The following is a summary of “Effect Modification of COVID-19 Symptoms on the Association between Timing of Surgery and Postoperative Complications in Pediatric Spinal Deformity: A Prospective Cohort Study,” published in the January 2024 issue of Surgery by Zhang et al.

This study aimed to determine the optimal timing and associated risks of pediatric spinal deformity surgery during the COVID-19 pandemic. A cohort of 81 consecutive patients undergoing spinal deformity surgery was analyzed between September 2022 and May 2023. Patients were categorized based on the time from SARS-CoV-2 infection diagnosis to surgery, and postoperative complications were assessed using logistic regression. The fully adjusted model revealed a 4.5-fold increased risk for peri-COVID-19 patients (OR=5.5, 95% CI 1.1-27.2, P=0.037) and a 2.3-fold increased risk for early post-COVID-19 patients (OR=3.3, 95% CI 0.7-16.1, P=0.133), with late post-COVID-19 patients having essentially equal risk to pre-COVID-19 patients. In asymptomatic populations, early and late post-COVID-19 patients showed similar risks to pre-COVID-19 patients. 

However, surgery should be delayed for at least 8 weeks or longer after SARS-CoV-2 infection for those with persistent symptoms. Interaction tests indicated that the impact of surgery timing on complications significantly differed among populations with different symptoms. In conclusion, surgery for pediatric spinal deformity should be deferred until 8 weeks after SARS-CoV-2 infection for cases with COVID-19-related symptoms within 2 weeks before surgery. Conversely, for those asymptomatic within two weeks before surgery, an interval of 4 weeks seemed sufficient, highlighting the nuanced approach required based on symptomatology and timing in the context of the pandemic.

Source: sciencedirect.com/science/article/abs/pii/S1878875024000652