COVID-19 Infection after Major Head and Neck Oncologic Surgery.

Abstract

Besides the possibility of post-admission nosocomial transmissions, we have to maintain a high index of suspicion even when the reverse transcriptase-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome-related coronavirus 2 is negative among patients admitted for major surgery as false negativity to the tune of 30 to 40% is still possible.[1] A gentleman aged 66 years with cancer of the left buccal mucosa (yT4aN3b M0), post-neoadjuvant chemotherapy with two courses of methotrexate, was admitted on May 5, 2021 for radical surgery after negative coronavirus disease 2019 (COVID-19) tests, that is, the rapid antigen test (RAT) and RT-PCR. However, he had a stormy postoperative course leading to death, the root cause of which was tracked down to a plausible nosocomial transmission of COVID-19 infection or initial false-negative COVID-19 tests despite all our relentless efforts to prevent such an event. His repeat COVID-19 test with RAT turned positive on the 7th postoperative day, and the high-resolution computed tomogram (HRCT) scan showed features of COVID-19 infested lungs.