¿Is there a really a need for preoperative PCR testing for COVID-19? Preliminary experience of an ENT Department
Article Sidebar
Main Article Content
Abstract
Introduction: The 2019 novel coronavirus disease (COVID-19) has changed global surgical activity causing massive elective surgery postponement. Current evidence surrounding surgical outcomes after otorhinolaryngological surgical procedures during COVID-19 pandemic is limited.
Objective: To describe our surgical experience during COVID-19 outbreak in an otolaryngology department in Bogotá, Colombia.
Methods: This retrospective study analysed the records and surgical information of adults and children’s patients who underwent an elective or emergency ENT surgery during COVID-19 outbreak at two hospitals between May 5 to August 15, 2020 in Bogotá, Colombia.
Results: A total of 199 patients were enrolled. (122 males, median age of 28 years). No patients died or required intensive unit care (ICU). Elective surgery represented the 97.5% surgeries. 19.5% patients had COVID-19 related symptoms in the postoperative period, from the tested patients only one obtained a positive COVID-19 polymerase chain reaction (PCR) test result and did not develop any associated respiratory complication. Six patients developed complications after surgery, and one had pneumonia with a negative COVID-19 PCR nasopharyngeal swab result.
Conclusions: This study shows that despite the high exposure to droplets during otorhinolaryngologic surgeries and the inherent high transmissibility from the virus, the surgical procedures with correct patient selection and appropriate use of PPE can be safe for both the patient and the otolaryngologist.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Este artículo es publicado por la Revista Acta de Otorrinolaringología & Cirugía de Cabeza y Cuello.
Este es un artículo de acceso abierto, distribuido bajo los términos de la LicenciaCreativeCommons Atribución-CompartirIgual 4.0 Internacional.( http://creativecommons.org/licenses/by-sa/4.0/), que permite el uso no comercial, distribución y reproducción en cualquier medio, siempre que la obra original sea debidamente citada.
eISSN: 2539-0856
ISSN: 0120-8411
References
Otoya AM, García-Chabur MA, Jaramillo C, Wills C, Campos AM. COVID-19: Generalidades, comportamiento epidemiológico y medidas adoptadas en medio de la pandemia en Colombia. Acta otorrinolaringol. cir. cabeza cuello.
;48(1):79-92. doi: 10.37076/acorl.v48i1.519
Ministerio del Interior de Colombia. [Internet]. Decreto número 636 de 2020 (2020). [Consultado el 12 de mayo de 2020].
Disponible en: https://dapre.presidencia.gov.co/normativa/normativa/DECRETO%20636%20DEL%206%20DE%20 MAYO%20DE%202020.pdf
Organización Mundial de la Salud (OMS). [Internet]. COVID-19:cronología de la actuación de la OMS. OMS; 27 de abril de
[Consultado el 13 de mayo de 2020]. Disponible en: https://www.who.int/es/news-room/detail/27-04-2020-whotimeline---covid-19
Barrios AJ, Prieto R, Torregrosa L, Álvarez C, HernándezJD, González LG, et al . Volver a empezar: cirugía electiva
durante la pandemia del SARS-CoV2. Recomendaciones desde la Asociación Colombiana de Cirugía. rev. colomb. cir.
;35(2):302-21. doi: 10.30944/20117582.656
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries
during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331. doi: 10.1016/j.eclinm.2020.100331
Gammeri E, Cillo GM, Sunthareswaran R, Magro T. Is a “COVID-19-free” hospital the answer to resuming elective
surgery during the current pandemic? Results from the first available prospective study. Surgery. 2020;168(4):572-77. doi:
1016/j.surg.2020.07.003
SaluData. Observatorio de Bogotá [Internet]. Porcentaje Ocupación de Unidades de Cuidado Intensivo – UCI para la
atención de COVID-19 en Bogotá D.C. [Consultado el 20 de julio de 2020]. Disponible en: http://saludata.saludcapital.gov.
co/osb/index.php/datos-de-salud/enfermedades-trasmisibles/ocupacion-ucis/
Prachand VN, Milner R, Angelos P, Posner MC, Fung JJ, Agrawal N, et al. Medically Necessary, Time-Sensitive Procedures:
Scoring System to Ethically and Efficiently Manage Resource Scarcity and Provider Risk During the COVID-19 Pandemic.
J Am Coll Surg. 2020;231(2):281-88. doi: 10.1016/j.jamcollsurg.2020.04.011
Maza-Solano JM, Plaza-Mayor G, Jiménez-Luna A, Parente-Arias P, Amor-Dorado JC. Strategies for the practice of
otolaryngology and head and neck surgery during the monitoring phase of COVID-19. Acta Otorrinolaringol Esp (Engl Ed).
;71(6):367-78. doi: 10.1016/j.otorri.2020.05.001
Zarrintan S. Surgical operations during the COVID-19 outbreak: Should elective surgeries be suspended? Int J Surg. 2020;78:5-6. doi: 10.1016/j.ijsu.2020.04.005
Pulido MA, Silva- Rueda R, Mora-Diaz C. Recomendaciones en rinología, cirugía endoscópica nasal y cirugía de base de cráneo en tiempos de COVID-19. Acta otorrinolaringol cir cabeza cuello [Internet]. 7 de mayo de 2020 [citado 26 de septiembre de 2021];48(1):72 -78. Disponible en: https://revista.acorl.org.co/index.php/acorl/article/view/505
Asociación Colombiana de Otorrinolaringología (ACORL), Asociación Colombiana de Otología y Neurotología (ACON) y Sociedad Colombiana de Cirugía Plástica Facial y Rinología (SCCPFR). [Internet].Comunicado oficial conjunto COVID-19. 2020. [Consultado el 12 de mayo de 2020]. Disponible en: acorl.org.co/resources/ archivos_varios/comunicado%20conjunto%20covid%2019%20v1.pdf
Patel ZM, Fernandez-Miranda J, Hwang PH, Nayak JV, Dodd R, Sajjadi H, Jackler RK. Letter: Precautions for Endoscopic
Transnasal Skull Base Surgery During the COVID-19 Pandemic. Neurosurgery. 2020;87(1):E66-E67. doi: 10.1093/
neuros/nyaa125
The Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) [Internet]. Guidance for ENT surgeons
during the COVID-19 pandemic. [Consultado el 26 de octubre de 2020]. Disponible en: https://asohns.org.au/About-Us/
COVID-19#7122493-guidance-for-ent-surgeons-during-thecovid-19-pandemic---20-march
Mick P, Murphy R. Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the
COVID-19 pandemic: a literature review. J Otolaryngol Head Neck Surg. 2020;49(1):29. doi: 10.1186/s40463-020-00424-7
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of
Infected Patients. N Engl J Med. 2020;382(12):1177-79. doi:10.1056/NEJMc2001737
COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to
inform surgical recovery plans. Br J Surg. 2020;107(11):1440-49. doi: 10.1002/bjs.11746
Prieto-Rivera J, Martínez H, Socha M, Franco CF, Macías-Tolosa C. Recomendaciones para el uso de equipos de protección personal (EPP), desinfección de instrumentos, equipos y superficies en consulta y procedimientos otorrinolaringológicos. Acta otorrinolaringol. cir. cabeza cuello. 2020;48(Supl.1):27-36. doi: 10.37076/acorl.v48i1.495
Organización Mundial de la Salud (OMS). [Internet]. WHO Coronavirus (COVID-19) Dashboard. [Consultado el 26 de
octubre de 2020]. Disponible en: https://covid19.who.int/
Organización Mundial de la Salud (OMS). [Internet]. WHO Coronavirus Disease (COVID-19) Dashboard. Situation by
Country, Territory & Area. [Consultado el 26 de octubre de 2020]. Disponible en: https://covid19.who.int/table
Ministerio de Salud y Protección Social de Colombia. [Internet]. Situación actual: nuevo Coronavirus (COVID-19). 2020.
[Consultado el 20 de febrero de 2021]. Disponible en: https://www.minsalud.gov.co/salud/publica/PET/Paginas/Covid-19_
copia.aspx
Kisser U, Kufeldt J, Adderson-Kisser C, Becker S, Baumeister P, Reiter M, et al. Clinical impact of malnutrition on complication rate and length of stay in elective ENT patients: a prospective cohort study. Eur Arch Otorhinolaryngol. 2016;273(8):2231-7.doi: 10.1007/s00405-016-3974-9
Neto AS, da Costa LGV, Hemmes SNT, Canet J, Hedenstierna G, Jaber S, et al. The LAS VEGAS risk score for prediction
of postoperative pulmonary complications: An observational study. Eur J Anaesthesiol. 2018;35(9):691-701. doi: 10.1097/
EJA.0000000000000845
COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with
perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396(10243):27-38. doi: 10.1016/S0140-
(20)31182-X