Acute care surgery and post-operative COVID-19 care: a comment.

Dear Editor,

We found the study by Lepre et al. to be very interesting. Lepre et al. concluded that ‘active surveillance with a liberal use of reverse transcriptase‐polymerase chain reaction test and thoracic computed tomography scan is required in this setting, to rule out coronavirus disease 2019 (COVID‐19) infection, in an effort to offer prompt treatment to infected patients and to protect other patients and health workers’. We agree that it is necessary to have a good preparedness for any surgery during the present COVID‐19 outbreak. In our setting, Thailand, the second country in the timeline of COVID‐19 pandemic, the surgeon's COVID‐19 infection is already recorded by local Center of Disease Control. In addition, the asymptomatic COVID‐19 patient who received the first diagnosis of disease after the surgical procedure was completed has already been reported. An interesting consideration is whether the present prevention is sufficient.

Lepre et al. recommended the method based on the case with respiratory symptoms. Nevertheless, the asymptomatic COVID‐19 patient might undergo surgery and can transmit the disease to the surgeon. How to manage the asymptomatic case is a challenge. It is questionable whether we have to use preoperational COVID‐19 test for all patients. Nevertheless, a simple method according to universal precautions should be used in the clinical care of any patient in the present situation of COVID‐19 outbreak.