Table 1.
Survey questions and results. CRP, C-reactive protein; PCR, polymerase chain reaction; VTE, venous thromboembolism. n(%): number of answers (% over 28 clinicians); %: sum of answers of agreements (strong+slight)/no agreement or disagreement/disagreements (strong+slight)/no opinion.
| Strong agreement |
Slight agreement |
No agreement or disagreement |
Slight disagreement |
Strong disagreement |
No opinion | |
|---|---|---|---|---|---|---|
| Agreement | Unsure | Disagreement | ||||
| 1. Patients after COVID-19 have an increased thromboembolic risk for at least ONE month from the time of PCR normalisation/neutralisation | ||||||
| n (%) | 16 (57.1) | 4 (14.3) | 5 (17.9) | 2 (7.1) | 1 (3.6) | 0 (0) |
| % | 71.4 | 17.9 | 10.7 | 0 | ||
| 2. Patients after COVID-19 have an increased thromboembolic risk for at least THREE months from the time of PCR normalisation/neutralisation | ||||||
| n (%) | 6 (21.4) | 8 (28.6) | 5 (17.9) | 5 (17.9) | 3 (10.7) | 1 (3.6) |
| % | 50.0 | 17.9 | 28.6 | 3.6 | ||
| 3. Patients after COVID-19 have an increased thromboembolic risk for at least SIX months from the time of PCR normalisation/neutralisation | ||||||
| n (%) | 1 (3.6) | 4 (14.3) | 9 (32.1) | 2 (7.1) | 7 (25.0) | 5 (17.9) |
| % | 20.9 | 32.1 | 32.1 | 17.9 | ||
| 4. Patients with moderate or severe COVID-19 experience a higher thromboembolic risk | ||||||
| n (%) | 22 (78.6) | 2 (7.1) | 2 (7.1) | 0 (0) | 1 (3.6) | 1 (3.6) |
| % | 85.7 | 7.1 | 3.6 | 3.6 | ||
| 5. Because of thromboembolic risk after COVID-19, non-oncologic elective surgery should be deferred for at least ONE month from the time of PCR normalisation/neutralisation, if no contraindications are present | ||||||
| n (%) | 16 (57.1) | 6 (21.4) | 1 (3.6) | 3 (10.7) | 2 (7.1) | 0 (0) |
| % | 78.5 | 3.6 | 17.8 | 0 | ||
| 6. Because of thromboembolic risk after COVID-19, non-oncologic elective surgery should be deferred for at least THREE months from the time of PCR normalisation/neutralisation, if no contraindications are present | ||||||
| n (%) | 4 (14.3) | 7 (25.0) | 3 (10.7) | 4 (14.3) | 8 (28.6) | 2 (7.1) |
| % | 39.3 | 10.7 | 42.9 | 7.1 | ||
| 7. Because of thromboembolic risk after COVID-19, non-oncologic elective surgery should be deferred for at least SIX months from the time of PCR normalisation/neutralisation, if no contraindications are present | ||||||
| n (%) | 0 (0) | 2 (7.1) | 6 (21.4) | 6 (21.4) | 12 (42.9) | 2 (7.1) |
| % | 7.1 | 21.4 | 64.3 | 7.1 | ||
| 8. Because of thromboembolic risk after COVID-19, non-oncologic elective surgery should NOT be deferred after PCR normalisation/neutralisation | ||||||
| n (%) | 3 (10.7) | 2 (7.1) | 4 (14.3) | 8 (18.6) | 9 (32.1) | 2 (7.1) |
| % | 17.8 | 14.3 | 50.7 | 7.1 | ||
| 9. A preoperative assessment of patients with prior or ongoing COVID-19 should include D-dimer measurement for VTE risk stratification | ||||||
| n (%) | 14 (50) | 4 (14.3) | 1 (3.6) | 3 (10.7) | 6 (21.4) | 0 (0) |
| % | 64.3 | 3.6 | 32.1 | 0 | ||
| 10. A preoperative D-dimer level higher than 1000 ng ml−1 preoperatively implies a higher thrombotic risk | ||||||
| n (%) | 7 (25.0) | 12 (42.9) | 3 (10.7) | 3 (10.7) | 2 (7.1) | 1 (3.6) |
| % | 67.9 | 10.7 | 17.8 | 3.6 | ||
| 11. Would you consider other markers such as interleukin-6, ferritin, or CRP to evaluate the inflammatory status in the preoperative exam? | ||||||
| n (%) | 4 (14.3) | 9 (32.1) | 3 (10.7) | 3 (10.7) | 7 (25.0) | 2 (7.1) |
| % | 46.4 | 10.7 | 35.7 | 7.1 | ||
| 12. Unless contraindicated, all patients after COVID-19 should receive pharmacological thromboprophylaxis postoperatively, when a surgery is performed during the first 6 months post-PCR normalisation/neutralisation | ||||||
| n (%) | 13 (46.4) | 4 (14.3) | 3 (10.7) | 3 (10.7) | 3 (10.7) | 2 (7.1) |
| % | 60.7 | 10.7 | 21.4 | 7.1 | ||
| 13. Hospitalised patients with COVID-19 who were receiving anticoagulant therapy with a direct oral anticoagulant or vitamin K antagonist should be switched to low-molecular-weight heparin | ||||||
| n (%) | 16 (57.1) | 3 (10.7) | 5 (17.9) | 3 (10.7) | 0 (0) | 1 (3.6) |
| % | 67.8 | 17.9 | 10.7 | 3.6 | ||
| 14. If a surgery is performed when the patient is at higher thromboembolic risk after COVID-19, the pharmacological thromboprophylaxis (low-molecular-weight heparin) dose should be increased over standard prophylaxis to an intermediate dose (100 IU kg−1 day−1) | ||||||
| n (%) | 10 (35.7) | 10 (35.7) | 4 (14.3) | 1 (3.6) | 3 (10.7) | 0 (0) |
| % | 71.4 | 14.3 | 14.3 | 0 | ||
| 15. If a surgery is performed when the patient is at higher thromboembolic risk after COVID-19, the pharmacological thromboprophylaxis duration should be increased with a factor of 1.5 | ||||||
| n (%) | 10 (35.7) | 7 (25.0) | 5 (17.9) | 1 (3.6) | 4 (14.3) | 1 (3.6) |
| % | 60.7 | 17.9 | 17.9 | 3.6 | ||
| 16. When a surgery is performed during the period of higher thromboembolic risk after COVID-19, mechanical thromboprophylaxis (intermittent pneumatic compression) should be used in addition to pharmacological thromboprophylaxis up to resuming ambulation, if not contraindicated | ||||||
| n (%) | 16 (57.1) | 5 (17.9) | 4 (14.3) | 1 (3.6) | 2 (7.1) | 0 (0) |
| % | 75.0 | 14.3 | 10.7 | 0 | ||