Swab test in biological fluids as predictor of COVID-19 transmission risk during surgery: A prospective cross-sectional study from an Italian COVID center

Abstract

Background. The contamination of body fluids by Severe Acute Respiratory Syndrome Coronavirus 2 during surgery is current matter of debate in the scientific literature concerning CoronaVIrus Disease 2019. Surgical guidelines were published during the first wave of the COVID-19 pandemic and recommended to avoid laparoscopic surgery as much as possible, in fear that the chimney effect of high flow intraperitoneal gas escape during, and after, the procedure would increase the risk of viral transmission.Aim. The aim of this study was to evaluate the possibility of SARS-CoV-2 transmission during surgery by searching for viral RNA in serial samplings of biological liquids.Methods. This is a single center prospective cross-sectional study. We used a real-time reverse transcriptase (RT) polymerase chain reaction (PCR) test to perform swab tests for the qualitative detection of nucleic acid from SARS-CoV-2 in abdominal fluids, during emergency surgery and on the first post-operative day. In the case of thoracic surgery, we performed a swab test of pleural fluids during chest drainage placement as well as on the first post-operative day. Results. A total of 20 samples were obtained: 5 from pleural fluids, 13 from peritoneal fluids and two from biliary fluid. All 20 swabs performed from biological fluids resulted negative for SARS-CoV-2 RNA detection.Conclusion. To date, there is no scientific evidence of possible contagion by laparoscopic aerosolization of SARS-CoV-2, neither is certain whether the virus is effectively present in biological fluids.

Evaluation of real and perceived risk to health care workers caring for patients with the Omicron variant of the SARS-CoV-2 virus in surgery and obstetrics

“…None of the surgical equipment samples for this study had tested positive (other than ETT, nasal probe), whereas, in our previous study, 2 of 11 samples from surgical equipment (scissors, clamps) had tested positive 14 . These low sample positivity rates align with findings of a study by Fabbri et.al that indicate that the transmission risk during surgery, specifically through aerosolization from the surgical field, is low 39 .…”

SARS-CoV-2 During Abdominal Operations: Are Surgeons at Risk?

“…15,16,34 Regardless, this should not be assumed as the rule as there have been other reports suggesting negative results in similar settings as well. 35,36 Agnes et al 37 reported a case similar to ours, where ascitic fluid was negative in a patient with a duodenal perforation, which may suggest that the virus be shed in the distal gastrointestinal tract by mechanisms not fully understood.…”

Swab test in biological fluids as predictor of COVID-19 transmission risk during surgery: a prospective cross-sectional study from an Italian COVID center

“…Our last hypothesis is that the virus could not be always present. In a recent article, we hypothesized that the possible presence of SARS-CoV-2 in the peritoneum may depend on the disease stage and the associated cytokine storm [ 31 ]. In the severe form of COVID-19, the hyperinflammation, manifesting with cytokine storming, can lead to a greater viremic spread and, in such cases, it is possible that the virus would cross the pleural/peritoneal membrane.…”