COVID-19 Outbreak and Surgical Practice

Aminian, Ali; Safari, Sepideh; Razeghian-Jahromi, Abdolali; Ghorbani, Mohammad; Delaney, Conor P.

doi:10.1097/sla.0000000000003925

Cited by 348 publications

(214 citation statements)

References 6 publications

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“…that compared with other complications, post-operative COVID-19 led to longer hospital stay and more frequent need for mechanical ventilation in the post-operative period. These results agree with previously published studies [2][3][4]. The one-month mortality did not differ substantially between COVID-19 and non-COVID-19 patients, but it is possible that the younger age of the first group in our cohort may have been a protective factor.…”

Section: Covid-19 and Recent Operations 419supporting

confidence: 93%

“…In the post-operative period, COVID-19 may also be associated with a poorer prognosis [2][3][4] because of factors such as general anesthesia and mechanical ventilation, blood loss/transfusion, and systemic inflammatory response syndrome associated with aggressive surgical management [5]. The diagnosis can also be challenging because symptoms of COVID-19 may be attributed to other common postoperative conditions.…”

mentioning

confidence: 99%

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COVID-19 in Post-Operative Patients: Imaging Findings

Molière

Veillon

2020

Surgical Infections

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Background: Coronavirus 2019 in the post-operative period is challenging. Its clinical manifestations may have similarities to other septic, thoracic, or gastrointestinal post-surgical complications. Additionally, the post-operative period may be a time of increased risk for severe manifestations of COVID-19. We sought to evaluate the frequency of COVID-19 in a cohort of patients who had recently had operations who were undergoing imaging for acute symptoms and the role of chest computed tomography (CT) in this setting. Patients and Methods:We included all patients who had chest CT for acute symptoms in the 15 days after a surgical procedure between March 1 and 31, 2020. Results: Of 46 patients with acute post-operative symptoms requiring chest imaging, eight (17%) were ultimately diagnosed with COVID-19. Among them, five (62%) required mechanical ventilation and two (25%) died. All had abnormal chest CT with typical findings of COVID-19 in 87%. Computed tomography provided an alternate diagnosis in 53% of patients who did not have COVID-19. The average time between a COVID-19-positive chest CT and the polymerase chain reaction (PCR) confirmation was 1.2 days (range, 0-4 days).

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Section: Covid-19 and Recent Operations 419supporting

confidence: 93%

mentioning

confidence: 99%

COVID-19 in Post-Operative Patients: Imaging Findings

Molière

Veillon

2020

Surgical Infections

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“…También desde este mismo día en el Servicio de Cirugía General del Hospital Universitario La Paz se suspendieron todas las reuniones presenciales y se realizaron los comités multidisciplinares de forma telemática. Así mismo se suspendieron las intervenciones quirúrgicas programadas por patología benigna (10) , se cancelaron las consultas no oncológicas del servicio y se extremaron las medidas de precaución entre el personal sanitario y administrativo del hospital.…”

Section: Discussionunclassified

Impacto de la pandemia por SARS-CoV-2 sobre la actividad y profesionales de un Servicio de Cirugía General y del Aparato Digestivo en un hospital terciario

et al. 2020

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“…Where there is wide community spread of COVID-19, deferring elective surgery is highly recommended. The Iranian series by Aminian et al [1] speaks about COVID-19 complicating the perioperative course with diagnostic challenges and a high potential post-operative fatality. The other approach would be to screen everyone planned for elective surgery; however, this is a very resource and labor intense process and even then, may not be fool-proof as there are varying reports on the sensitivity, specificity, positive predictive value and negative predictive values of the available COVID-19 tests.…”

Section: Wide Community Spread Vs Limited Spread/ Recovery Phasementioning

confidence: 99%

ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases

et al. 2020

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Background The COVID-19 pandemic has resulted in significant changes to surgical practice across the worlds. Some countries are seeing a tailing down of cases, while others are still having persistent and sustained community spread. These evolving disease patterns call for a customized and dynamic approach to the selection, screening, planning, and for the conduct of surgery for these patients. Methods The current literature and various international society guidelines were reviewed and a set of recommendations were drafted. These were circulated to the Governors of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA) for expert comments and discussion. The results of these were compiled and are presented in this paper. Results The recommendations include guidance for selection and screening of patients in times of active community spread, limited community spread, during times of sporadic cases or recovery and the transition between phases. Personal protective equipment requirements are also reviewed for each phase as minimum requirements. Capability management for the re-opening of services is also discussed. The choice between open and laparoscopic surgery is patient based, and the relative advantages of laparoscopic surgery with regard to complications, and respiratory recovery after major surgery has to be weighed against the lack of safety data for laparoscopic surgery in COVID-19 positive patients. We provide recommendations on the operating room set up and conduct of general surgery. If laparoscopic surgery is to be performed, we describe circuit modifications to assist in reducing plume generation and aerosolization. Conclusion The COVID-19 pandemic requires every surgical unit to have clear guidelines to ensure both patient and staff safety. These guidelines may assist in providing guidance to units developing their own protocols. A judicious approach must be adopted as surgical units look to re-open services as the pandemic evolves.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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COVID-19 Outbreak and Surgical Practice

Cited by 348 publications

References 6 publications

COVID-19 in Post-Operative Patients: Imaging Findings

COVID-19 in Post-Operative Patients: Imaging Findings

Impacto de la pandemia por SARS-CoV-2 sobre la actividad y profesionales de un Servicio de Cirugía General y del Aparato Digestivo en un hospital terciario

ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases

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