COVID patients encountered by a general surgeon- 6 unique scenarios.

Abstract

Background and Objectives :With rising demand of surgical interventions post lockdown due to Corona Virus Infectious Disease(COVID)-19, surgeons need to restart their surgical practice shortly. To increase caution and safety, six scenarios in which a surgeon may encounter COVID patients are hereby highlighted in the present study.Patients and Methods:A hospital based case series analysis of eight surgical patients admitted in past two months was done. Clinical and radiological records of these patients were studied separately and concluded consensually by two surgeons.Results:Six unique scenarios were identified:1. COVID positive patient, with concurrent surgical pathology.2. COVID positive patient incidentally diagnosed with additional surgical pathology.3. A solely surgical patient mimicking COVID positive symptomatology.4. A COVID negative surgical patient acquiring nosocomial COVID infection postoperatively.5. COVID positive surgical patient with false negative COVID report.6. COVID suspected by intraoperative COVID specific intestinal findings and then getting postoperative COVID test positive for the patient.Interpretations:· Deferrable surgeries to be avoided· A stringent institutional protocol for all patients is the essence of current surgical practice.· Minimal surgical or radiological intervention should be sought whenever possible.· The bias towards COVID, should not let us miss a surgical pathology in patients mimicking COVID clinically.· The possibility of a false negative COVID test, should be kept in mind in patients with typical COVID like symptomatology.· Immunocompromised surgical patients susceptible to nosocomial COVID infections should be dealed with extra caution and precaution.