Abstract
BackgroundPatients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission.MethodsThe screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded.ResultsOut of the study population (n = 657), 509 patients (77.5%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected.ConclusionThe implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.
Highlights
In response to the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), many surgical departments have had to indefinitely postpone semi-urgent and elective operations to accommodate the rising number of severely affected patients [1, 2]
We introduced a number of precautionary measures including standardized preoperative SARS-CoV-2 testing, establishment of COVID19 and non-COVID-19 areas and prioritization of operational interventions based on medical urgency and logistical resources [1]
During the observation period, 657 patients were admitted to our department with an average age of 59.93 ± 17.92 years and body mass index (BMI) of 26.82 ± 5.39 kg/m2, of whom 101 patients underwent emergency surgery and 61 patients received urgent non-surgical treatment
Summary
In response to the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), many surgical departments have had to indefinitely postpone semi-urgent and elective operations to accommodate the rising number of severely affected patients [1, 2]. Since the middle- to long-term consequences of postponing surgery in non-COVID-19 patients are presently unclear, specific containment and testing strategies are mandatory to ensure universally high-quality medical and surgical treatment while minimizing the risk of inhospital-acquired infections [1, 11]. Presented with this problem, we introduced a number of precautionary measures including standardized preoperative SARS-CoV-2 testing, establishment of COVID19 and non-COVID-19 areas (intensive care units, non-intensive care units, emergency rooms and operation rooms) and prioritization of operational interventions based on medical urgency and logistical resources (intensive care unit capacity for COVID-19 and nonCOVID-19 patients, personnel and material capacities) [1]. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission
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