Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19

Flemming, Sven; Hankir, Mohammed K.; Hering, Ilona; Meybohm, Patrick; Krone, Manuel; Weißbrich, Benedikt; Germer, Christoph T.; Wiegering, Armin

doi:10.1002/bjs.11713

Cited by 22 publications

(23 citation statements)

References 4 publications

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“…On the other hand, while reports on patients with cirrhosis and SARS-CoV-2 show a high rate of decompensation with ascites [10], viral etiology in this clinical scenario has not been very well described thus far. At the same time, viral RNA was not detected in samples of ascitic fluid from surgical patients according to previous studies [11,12], so it remains a matter demanding further investigation, especially because these reports present a small number of patients requiring emergency operations and no information regarding comorbidities or immune status.…”

Section: Discussionmentioning

confidence: 91%

“…At the same time, viral RNA was not detected in samples of ascitic fluid from surgical patients according to previous studies [ 11 , 12 ], so it remains a matter demanding further investigation, especially because these reports present a small number of patients requiring emergency operations and no information regarding comorbidities or immune status.…”

Section: Discussionmentioning

confidence: 94%

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Detected SARS-CoV-2 in Ascitic Fluid Followed by Cryptococcemia: a Case Report

Passarelli

Perosa

Luna

et al. 2020

SN Compr. Clin. Med.

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SARS coronavirus-2 (SARS-CoV-2) detection in different clinical specimens has raised important insights about its pathogenesis, but some details remain to be understood. In that respect, disrupt viral control seen in solid organ transplant patients on chronic immunosuppression can help unveil pathogenic mechanisms and characterize new coronavirus disease-19 (COVID-19) immunological and clinical aspects, as well as secondary complications. We herein report a case of SARS-CoV-2 detection in ascitic fluid from a kidney transplant patient with decompensated cirrhosis and COVID-19 and then discuss about immune, cellular, and virological aspects of such clinical presentation of the disease, which also included a disseminated infection, demonstrated by viral detection in his blood sample. We subsequently discuss about the fatal outcome caused by a secondary bloodstream infection by Cryptococcus neoformans. This unprecedented case report presents ascitic fluid as a novel specimen in which SARS-CoV-2 can be detected. Immune dysregulation and cumulative risk factors may lead to secondary infections by opportunistic agents, including Cryptococcus neoformans.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Detected SARS-CoV-2 in Ascitic Fluid Followed by Cryptococcemia: a Case Report

Passarelli

Perosa

Luna

et al. 2020

SN Compr. Clin. Med.

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“…Nonetheless, we implemented precautions in order to reduce the risk of SARS-CoV-2 transmission during surgery. It is still controversial whether peritoneal fluid of COVID-19 patients contain SARS-CoV-2, as only few studies report analysis of peritoneal fluid with discordant results [ 37 , 38 ]. Similarly, SARS-CoV-2 has never been identified in surgical smoke [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

The role of a pediatric tertiary care center in avoiding collateral damage for children with acute appendicitis during the COVID-19 outbreak

et al. 2020

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Purpose To evaluate the impact of the COVID-19 pandemic-related lockdown on management and outcomes of children with acute appendicitis. Methods A retrospective cohort study was conducted, including children treated for acute appendicitis (January 20th–May 11th, 2020). The data regarding the severity of appendicitis and outcome were collected and compared for two time periods, before and after the nationwide lockdown (March 17th, 2020). Results The number of cases of acute appendicitis increased by 77% during the lockdown ( n = 39 vs. n = 69, p = 0.03). During the lockdown, children treated for appendicitis were older (11.1 vs. 8.9 years, p = 0.003), and were more likely to live more than 5 km away from our institution (77% vs. 52%, p = 0.017). Less children had previously consulted a general practitioner (15% vs. 33%, p = 0.028), whereas more children were transferred from other hospitals (52% vs. 31%, p = 0.043). There was no difference in terms of length of hospital stay, rate of postoperative intra-abdominal abscess, ER visits, and readmissions between both periods. Three children (4%) were diagnosed with COVID-19 and appendicitis. Conclusions Despite an increase in the number of children with appendicitis managed at our hospital during the COVID-19-related lockdown, management, and outcome remained similar. Although our pediatric center was strongly affected by this pandemic, maintaining our prior practice strategies for acute appendicitis avoided the occurrence of collateral damage for those children.

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“…In the same way in the surgical theater is crucial that staff are properly trained and in particular they use appropriate tools and follow recommendations strictly to avoid increasing the risk of contamination. Both laparoscopic or open surgical procedures in fact, may potentially cause aerosolization of the virus and therefore infection of the personnel, probably even in absence of intestinal perforation or ischemia, due to presence of SARS-CoV-2 in peritoneal fluids [32][33][34][35]. The major concern is, however, the potential recurrence of the disease and persistent transmission from treated patients who meet discharge criteria with 2 sequential negative oropharyngeal swab tests collected 24 h apart since the clearance of viral RNA in patient stools is delayed as compared to oropharyngeal swabs.…”

Section: Discussionmentioning

confidence: 99%

Fecal-oral transmission of SARS-CoV-2: review of laboratory-confirmed virus in gastrointestinal system

Cuicchi

Lazzarotto

Poggioli

2020

Int J Colorectal Dis

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Purpose The objective was to collect the data available regarding the presence of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in gastrointestinal system and to evaluate whether the digestive system could contribute to viral transmission. Methods Bibliographic databases were searched to identify all studies documenting, in adult patients with a confirmed diagnosis of coronavirus disease 2019 (COVID-19): (1) the presence of SARS-CoV-2 ribonucleic acid in the feces; (2) the presence of SARS-CoV-2 ribonucleic acid in the intestinal cells; (3) live SARS-CoV-2 in the feces. Results Twenty seven met the inclusion criteria. In 26 studies, the presence or absence of SARS-CoV-2 ribonucleic acid in the feces of COVID-19 patients had been reported. Out of the 671 patients, 312 (46.5%) had a positive stool sample for viral nucleic acid. Of these patients, 63.9% remained positive for viral nucleic acid in the feces after pharyngeal swabs became negative; Three studies also evaluated the viral ribonucleic acid in the gastrointestinal tissues and the presence of SARS-CoV-2 nucleic acid was found in samples of 3 patients out of 8 examined (37.5%). The presence of the live virus in stool samples was confirmed in two studies but no in in a recent study from Germany. These results suggested that SARS-CoV-2 could infect gastrointestinal epithelial cells and it may be transmitted through the digestive tract. Conclusion In order to control the pandemic, every effort should be made to understand all the possible routes of transmission of the infections, even the less important ones. Keywords COVID-19. Feces. Fecal-oral transmission. Gastrointestinal system. Severe acute respiratory syndrome coronavirus 2 "Sed domus corporibus exanimis, itinera funeribus complebantur; non sexus, non aetas periculo vacua; servitia perinde et ingenua plebes raptim extingui, inter coniugum et liberorum lamenta, qui dum adsident, dum deflent, saepe eodem rogo cremabantur." Annales XVI, 13 Tacito "Yet the houses were filled with lifeless bodies, the streets with funerals. Neither sex nor age gave immunity from danger; slaves and the free-born populace alike were summarily cut down, amid the laments of their wives and children, who, themselves infected while tending or mourning the victims, were often burnt upon the same pyre." Annals Book XVI, 13 Tacitus * Dajana Cuicchi

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Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19

Cited by 22 publications

References 4 publications

Detected SARS-CoV-2 in Ascitic Fluid Followed by Cryptococcemia: a Case Report

Detected SARS-CoV-2 in Ascitic Fluid Followed by Cryptococcemia: a Case Report

The role of a pediatric tertiary care center in avoiding collateral damage for children with acute appendicitis during the COVID-19 outbreak

Fecal-oral transmission of SARS-CoV-2: review of laboratory-confirmed virus in gastrointestinal system

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