Daithi S Heffernan1,2, Heather L Evans3, Jared M Huston4, Jeffrey A Claridge5, David P Blake6,7, Addison K May8, Greg S Beilman9, Philip S Barie10,11, Lewis J Kaplan12,13. 1. Department of Surgery, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA. 2. Division of Trauma and Surgical Critical Care, Department of Surgery, Brown University/Rhode Island Hospital, Providence, Rhode Island, USA. 3. Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA. 4. Departments of Surgery and Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA. 5. Division of Trauma, Critical Care, Burns & Acute Care Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA. 6. Department of Surgery, Division of Trauma/Surgical Critical Care, Inova Medical Group, Inova Fairfax Medical Campus, Falls Church, Virginia, USA. 7. Department of Surgery, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, Maryland, USA. 8. Division of Acute Care Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA. 9. Division of General Surgery/Critical Care Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA. 10. Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Weill Cornell Medicine, New York, New York, USA. 11. Division of Medical Ethics, Weill Cornell Medicine, New York, New York, USA. 12. Division of Trauma, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 13. Society of Critical Care Medicine, Mount Prospect, Illinois, USA.
Abstract
Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated viral infection (coronavirus disease 2019, COVID-19) is a virulent, contagious viral pandemic that is affecting populations worldwide. As with any airborne viral respiratory infection, surgical and non-surgical patients may be affected. Methods: Review and synthesis of pertinent English-language literature pertaining to COVID-19 infection among adult patients. Results: COVID-19 disease that requires hospitalization results in critical illness approximately 25% of the time and requires mechanical ventilation with positive airway pressure. Acute kidney injury, a marked hypercoagulable state, and sometimes myocarditis can be features of COVID-19 in addition to the characteristic severe acute lung injury. Even if not among the most seriously afflicted, older patients with medical comorbidities are both predisposed to infection and risk increased morbidity and mortality, however, all persons presenting for surgical intervention should be suspected of infection (and thus transmissibility) even if asymptomatic. Although most elective surgery has been curtailed by administrative or governmental fiat, patients will still need urgent or emergency operative intervention for time-sensitive disease processes such as malignant neoplasia or for true emergencies such as perforated viscus or traumatic injury. It is possible to provide safe surgical care for SARS-CoV-2-positive patients and minimize nosocomial transmission to healthcare workers. Conclusions: This guidance will facilitate appropriate protection of patients and staff, and maintenance of infection control measures to assist surgical personnel and facilities to prepare for COVID-19-infected adult patients requiring urgent or emergent operative intervention and to provide optimal patient care.
Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated viral infection (coronavirus disease 2019, COVID-19) is a virulent, contagious viral pandemic that is affecting populations worldwide. As with any airborne viral respiratory infection, surgical and non-surgical patients may be affected. Methods: Review and synthesis of pertinent English-language literature pertaining to COVID-19infection among adult patients. Results:COVID-19 disease that requires hospitalization results in critical illness approximately 25% of the time and requires mechanical ventilation with positive airway pressure. Acute kidney injury, a marked hypercoagulable state, and sometimes myocarditis can be features of COVID-19 in addition to the characteristic severe acute lung injury. Even if not among the most seriously afflicted, older patients with medical comorbidities are both predisposed to infection and risk increased morbidity and mortality, however, all persons presenting for surgical intervention should be suspected of infection (and thus transmissibility) even if asymptomatic. Although most elective surgery has been curtailed by administrative or governmental fiat, patients will still need urgent or emergency operative intervention for time-sensitive disease processes such as malignant neoplasia or for true emergencies such as perforated viscus or traumatic injury. It is possible to provide safe surgical care for SARS-CoV-2-positive patients and minimize nosocomial transmission to healthcare workers. Conclusions: This guidance will facilitate appropriate protection of patients and staff, and maintenance of infection control measures to assist surgical personnel and facilities to prepare for COVID-19-infected adultpatients requiring urgent or emergent operative intervention and to provide optimal patient care.
Authors: Philip S Barie; Vanessa P Ho; Catherine J Hunter; Elinore J Kaufman; Mayur Narayan; Fredric M Pieracci; Sebastian D Schubl; Daithi S Heffernan; Jared M Huston Journal: Surg Infect (Larchmt) Date: 2021-02-25 Impact factor: 1.853
Authors: Nurcihan Aygun; Yalin Iscan; Murat Ozdemir; Selen Soylu; Oguz Ugur Aydin; Ismail Cem Sormaz; Ahmet Cem Dural; Nuri Alper Sahbaz; Serkan Teksoz; Ozer Makay; Ali Ugur Emre; Mehmet Haciyanli; Recep Gokhan Icoz; Yasemin Giles; Adnan Isgor; Mehmet Uludag; Fatih Tunca Journal: Sisli Etfal Hastan Tip Bul Date: 2020-06-16