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

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.

How’s It Stack Up?