Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic (original) (raw)
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Annals of Surgical Oncology, 2022
Background. Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission. Methods. This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days. Results. A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%.
Journal of Surgical Oncology, 2021
Background and Objectives: The COVID-19 pandemic, with high rate of asymptomatic infections and increased perioperative complications, prompted widespread adoption of screening methods. We analyzed the incidence of asymptomatic infection and perioperative outcomes in patients undergoing cancer surgery. We also studied the impact on subsequent cancer treatment in those with COVID-19. Methods: All patients who underwent elective and emergency cancer surgery from April to September 2020 were included. After screening for symptoms, a preoperative test was performed from nasopharyngeal and oropharyngeal swabs before the procedure. Patients were followed up for 30 days postoperatively and complications were noted. Results: 2108 asymptomatic patients were tested, of which 200 (9.5%) tested positive. Of those who tested positive, 140 (70%) underwent the planned surgery at a median of 30 days from testing positive, and 20 (14.3%) had ≥ Grade III complications. Forty (20%) patients did not receive the intended treatment; 110 patients were retested in the Postoperative period, and 41 (37.3%) tested positive and 9(22%) patients died of COVID-related complications. Conclusion: Routine preoperative testing for COVID-19 helps to segregate patients with asymptomatic infection. Higher complications occur in those who develop COVID-19 in postoperative period. Prolonged delay in surgery after COVID infection may influence planned treatment.
International Journal of Clinical Practice, 2023
Objectives. During coronavirus disease (COVID-19) pandemic, preoperative screening before thoracic surgery is paramount in order to protect patients and staf from undetected infections. Tis study aimed to determine which preoperative COVID-19 screening tool was the most efective strategy before thoracic surgery. Methods. Tis retrospective cohort multicenter study was performed at 3 Italian thoracic surgery centers. All adult patients scheduled for thoracic surgery procedures from 4th March until 24th April, 2020, and submitted to COVID-19 preoperative screenings were included. Te primary outcome was the yield of screening of the diferent strategies. Results. A total of 430 screenings were performed on 275 patients; 275 anamnestic questionnaires were administered. 77 patients were screened by an anamnestic questionnaire and reverse transcriptase polymerase chain reaction (RT-PCR). 78 patients were selected to combine screening with anamnestic questionnaire and chest computed tomography (CT). Te positive yield of screening using a combination of anamnestic questionnaire and RT-PCR was 7.8% (95% CI: 2.6-14.3), while using a combination of anamnestic questionnaire and chest CT was 3.8% (95% CI: 0-9). Individual yields were 1.1% (95% CI: 0-2.5) for anamnestic questionnaire, 5.2% (95% CI: 1.3-11.7) for RT-PCR, and 3.8% (95% CI: 0-9). Conclusions. Te association of anamnestic questionnaire and RT-PCR is able to detect around 8 positives in 100 asymptomatic patients. Tis combined strategy could be a valuable preoperative SARS-CoV-2 screening tool before thoracic surgery.
British Journal of Surgery, 2021
Preoperative real-time polymerase chain reaction (RT-PCR) testing has become widely used as a means of excluding SARS CoV-2 prior to elective surgery 1. Most data on preoperative patients have focused on SARS-CoV-2 detection, but without comprehensive follow-up of patients to assess the risk of transitioning to a COVID-19-positive status in the postoperative period 2. Among asymptomatic patients, an RT-PCR test may be falsely negative if performed too early in the disease incubation period 3. The authors wished to evaluate the outcome of preoperative RT-PCR testing prior to elective otolaryngological surgery, with systematic follow-up of all patients at 14 days, to capture cases transitioning to symptomatic COVID-19 in the postoperative period. A prospective cohort study was carried out at five sites in the Republic of Ireland. Ethical approval was granted by the National Research Ethics Committee (20-NREC-COV-087). Patients presenting for elective otolaryngology surgery from 2 September to 18 December 2020, with negative preoperative RT-PCR (AllplexTM 2019 nCoV Assay, Seegene Inc.) swabs, taken within 72 hours of hospital admission, were eligible for inclusion. Study data were collected prospectively and managed using the REDCap TM (Royal College of Surgeons, Ireland) electronic datacapture tool. Participants were contacted 14 days after surgery and answered a questionnaire. The 14-day community prevalence data were obtained from the Health Surveillance Protection Centre. The primary outcome measure was a postoperative
Journal of Surgical Oncology, 2021
Background: There are limited data on surgical complications for patients that have delayed surgery after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to analyze the surgical outcomes of patients submitted to surgery after recovery from SARS-CoV-2 infection. Methods: Asymptomatic patients that had surgery delayed after preoperative reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 were matched in a 1:2 ratio for age, type of surgery and American Society of Anesthesiologists to patients with negative RT-PCR for SARS-CoV-2. Results: About 1253 patients underwent surgical procedures and were subjected to screening for SARS-CoV-2. Forty-nine cases with a delayed surgery were included in the coronavirus disease (COVID) recovery (COVID-rec) group and were matched to 98 patients included in the COVID negative (COVID-neg) group. Overall, 22 (15%) patients had 30-days postoperative complications, but there was no statistically difference between groups-16.3% for COVID-rec and 14.3% for COVID-neg, respectively (odds ratio [OR] 1.17:95% confidence interval [CI] 0.45-3.0; p = .74). Moreover, we did not find difference regarding grades more than or equal to 3 complication rates-8.2% for COVID-rec and 6.1% for COVID-neg (OR 1.36:95%CI 0.36-5.0; p = .64). There were no pulmonary complications or SARS-CoV-2 related infection and no deaths within the 30-days after surgery.
NATIONAL JOURNAL OF LABORATORY MEDICINE
Introduction: Pre-surgical screening of patients for COVID-19 by Reverse transcription-Polymerase Chain Reaction (RT-PCR) is essential before surgeries as a precautionary measure in view of preventing COVID-19 to the health care workers. The inception of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS- COV-2) posed major hurdles and challenges in conducting elective surgeries. Considering that COVID-19 is expected to continue to be a problem for the public health system in the near future, institutions will need to create risk mitigation strategies with meticulous resource management especially in high burden centers. Aim: To assess the role and need of repeat RT-PCR testing after an initial negative at a tertiary care center in view of the ever changing dynamics of COVID-19. Materials and Methods: A retrospective observational study was conducted at the Mobile Virology Research & Diagnostic Laboratory in the Department of Microbiology, ESIC Medical College & Hospital, Hyderab...