Elective surgery in asymptomatic patients with undetected SARS-CoV-2 infection: lessons learned from the global operating room

• Published in: British Journal of Surgery Vol. 107; no. 10; pp. e399 - e400
• Main Authors: Bustos, S S, Bustos, V P, Nguyen, M-D T
• Format: Journal Article Web Resource
• Language: English
• Published: Chichester, UK Oxford University Press 01.09.2020; John Wiley & Sons, Ltd; John Wiley & Sons, Inc
• Subjects: Asymptomatic Diseases; Correspondence; COVID-19 - complications; COVID-19 - diagnosis; Elective surgery; Elective Surgical Procedures; Humans; Postoperative Complications - virology; Preoperative Care; Severe acute respiratory syndrome coronavirus 2
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.11843

[...]many surgical associations and national institutions recommend detection of SARS‐CoV‐2 infection before planned surgery1, 2. [...]difficulty in tracking asymptomatic patients due to the long incubation period from contact to diagnosis (from 8 to 24 days), overburdened pathology laboratories, and the variable false‐negative rates of SARS‐CoV‐2 RT‐PCR tests, represent a real challenge for screening patients prior to surgery. Reports on postoperative COVID‐19‐related complications in patients with undiagnosed SARS‐CoV‐2 infection who underwent elective surgeries Country Patients Median age, y (range) Sex Comorbidities Grade of surgerya a Based on Surgery grades – National Institute for Health and Care Excellence (NICE) guidelines Symptoms prior to surgery SARS‐CoV‐2 RT‐PCR prior to surgery Median time from surgery to symptoms onset, d (range) Required ICU Deaths Greece 3 1 70 F = 1 HTN, DM, glaucoma and obesity Major = 1 No No POD 3 0 0 China 4 34 55 (21 – 84) F= 20 M= 14 HTN = 13 Malignancy = 9 DM = 8 CVD = 7 CBVD = 2 COPD = 1 CKD = 1 Minor = 4 Intermediate = 1 Major = 29 No No POD 2 (1 – 4) 15 7 Iran 5 3b b This is a case series of four patients.