COVID and Surgery: Testing Strategy

As we re-open, patients who have postponed elective surgery will have to decide when to move forward with scheduling surgery. That decision should be made with your surgeon so you can best weigh the risks and benefits of having elective surgery during the COVID pandemic.

Impact of surgery and anesthesia on COVID-19 infection

Once you decide to move forward with surgery, you may be tested for COVID-19. Testing can be important, because having surgery while infected with coronavirus (even if you have no symptoms) can lead to worse surgical outcomes and more severe COVID-19 infection. We don’t yet understand why, but it appears the stress of surgery can accelerate and exacerbate COVID-19 infection.

Viral swab testing before surgery

It takes roughly 5 days for viral swab tests to become positive after exposure to coronavirus. Therefore, you should limit possible exposures for 5 days prior to your viral swab for surgery. You should also limit possible exposures after your test because you don’t want to get infected before your surgery!


  • Lei, Shaoqing, et al. “Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection.” EClinicalMedicine (2020): 100331.
  • Kucirka, Lauren M., et al. “Variation in false-negative rate of reverse transcriptase polymerase chain reaction–based SARS-CoV-2 tests by time since exposure.” Annals of Internal Medicine (2020).
  • Sethuraman, Nandini, Sundararaj Stanleyraj Jeremiah, and Akihide Ryo. “Interpreting diagnostic tests for SARS-CoV-2.” Jama (2020).
  • Bryan, Ava Ferguson, et al. “Unknown unknowns: Surgical consent during the COVID-19 pandemic.” Annals of surgery (2020).

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The information provided in this post in intended for general education. It is not medical advice. While I make every effort to provide the most up-to-date information, please note that new data is continuously becoming available and may change the conclusions I present here.

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