{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:35:46Z","timestamp":1767792946532,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Zhejiang Provincial Health Commission","award":["2022KY208"],"award-info":[{"award-number":["2022KY208"]}]},{"name":"Wenzhou basic scientific research project","award":["Y20220308"],"award-info":[{"award-number":["Y20220308"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,10,26]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Background<\/jats:title>\n Fever in children with SARS-CoV-2 infection may increase the risk of intraoperative oxygen desaturation during surgery. This study seeks to find the optimal surgery timing by examining oxygen desaturation rates after fever resolution.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective cohort study from March to August 2023 included children with SARS-CoV-2 infection who were scheduled for surgery after fever resolution. The primary outcome was the incidence of intraoperative oxygen desaturation. Logistic regression models were used to calculate the adjusted incidence of oxygen desaturation, stratified by time intervals from fever resolution to the day of surgery: 0\u20132 weeks, 3\u20134 weeks, 5\u20136 weeks, 7\u20138 weeks and \u22653\u2009months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The intraoperative oxygen desaturation rate was 7.96%. It was highest in the 0\u20132 weeks group (18.3%), lower in the 3\u20134 weeks group (11.5%), and further decreased in the 5\u20136 weeks (6.8%), 7\u20138 weeks (4.7%) and \u22653 months (4.9%) groups. Adjusted analysis showed significantly higher oxygen desaturation risk in the 0\u20132 weeks (adjusted OR (aOR), 5.56; 95% CI 3.76 to 8.21) and 3\u20134 weeks (aOR, 3.31; 95%\u2009CI 2.15 to 5.09) groups compared with the \u22653 months group. Risk factors for intraoperative oxygen desaturation included younger age, higher Body Mass Index (BMI), an abnormal chest radiograph and ongoing symptoms (all p<0.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n To minimise the risk of intraoperative oxygen desaturation, elective surgeries in paediatric patients should be scheduled no earlier than 4 weeks after fever resolution.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n The study was registered at Chinese Clinical Trial Registry\n http\/\/www.chictr.org.cn\/<\/jats:ext-link>\n (Registration date 13\/03\/23 Trial ID ChiCTR2300069293).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003149","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:05:40Z","timestamp":1764306340000},"page":"e003149","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of surgery after fever resolution in children with SARS-CoV-2: a prospective cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6960-461X","authenticated-orcid":false,"given":"Yi","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Longxiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingting","family":"Lu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Wenzhou Medical University, Chashan Campus, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Wenzhou Medical University, Chashan Campus, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyuan","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Wenzhou Medical University, Chashan Campus, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenchen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangning","family":"Shangguan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"2026010701520537000_12.1.e003149.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7003e1"},{"key":"2026010701520537000_12.1.e003149.2","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1213\/ANE.0000000000005606","article-title":"Anesthetic Complications Associated With Severe Acute Respiratory Syndrome Coronavirus 2 in Pediatric Patients","volume":"133","author":"Saynhalath","year":"2021","journal-title":"Anesth Analg"},{"key":"2026010701520537000_12.1.e003149.3","first-page":"E306","article-title":"Stenting techniques for coronary bifurcation lesions: Evidence from a network meta\u2010analysis of randomized clinical trials","volume":"97","author":"Chiabrando","year":"2021","journal-title":"Cathet Cardio Intervent"},{"key":"2026010701520537000_12.1.e003149.4","first-page":"e644","article-title":"Favourable perioperative outcomes for children with SARS-CoV-2","volume":"107","author":"Nepogodiev","year":"2020","journal-title":"Br J Surg"},{"key":"2026010701520537000_12.1.e003149.5","unstructured":"Health RCoPaC . National guidance for the restoration and recovery of elective surgery in children. Available: https:\/\/www.rcpch.ac.uk\/ resources\/national-guidance-restoration-recovery-electivesurgery-children [Accessed 05 Dec 2023]."},{"key":"2026010701520537000_12.1.e003149.6","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1016\/j.bja.2024.07.035","article-title":"Preoperative preparation of children with upper respiratory tract infection: a focussed narrative review","volume":"133","author":"Stepanovic","year":"2024","journal-title":"Br J Anaesth"},{"key":"2026010701520537000_12.1.e003149.7","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.bjae.2023.08.004","article-title":"The influence of the COVID pandemic on the management of URTI in children","volume":"23","author":"Stepanovic","year":"2023","journal-title":"BJA Educ"},{"key":"2026010701520537000_12.1.e003149.8","doi-asserted-by":"publisher","DOI":"10.1038\/nri3843"},{"key":"2026010701520537000_12.1.e003149.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-023-02390-9","article-title":"Timing of general anesthesia for pediatric patients recovering from COVID-19: a prospective cohort study","volume":"24","author":"Zhao","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"2026010701520537000_12.1.e003149.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026010701520537000_12.1.e003149.11","unstructured":"Wang W , Huang G , Sun K , et al . Diagnostics. 10th edn. Beijing: People\u2019s Medical Publishing House, 2021:8\u201312."},{"key":"2026010701520537000_12.1.e003149.12","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005267","article-title":"Tympanic temperature versus temporal temperature in patients with pyrexia and chills","volume":"95","author":"Yang","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2026010701520537000_12.1.e003149.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0146736(20)30183-5"},{"key":"2026010701520537000_12.1.e003149.14","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.bja.2018.11.022","article-title":"Incidence and risk factors of hypoxaemia after preoxygenation at induction of anaesthesia","volume":"122","author":"Baillard","year":"2019","journal-title":"Br J Anaesth"},{"key":"2026010701520537000_12.1.e003149.15","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/S0140-6736(10)61193-2","article-title":"Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study","volume":"376","author":"von Ungern-Sternberg","year":"2010","journal-title":"The Lancet"},{"key":"2026010701520537000_12.1.e003149.16","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1097\/EJA.0b013e32835df608","article-title":"The effect of deep vs. awake extubation on respiratory complications in high-risk children undergoing adenotonsillectomy: a randomised controlled trial","volume":"30","author":"von Ungern-Sternberg","year":"2013","journal-title":"Eur J Anaesthesiol"},{"key":"2026010701520537000_12.1.e003149.17","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/anae.15716","article-title":"Complications associated with paediatric airway management during the COVID-19 pandemic: an international, multicentre, observational study","volume":"77","author":"Peterson","year":"2022","journal-title":"Anaesthesia"},{"key":"2026010701520537000_12.1.e003149.18","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1097\/EJA.0000000000000875","article-title":"Peri-operative respiratory adverse events in children with upper respiratory tract infections allowed to proceed with anaesthesia: A French national cohort study","volume":"35","author":"Michel","year":"2018","journal-title":"Eur J Anaesthesiol"},{"key":"2026010701520537000_12.1.e003149.19","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.21037\/tp-21-257","article-title":"Identification of the risk factors in perioperative respiratory adverse events in children under general anesthesia and the development of a predictive model","volume":"10","author":"Tao","year":"2021","journal-title":"Transl Pediatr"},{"key":"2026010701520537000_12.1.e003149.20","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.827663","article-title":"Perioperative Respiratory Adverse Events Among Pediatric Surgical Patients in University Hospitals in Northwest Ethiopia; A Prospective Observational Study","volume":"10","author":"Wudineh","year":"2022","journal-title":"Front Pediatr"},{"key":"2026010701520537000_12.1.e003149.21","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S0140-6736(16)31719-6","article-title":"The effect of endotracheal tubes versus laryngeal mask airways on perioperative respiratory adverse events in infants: a randomised controlled trial","volume":"389","author":"Drake-Brockman","year":"2017","journal-title":"Lancet"},{"key":"2026010701520537000_12.1.e003149.22","doi-asserted-by":"crossref","first-page":"193","DOI":"10.2344\/anpr-68-04-02","article-title":"Airway Complications in Intubated Versus Laryngeal Mask Airway-Managed Dentistry: A Meta-Analysis","volume":"68","author":"Prince","year":"2021","journal-title":"Anesth Prog"},{"key":"2026010701520537000_12.1.e003149.23","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/pan.12495","article-title":"Supraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications","volume":"24","author":"Luce","year":"2014","journal-title":"Paediatr Anaesth"},{"key":"2026010701520537000_12.1.e003149.24","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijsu.2019.02.020","article-title":"The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials","volume":"64","author":"Li","year":"2019","journal-title":"Int J Surg"},{"key":"2026010701520537000_12.1.e003149.25","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/pan.14376","article-title":"Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia-Part 2: Anesthesia-related risk and treatment options","volume":"32","author":"Templeton","year":"2022","journal-title":"Paediatr Anaesth"},{"key":"2026010701520537000_12.1.e003149.26","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.bja.2017.11.094","article-title":"Deep or awake removal of laryngeal mask airway in children at risk of respiratory adverse events undergoing tonsillectomy-a randomised controlled trial","volume":"120","author":"Ramgolam","year":"2018","journal-title":"Br J Anaesth"},{"key":"2026010701520537000_12.1.e003149.27","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/anae.15699","article-title":"Timing of elective surgery and risk assessment after SARS-CoV-2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England","volume":"77","author":"El-Boghdadly","year":"2022","journal-title":"Anaesthesia"},{"key":"2026010701520537000_12.1.e003149.28","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/pan.14585","article-title":"Postanesthesia complications in pediatric patients with previous SARS-CoV-2 infection: A cohort study","volume":"33","author":"Geng-Ramos","year":"2023","journal-title":"Paediatr Anaesth"},{"key":"2026010701520537000_12.1.e003149.29","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/ACO.0000000000000460","article-title":"An update on the perioperative management of children with upper respiratory tract infections","volume":"30","author":"Regli","year":"2017","journal-title":"Curr Opin Anaesthesiol"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2025-003149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T09:53:52Z","timestamp":1767779632000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2025-003149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,11,27]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bmjresp-2025-003149"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2025-003149","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}