Patients Evaluated before and after Surgery during the COVID-19 Outbreak: A Study from a Pandemic Hospital

Abstract

Background: This study aims to evaluate patients who tested positive for COVID-19 (Coronavirus Disease 2019) in the preoperative period while they were scheduled for surgery in a pandemic hospital and patients who were diagnosed with COVID-19 in the postoperative period as well. Materials and Method: A retrospective analysis was made on 420 patients who were planned to undergo surgery on March 11, 2020 (the beginning of the pandemic in our country) with a compulsory COVID-19 test in the preoperative evaluation. Among the patients examined, about 26 of them were found positive by the COVID PCR (polymerase chain reaction) test preoperative evaluation. 18 patients had a positive COVID PCR test after the operation. The recorded data included patient demographics, pre-op and post-op symptoms, laboratory and radiological findings, and a history of exposure to COVID-19. Results: We detected the additional disease in 88.6% of 44 evaluated patients, 25 men and 19 women. Symptoms were present in 50% of the patients. The most common symptoms were fever and cough. When postoperative and preoperative patients were compared, only fever symptoms were found to be statistically higher in patients with postoperative PCR positive. In terms of laboratory findings, lymphocyte level was statistically low and CRP (c- reactive protein) level was higher in postoperative patients. Conclusion: In the pre-op evaluation, there is no test or finding that ensures that the patient has not contracted COVID-19 for certain. It required a multidisciplinary assessment to minimize false-negative results. In the postoperative period, patients with positive COVID PCR test may have in-hospital contamination or transmission from patients’ relatives. Unnecessary hospital visits should be limited as much as possible.