Surgery and COVID-19: Balancing the nosocomial risk a french academic center experience during the epidemic peak

Ingels, Alexandre; Bibas, Steeven; Costa, José Batista da; Attias, Arié; Brunetti, F; Angelis, Nicola De; Desgranges, Pascal; Flouzat-Lachaniette, Charles-Henri; Folliguet, Thierry; Ivanov, Todor; Langeron, Olivier; Lelde, L.; Levesque, Éric; Corvoisier, Philippe Le; Marmorat, C.; Melendugno, F.; Méningaud, Jean-Paul; Mesli, Farida; Paillusson, W.; Palfi, Stéphane; Pedre, L.; Somacale, D.; Champy, C.; Taille, Alexandre de la

doi:10.1002/bjs.11841

Cited by 6 publications

(8 citation statements)

References 5 publications

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“…There is a growing international literature on nosocomial SARS-CoV-2 infection, from single ward or department reports, [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] to hospital-wide studies, [24] , [25] , [26] but only one (from Malta) based on limited national surveillance data. 27 The lull between phases of the pandemic in Europe has allowed prospective studies to be planned, but these have yet to report.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated COVID-19 in England: A national data linkage study

Bhattacharya

Collin

Stimson

et al. 2021

Journal of Infection

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Objectives : Nosocomial transmission was an important aspect of SARS-CoV-1 and MERS-CoV outbreaks. Healthcare-associated SARS-CoV-2 infection has been reported in single and multi-site hospital-based studies in England, but not nationally. Methods : Admission records for all hospitals in England were linked to SARS-CoV-2 national test data for the period 01/03/2020 to 31/08/2020. Case definitions were: community-onset community-acquired, first positive test <14 days pre-admission, up to day 2 of admission; hospital-onset indeterminate healthcare-associated, first positive on day 3-7; hospital-onset probable healthcare-associated, first positive on day 8-14; hospital-onset definite healthcare-associated, first positive from day 15 of admission until discharge; community-onset possible healthcare-associated, first positive test ≤14 days post-discharge. Results : One-third (34.4%, 100,859/293,204) of all laboratory-confirmed COVID-19 cases were linked to a hospital record. Hospital-onset probable and definite cases represented 5.3% (15,564/293,204) of all laboratory-confirmed cases and 15.4% (15,564/100,859) of laboratory-confirmed cases among hospital patients. Community-onset community-acquired and community-onset possible healthcare-associated cases represented 86.5% (253,582/293,204) and 5.1% (14,913/293,204) of all laboratory-confirmed cases, respectively. Conclusions : Up to 1 in 6 SARS-CoV-2 infections among hospitalised patients with COVID-19 in England during the first 6 months of the pandemic could be attributed to nosocomial transmission, but these represent less than 1% of the estimated 3 million COVID-19 cases in this period.

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Section: Discussionmentioning

confidence: 99%

Healthcare-associated COVID-19 in England: A national data linkage study

Bhattacharya

Collin

Stimson

et al. 2021

Journal of Infection

View full text Add to dashboard Cite

show abstract

“…There is a growing international literature on nosocomial SARS-CoV-2 infection, from single ward or department reports, 15-23 to hospital-wide studies, 24-26 but only one (from Malta) based on limited national surveillance data. 27 The lull between phases of the pandemic in Europe has allowed prospective studies to be planned, but these have yet to report.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated COVID-19 in England: a national data linkage study

Bhattacharya¹,

Collin²,

Stimson³

et al. 2021

Preprint

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Objectives: Nosocomial transmission was an important aspect of SARS-CoV-1 and MERS-CoV outbreaks. Healthcare-associated SARS-CoV-2 infection has been reported in single and multi-site hospital-based studies in England, but not nationally. Methods: Admission records for all hospitals in England were linked to SARS-CoV-2 national test data for the period 01/03/2020 to 31/08/2020. Case definitions were: community-onset community-acquired (CO.CA), first positive test (FPT) <14 days pre-admission, up to day 2 of admission; hospital-onset indeterminate healthcare-associated (HO.iHA), FPT on day 3-7; hospital-onset probable healthcare-associated (HO.pHA), FPT on day 8-14; hospital-onset definite healthcare-associated (HO.HA), FPT from day 15 of admission until discharge; community-onset possible healthcare-associated (CO.pHA), FPT ≤14 days post-discharge. Results: One-third (34.4%, 100,859/293,204) of all laboratory-confirmed COVID-19 cases were linked to a hospital record. HO.pHA and HO.HA cases represented 5.3% (15,564/293,204) of all laboratory-confirmed cases and 15.4% (15,564/100,859) of laboratory-confirmed cases among hospital patients. CO.CA and CO.pHA cases represented 86.5% (253,582/293,204) and 5.1% (14,913/293,204) of all laboratory-confirmed cases, respectively. Conclusions: Up to 1 in 6 SARS-CoV-2 infections among hospitalised patients with COVID-19 in England during the first 6 months of the pandemic could be attributed to nosocomial transmission, but these represent less than 1% of the estimated 3 million COVID-19 cases in this period.

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“…Vaccination programs and treatment protocols continue to advance, but disease-related hospital admissions remain high. COVID-19 poses significant risk to both patients and hospital staff [4][5][6][7]. There are very few evidence-based guidelines currently published by surgical societies that provide recommendations regarding the surgical management of the COVID-19 patients.…”

Section: Description Of the Health Problemsmentioning

confidence: 99%

SAGES 2022 guidelines regarding the use of laparoscopy in the era of COVID-19

et al. 2022

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Background SARS-CoV-2 has changed global healthcare since the pandemic began in 2020. The safety of minimally invasive surgery (MIS) utilizing insufflation from the standpoint of safety to the operating room personnel is currently being explored. The aims of this guideline are to examine the existing evidence to provide guidance regarding MIS for the patient with, or suspecting of having, the SARS-CoV-2 as well as the healthcare team involved. Methods Systematic literature reviews were conducted for 2 key questions (KQ) regarding the safety of MIS in the setting of COVID-19 pandemic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria. Evidence-based recommendations were formulated using a narrative synthesis of the literature by subject experts. Recommendations for future research were also proposed. ResultsIn KQ1, a total of 1361 articles were reviewed, with 2 articles meeting inclusion. In KQ2, a total of 977 articles were reviewed, with 4 articles met inclusions criteria, of which 2 studies reported on the SARS-CoV2 virus specifically. Despite many publications in the field, very little well-controlled and unbiased data exist to inform the recommendations. Of that which is available, it shows that both laparoscopic and open operations in Covid-positive patients had similar rates of OR staff positivity rates; however, patients who underwent laparoscopic procedures had a lower perioperative mortality than open procedures. Also, SARS-CoV-2 particles have been detected in the surgical plume at laparoscopy. Conclusion With demonstrated equivalence of operating room staff exposure, and noninferiority of laparoscopic access with respect to mortality, either laparoscopic or open approaches to abdominal operations may be used in patients with SARS-CoV-2. Measures should be employed for all laparoscopic or open cases to prevent exposure of operating room staff to the surgical plume, as virus can be present in this plume.

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Surgery and COVID-19: Balancing the nosocomial risk a french academic center experience during the epidemic peak

Cited by 6 publications

References 5 publications

Healthcare-associated COVID-19 in England: A national data linkage study

Healthcare-associated COVID-19 in England: A national data linkage study

Healthcare-associated COVID-19 in England: a national data linkage study

SAGES 2022 guidelines regarding the use of laparoscopy in the era of COVID-19

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