SURGICAL INFECTIONSVolume 24,Number 1,2023ReviewsMary Ann Liebert.Inc.D0l:10.1089sur.2022.274马贺只Open camera or QR reader andscan code to access this articleand other resources online.▣Omicron,Long-COVID,and the Safetyof Elective Surgery for Adults and Children:Joint Guidance from the Therapeutics and GuidelinesCommittee of the Surgical Infection Society and the SurgeryStrategic Clinical Network,Alberta Health ServicesPhilip S.Barie,Mary E.Brindle,2.3 Rachel G.Khadaroo.3.4 Tara L.Klassen,3.5 and Jared M.Huston.7AbstractBackground:Active and recent coronavirus disease 2019(COVID-19)infections are associated with morbidityand mortality after surgery in adults.Current recommendations suggest delaying elective surgery in survivorsfor four to 12 weeks,depending on initial illness severity.Recently,the predominant causes of COVID-19 arethe highly transmissible/less virulent Omicron variant/subvariants.Moreover,increased survivability of primaryinfections has engendered the long-COVID syndrome,with protean manifestations that may persist for months.Considering the more than 600,000,000 COVID-19 survivors,surgeons will likely be consulted by recoveredpatients seeking elective operations.Knowledge gaps of the aftermath of Omicron infections raise questionswhether extant guidance for timing of surgery still applies to adults or should apply to the pediatric population.Methods:Scoping review of relevant English-language literature.Results:Most supporting data derive from early in the pandemic when the Alpha variant of severe acuterespiratory syndrome coronavirus-2(SARS-CoV-2)predominated.The Omicron variant/subvariants generallycause milder infections with less organ dysfunction;many infections are asymptomatic,especially in children.Data are scant with respect to adult surgical outcomes after Omicron infection,and especially so for pediatricsurgical outcomes at any stage of the pandemic.Conclusions:Numerous knowledge gaps persist with respect to the disease,the recovered pre-operative patient,the nature of the proposed procedure,and supporting data.For example,should the waiting period for all buturgent elective surgery be extended beyond 12 weeks,e.g.,after serious/critical illness,or for patients withlong-COVID and organ dysfunction?Conversely,can the waiting periods for asymptomatic patients or vac-cinated patients be shortened?How shall children be risk-stratified,considering the distinctiveness of pediatricCOVID-19 and the paucity of data?Forthcoming guidelines will hopefully answer these questions but mayrequire ongoing modifications based on additional new data and the epidemiology of emerging strains.Keywords:COVID-19;elective surgery;long-COVID;omicron variantDepartment of Surgery,Weill Cornell Medicine,New York,New York,USA.Departments of Surgery and Community Health Sciences,Cumming School of Medicine,University of Calgary,Calgary,Alberta,Canada.Surgery Strategic Clinical Network,Department of Surgery,Calgary Zone,Alberta Health Services,Edmonton
