Postoperative Nosocomial COVID-19 Infection in Cardiac Surgery: An Uncommon Event With High Mortality Rate

Ridwan, Khalid; DeVarennes, Benoît; Tchervenkov, Christo I.; Shum‐Tim, Dominique; Cecere, Renzo; Lachapelle, Kevin

doi:10.1016/j.cjco.2021.05.017

Cited by 3 publications

(4 citation statements)

References 5 publications

(3 reference statements)

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“…Vaccination programs and treatment protocols continue to advance, but disease-related hospital admissions remain high. COVID-19 poses significant risk to both patients and hospital staff [4][5][6][7]. There are very few evidence-based guidelines currently published by surgical societies that provide recommendations regarding the surgical management of the COVID-19 patients.…”

Section: Description Of the Health Problemsmentioning

confidence: 99%

SAGES 2022 guidelines regarding the use of laparoscopy in the era of COVID-19

et al. 2022

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Background SARS-CoV-2 has changed global healthcare since the pandemic began in 2020. The safety of minimally invasive surgery (MIS) utilizing insufflation from the standpoint of safety to the operating room personnel is currently being explored. The aims of this guideline are to examine the existing evidence to provide guidance regarding MIS for the patient with, or suspecting of having, the SARS-CoV-2 as well as the healthcare team involved. Methods Systematic literature reviews were conducted for 2 key questions (KQ) regarding the safety of MIS in the setting of COVID-19 pandemic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria. Evidence-based recommendations were formulated using a narrative synthesis of the literature by subject experts. Recommendations for future research were also proposed. ResultsIn KQ1, a total of 1361 articles were reviewed, with 2 articles meeting inclusion. In KQ2, a total of 977 articles were reviewed, with 4 articles met inclusions criteria, of which 2 studies reported on the SARS-CoV2 virus specifically. Despite many publications in the field, very little well-controlled and unbiased data exist to inform the recommendations. Of that which is available, it shows that both laparoscopic and open operations in Covid-positive patients had similar rates of OR staff positivity rates; however, patients who underwent laparoscopic procedures had a lower perioperative mortality than open procedures. Also, SARS-CoV-2 particles have been detected in the surgical plume at laparoscopy. Conclusion With demonstrated equivalence of operating room staff exposure, and noninferiority of laparoscopic access with respect to mortality, either laparoscopic or open approaches to abdominal operations may be used in patients with SARS-CoV-2. Measures should be employed for all laparoscopic or open cases to prevent exposure of operating room staff to the surgical plume, as virus can be present in this plume.

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Section: Description Of the Health Problemsmentioning

confidence: 99%

SAGES 2022 guidelines regarding the use of laparoscopy in the era of COVID-19

et al. 2022

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“…15 Similarly, a lower frequency of nosocomial COVID-19, ranging from 0% to 1.4%, has been described. 16,17 However, studies from Wuhan and London in 2020 reported a higher proportion (12.3% and 11%, respectively) of patients presumed to have nosocomial COVID-19. 5,11 The lower frequency in this study could be explained by several reasons.…”

Section: Resultsmentioning

confidence: 99%

“…In some studies, the length of stay for patients with nosocomial SARS-CoV-2 infection has ranged from 2.2 to 52 days. 15,16,18 However, comparisons with patients without nosocomial COVID-19 have not been described. In a study conducted in a stroke/neurology ward in the United Kingdom, Jewkes stated that the mean age of cases with nosocomial COVID-19 was 75 years.…”

Section: Resultsmentioning

confidence: 99%

Nosocomial Transmission of SARS CoV-2 in a Tertiary Care Hospital in Peshawar, Pakistan

Mahmood,

Rahim,

Amin

et al. 2023

J Gandhara Med Dent Sci

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Objective The study aimed to determine the frequency of nosocomial transmission of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) in a tertiary care hospital in Peshawar, Pakistan. Methodology This cross sectional, analytical study was carried out in Hayatabad Medical Complex, Peshawar, Pakistan from 1st June 2021 to 31st August 2021. Consecutive patients aged 18 years and above admitted for conditions other than COVID-19 with a negative rapid antigen test for COVID-19 at admission were included. Patients with respiratory symptoms or those who were hospitalized for any reason in the preceding six weeks in any health care facility were excluded. The study protocol was completed by 90.9% of participants. The rapid antigen test was repeated for participants at the time of discharge or symptoms suggestive of COVID-19. Patients with a positive rapid antigen test for COVID-19 either at the time of discharge or symptom onset were considered to have acquired nosocomial SARS-CoV-2 infection. Statistical Package for the Social Sciences version 21 for Windows was used for data analysis. Results The frequency of nosocomial transmission of SARS-CoV-2 was 2.7% (13/482). Patients with nosocomial COVID-19 stayed longer in the hospital than those who tested negative (7.5±4.0 versus 4.8±3.6 days; p=0.006). Age (p=0.796), gender (p=0.453), department of inpatient stay (p=0.943), major surgery (p=0.678), minor surgery (p=0.576), and visit to the radiology department (p=0.707) did not affect nosocomial spread of SARS-CoV-2. Conclusion Nosocomial transmission of COVID-19 was infrequent, accounting for 2.7% of participants in this study.

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“…2 patients required admission to the ICU and subsequently died. Wound dehiscence and mediastinitis occurred in a patient who stayed in the hospital for 52 days [ 8 ]. Silveira et al report a case of coronary artery bypass surgery tested positive for COVID-19 on POD 9.…”

Section: Discussionmentioning

confidence: 99%