month after a positive COVID test to have elective joint replacement.
