The world has seen two outbreaks of covid-19 disease in the last two years. The disease was worldwide and involved each and every part of India also. During the pandemic lots of people were affected by the disease and many unfortunate people died also.
Corona posed tremendous pressure on health network which includes surgery also. Surgeons had to perform emergency surgery on covid patients and many surgical teams were infected during treatment of patients.
Elective surgery was not taken up during the pandemic time and that created burden on the health care system afterwards.
Covid-19 is a serious disease. Many patients were admitted in the wards and many patients were put in the ICU and on ventilator. Later on it was found to be an inflammatory disease with coagulation disorder and anti coagulants & steroids were the first line of management besides general care of patients.
Now in future, after the pandemic patients who are attending the surgery OPD have to be investigated keeping these points in mind-
Patient might be having sequelae of covid infection which may include fibrosis of lungs and cardiovascular diseases in the forms of cardiomyopathies and coagulation disorders. They may also be having neurological symptoms and sleep disorders.
We have to investigate the patient keeping in mind their covid history. All patients being taken up for surgery should have a x-ray chest, complete metabolic checkup, ECG, prothrombin time and d-dimer. This should be done for all surgical patients. Other inflammatory markers and echo can be done if needed. RT PCR is also mandatory.
We have to take proper history of covid infection, history of complications and history of vaccination for all patients.
We have to undertake every surgery with full precautions and proper sanitization.
The outcome of surgery may differ from non covid times because patients may be having some hidden factors of covid-19 infection. We have to communicate with the patient for this. They should be aware that the post surgical period may pose some unforeseen complications.
Still in India 20,000 new patients are detected everyday and about 200 deaths are due to covid.
We all know about the third wave but no one knows whether it will come or not. We need to be prepared.
Dr Puneet Agrawal
