Perioperative Coronavirus Vaccination—Timing and Implications: A Guidance Document

Merritt-Genore, HelenMari; Moosdorf, Rainer; Gillaspie, Erin A.; Lother, Sylvain; Engelman, Daniel; Ahmed, Shahnur; Baciewicz, Frank A.; Grant, Michael C.; Milewski, Rita C.; Cawcutt, Kelly; Hayanga, Jeremiah A; Chatterjee, Subhasis; Arora, Rakesh C.

doi:10.1016/j.athoracsur.2021.07.016

Cited by 14 publications

(31 citation statements)

References 56 publications

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“… 74 The Society for Thoracic Surgery recommends that patients complete the vaccination series before elective surgery, ideally at least two weeks before surgery to achieve full vaccination status, but allowing at least a few days between vaccination and surgery date. 75 The European society joint statement also recommends that the complete vaccination series, including appropriate boosters/third doses, be received at least two weeks preoperatively. They suggest that vaccination confirmation and counseling should optimally occur at the time of surgery decision-making.…”

Section: Onus On Vaccinationsmentioning

confidence: 99%

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

O’Glasser¹,

Schenning²

2022

Perioperative Care and Operating Room Management

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Section: Onus On Vaccinationsmentioning

confidence: 99%

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

O’Glasser¹,

Schenning²

2022

Perioperative Care and Operating Room Management

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“…This measure serves both to avoid any diagnostic confusion about the cause of symptoms such as fever (a consequence of vaccination or complication of the surgery?) and to allow sufficient time for the formation of antibodies [ 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Cortegiani

Tripodi

Castioni

et al. 2022

J Anesth Analg Crit Care

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Background The appropriate timing of surgery and perioperative management of patients with previous SARS-CoV-2 infection are open issues. The purpose of this document is to support the clinical decision-making process regarding the patient with previous Sars-CoV-2 infection to undergo elective surgery. The recipients of this document are physicians, nurses, healthcare personnel, and other professionals involved in the patient’s surgical process. Methods The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) selected 11 experts to reach a consensus on key aspects of this theme in adult and pediatric population. The methods of this process document were in accordance to the principles of rapid review of the scientific literature and modified Delphi method. The experts produced statements and supporting reasons in the form of an informative text. The overall list of statements was subjected to a vote in order to express the degree of consent. Results Patients should not undergo elective surgery within 7 weeks of infection unless there is the risk of a negative evolution of the disease. To mitigate the risk of postsurgical mortality, a multidisciplinary approach seemed useful in addition to the use of validated algorithms to estimate the risk of perioperative morbidity and mortality; the risk related to SARS-CoV-2 infection should be added. The risk of potential nosocomial contagion from a positive patients should also be considered when deciding to proceed with surgery. Most of the evidence came from previous SARS-CoV-2 variants, so the evidence should be considered indirect. Conclusion A balanced preoperative multidisciplinary risk–benefit evaluation is needed in patients with previous infection by SARS-CoV-2 for elective surgery.

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“…2 and 3 , might have been associated with lower antibody titres before surgery and shorter interval from vaccination to surgery in Group CPB than in Group None. One should bear in mind that the recommended vaccination schedule prior to the surgery is at least 7 days [ 24 , 25 ], with the context of possible side effects and reactogenicity of the vaccine which approximately takes 10–14 days [ 7 , 8 , 25 ]. No patient had vaccination less than a week before surgery in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of cardiopulmonary bypass on immunoglobulin G antibody titres after SARS-CoV2 vaccination

Hayashi

Takami

Fujigaki

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Background Patients with cardiovascular disease are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Although SARS-CoV2 vaccination may be effective, its impact on surgical patients is not well studied. We investigated the effects of cardiovascular surgery, especially under cardiopulmonary bypass (CPB), on the antibody titers after SARS-CoV2 vaccination. Methods A prospective observational study was designed for patients undergoing surgery between July to November 2021. The IgG against the receptor binding domain (RBD-IgG) was measured and antibody preserved rate (APR) was calculated from perioperative titers comparison. Results Enrolled 63 study patients were divided into 39 undergoing surgery with CPB (Group CPB) and 24 without CPB (Group None). Preoperative vaccines were BNT162b2 (Pfizer/BioNTech) (n = 58, 92%) and mRNA-1273 (Moderna) (n = 5, 8%). While RBD-IgG titers did not significantly decrease after surgery in Group None, they decreased significantly in Group CPB from 21.80 [11.15, 37.85] U/ml to 11.95 [6.80, 18.18] U/ml (p < 0.001) a day after surgery, 11.40 [7.85, 22.65] U/ml (p < 0.001) 14 days after surgery, and 7.60 [4.80, 17.60] U/ml (p < 0.001) a month after surgery, respectively. The APRs a day after the surgery were significantly lower in in Group CPB (0.46 [0.41, 0.60]) than in Group None (0.80 [0.68, 0.87]) (p < 0.001). Conclusions The SARS-CoV2 antibody titers significantly decreased with lower APRs immediately after surgery under CPB. Based upon our informative results, careful considerations of vaccination schedule might be required for surgery under CPB. Clinical registration number Fujita Health University Ethics Committee (HM 21-164)

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Perioperative Coronavirus Vaccination—Timing and Implications: A Guidance Document

Abstract: Graphical abstract

Cited by 14 publications

References 56 publications

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

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

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Effects of cardiopulmonary bypass on immunoglobulin G antibody titres after SARS-CoV2 vaccination

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