Postanesthesia complications in pediatric patients with previous SARS‐CoV‐2 infection: A cohort study

Background Children with SARS‐CoV‐2 infection are at increased risk for postanesthesia complications. There is minimal data regarding how long that elevated complication risk persists beyond initial SARS‐CoV‐2 diagnosis. Aims We investigated postanesthesia complications in children with SARS‐CoV‐2 infection within 90 days of diagnosis. Methods We completed a single‐center, retrospective, case–control study of pediatric patients with confirmed SARS‐CoV‐2 infection within 90 days undergoing anesthesia between January 3–October 7, 2020. Each SARS‐CoV‐2 positive patient was matched 1:2 by age and type of procedure with a non–SARS‐CoV‐2 cohort. The primary outcome was the rate of all postanesthesia complications within 30 days of the procedure, defined as unplanned escalations of care within 48 h, cardiac, respiratory, thrombotic, and hemorrhagic events within 30 days. Secondary outcomes were 30‐day mortality and hospital length of stay. Results Of the 341 patients included, 114 patients were SARS‐CoV‐2 positive and 227 were SARS‐CoV‐2 negative. Patients with a positive test 0–7 days prior to anesthesia had an increased risk difference in all postanesthesia complications within 30 days (19.9, 95% CI [4.7, 35.1], p = .001) and increased risk difference in length of hospital stay (7.8, 95% CI [1.2, 14.4], p