{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T05:22:28Z","timestamp":1739337748104,"version":"3.37.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>COVID\u201019 increases anesthetic risk in children, but understanding of complication differences by symptom presence and severity is limited. We hypothesized that symptomatic COVID\u201019+ children, especially with lower respiratory symptoms, would have higher perioperative complications than asymptomatic patients and that complications would be higher in all patients diagnosed &lt;\u20096\u2009days before anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, retrospective cohort study reviewed records of children &lt;\u200918\u2009years old undergoing surgery with general anesthesia from March 1, 2020, to March 1, 2022, who tested COVID\u201019+. A total of 225 patients who tested positive \u2264\u200910\u2009days before anesthesia were analyzed for the primary outcome, and an additional 298 patients who tested positive \u2264\u200921\u2009days before anesthesia were analyzed for secondary outcomes. Data on demographics, comorbidities, vaccination, preoperative and perioperative care, complications, and mortality were collected. Primary outcome analysis used univariate regression; secondary outcome analysis used analysis of variance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Primary Outcome<\/jats:italic>: Symptomatic patients were more likely to experience postoperative respiratory complications (OR: 3.53, 1.18\u201310.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.024), require postoperative medications (OR: 7.64, 2.29\u201325.51, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and require postoperative oxygen support (OR: 2.62, 1.19\u20135.79, <jats:italic>p<\/jats:italic>\u2009=\u20090.017) versus asymptomatic patients. Those with upper respiratory symptoms were less likely to require postoperative medications (OR: 0.1, 0.01\u20130.89, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) and oxygen support (OR: 0.08, 0.01\u20130.45, <jats:italic>p<\/jats:italic>\u2009=\u20090.004) versus those with lower respiratory symptoms. <jats:italic>Secondary Outcome<\/jats:italic>: Patients testing COVID\u201019+ &lt;\u20096\u2009days before anesthesia had longer PACU stays (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and more postoperative respiratory complications (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), medication use (<jats:italic>p<\/jats:italic>\u2009=\u20090.038), and oxygen use (<jats:italic>p<\/jats:italic>\u2009=\u20090.002) versus other groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Preoperative symptoms, especially of the lower respiratory tract, increased the risk for perioperative complications in children diagnosed with COVID\u201019 within 10\u2009days of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of symptoms, particularly of the lower respiratory tract, should be strongly considered in the shared decision\u2010making process between providers and families when discussing the potential delay of procedures in the setting of COVID\u201019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.15051","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T15:09:47Z","timestamp":1733411387000},"page":"239-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Cohort Study of Perioperative Complications in Symptomatic and Asymptomatic Children Testing <scp>SARS<\/scp>\u2010<scp>CoV<\/scp>\u20102\u2010Positive Within 21\u2009Days Before Surgery"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5182-3512","authenticated-orcid":false,"given":"Anitra","family":"Karthic","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"},{"name":"The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0641-4135","authenticated-orcid":false,"given":"Zandantsetseg","family":"Orgil","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Services Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidhant","family":"Kalsotra","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Cugino","sequence":"additional","affiliation":[{"name":"Ohio University Heritage College of Osteopathic Medicine  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelei","family":"Durban","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen K.","family":"Tram","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Rice\u2010Weimer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4123-6867","authenticated-orcid":false,"given":"Brittany L.","family":"Willer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1056-6828","authenticated-orcid":false,"given":"Ajay","family":"D'Mello","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-6951","authenticated-orcid":false,"given":"Joseph D.","family":"Tobias","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine Nationwide Children's Hospital  Columbus Ohio 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