Is minor surgery safe during the COVID-19 pandemic? A multi-disciplinary study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 16 03 2021
accepted: 20 04 2021
entrez: 11 5 2021
pubmed: 12 5 2021
medline: 25 5 2021
Statut: epublish

Résumé

To assess the risk of postoperative SARS-CoV-2 infection during the COVID-19 pandemic. The CONCEPTION study was a cohort, multidisciplinary study conducted at Conception University Hospital, in France, from March 17th to May 11th, 2020. Our study included all adult patients who underwent minor surgery in one of the seven surgical departments of our hospital: urology, digestive, plastic, gynecological, otolaryngology, gynecology or maxillofacial surgery. Preoperative self-isolation, clinical assessment using a standardized questionnaire, physical examination, nasopharyngeal RT-PCR and chest CT scan performed the day before surgery were part of our active prevention strategy. The main outcome was the occurrence of a SARS-CoV-2 infection within 21 days following surgery. The COVID-19 status of patients after discharge was updated during the postoperative consultation and to ensure the accuracy of data, all patients were contacted again by telephone. A total of 551 patients from six different specialized surgical Departments in our tertiary care center were enrolled in our study. More than 99% (546/551) of included patients underwent a complete preoperative Covid-19 screening including RT-PCR testing and chest CT scan upon admission to the Hospital. All RT-PCR tests were negative and in 12 cases (2.2%), preoperative chest CT scans detected pulmonary lesions consistent with the diagnosis criteria for COVID-19. No scheduled surgery was postponed. One patient (0.2%) developed a SARS-CoV-2 infection 20 days after a renal transplantation. No readmission or COVID-19 -related death within 30 days from surgery was recorded. Minor surgery remained safe in the COVID-19 Era, as long as all appropriate protective measures were implemented. These data could be useful to public Health Authorities in order to improve surgical patient flow during a pandemic.

Sections du résumé

BACKGROUND
To assess the risk of postoperative SARS-CoV-2 infection during the COVID-19 pandemic.
METHODS
The CONCEPTION study was a cohort, multidisciplinary study conducted at Conception University Hospital, in France, from March 17th to May 11th, 2020. Our study included all adult patients who underwent minor surgery in one of the seven surgical departments of our hospital: urology, digestive, plastic, gynecological, otolaryngology, gynecology or maxillofacial surgery. Preoperative self-isolation, clinical assessment using a standardized questionnaire, physical examination, nasopharyngeal RT-PCR and chest CT scan performed the day before surgery were part of our active prevention strategy. The main outcome was the occurrence of a SARS-CoV-2 infection within 21 days following surgery. The COVID-19 status of patients after discharge was updated during the postoperative consultation and to ensure the accuracy of data, all patients were contacted again by telephone.
RESULTS
A total of 551 patients from six different specialized surgical Departments in our tertiary care center were enrolled in our study. More than 99% (546/551) of included patients underwent a complete preoperative Covid-19 screening including RT-PCR testing and chest CT scan upon admission to the Hospital. All RT-PCR tests were negative and in 12 cases (2.2%), preoperative chest CT scans detected pulmonary lesions consistent with the diagnosis criteria for COVID-19. No scheduled surgery was postponed. One patient (0.2%) developed a SARS-CoV-2 infection 20 days after a renal transplantation. No readmission or COVID-19 -related death within 30 days from surgery was recorded.
CONCLUSIONS
Minor surgery remained safe in the COVID-19 Era, as long as all appropriate protective measures were implemented. These data could be useful to public Health Authorities in order to improve surgical patient flow during a pandemic.

Identifiants

pubmed: 33974628
doi: 10.1371/journal.pone.0251122
pii: PONE-D-21-08635
pmc: PMC8112651
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0251122

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Michael Baboudjian (M)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

Mehdi Mhatli (M)

Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France.
Department of Head and Neck Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France.

Adel Bourouina (A)

Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France.

Bastien Gondran-Tellier (B)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

Vassili Anastay (V)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

Lea Perez (L)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

Pauline Proye (P)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

Jean-Pierre Lavieille (JP)

Department of Head and Neck Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France.

Fanny Duchateau (F)

Department of Obstetrics and Gynecology, Conception Hospital, Marseilles, France.

Aubert Agostini (A)

Department of Obstetrics and Gynecology, Conception Hospital, Marseilles, France.

Yann Wazne (Y)

Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France.

Frederic Sebag (F)

Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France.

Jean-Marc Foletti (JM)

Department of Oral and maxillofacial Surgery, Aix Marseille University, APHM, IFSTTAR, LBA, Conception University Hospital, Marseilles, France.

Cyrille Chossegros (C)

Department of Oral and maxillofacial Surgery, Aix Marseille University, APHM, IFSTTAR, LBA, Conception University Hospital, Marseilles, France.

Didier Raoult (D)

Aix-Marseille University, IRD, AP-HM, IHU Méditerranée Infectious Disease Research Institute, Marseilles, France.

Julian Touati (J)

Department of Radiology, Conception University Hospital, APHM, Marseilles, France.

Christophe Chagnaud (C)

Department of Radiology, Conception University Hospital, APHM, Marseilles, France.

Justin Michel (J)

Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France.

Baptiste Bertrand (B)

Department of Plastic Surgery, Conception University Hospital, APHM, Marseilles, France.

Antoine Giovanni (A)

Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France.

Thomas Radulesco (T)

Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France.

Catherine Sartor (C)

Operational Hospital Hygiene Team, Conception University Hospital, Marseilles, France.

Pierre-Edouard Fournier (PE)

Aix-Marseille University, IRD, AP-HM, IHU Méditerranée Infectious Disease Research Institute, Marseilles, France.

Eric Lechevallier (E)

Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France.

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