Surgical Infection Society Guidance for Operative and Peri-Operative Care of Adult Patients Infected by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated viral infection (coronavirus disease 2019, COVID-19) is a virulent, contagious viral pandemic that is affecting populations worldwide. As with any airborne viral respiratory infection, surgical and non-surgical patients may be a...

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Bibliographic Details
Published in:	Surgical infections Vol. 21; no. 4; p. 301
Main Authors:	Heffernan, Daithi S, Evans, Heather L, Huston, Jared M, Claridge, Jeffrey A, Blake, David P, May, Addison K, Beilman, Greg S, Barie, Philip S, Kaplan, Lewis J
Format:	Journal Article
Language:	English
Published:	United States 01-05-2020
Subjects:	Adult Aerosols - adverse effects Betacoronavirus - isolation & purification Coronavirus Infections - complications Coronavirus Infections - prevention & control Coronavirus Infections - transmission COVID-19 Cross Infection - etiology Cross Infection - prevention & control Cross Infection - virology Elective Surgical Procedures - adverse effects Elective Surgical Procedures - methods Elective Surgical Procedures - standards Health Facilities - standards Humans Infection Control - methods Infection Control - standards Infectious Disease Transmission, Patient-to-Professional - prevention & control Intraoperative Care - methods Intraoperative Care - standards Intubation, Intratracheal - adverse effects Pandemics - prevention & control Patient Safety - standards Perioperative Care - methods Perioperative Care - standards Pneumonia, Viral - complications Pneumonia, Viral - prevention & control Pneumonia, Viral - transmission SARS-CoV-2 COVID-19 guidelines SARS-CoV-2 SIS pandemic virus infection
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Summary:	Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated viral infection (coronavirus disease 2019, COVID-19) is a virulent, contagious viral pandemic that is affecting populations worldwide. As with any airborne viral respiratory infection, surgical and non-surgical patients may be affected. Review and synthesis of pertinent English-language literature pertaining to COVID-19 infection among adult patients. COVID-19 disease that requires hospitalization results in critical illness approximately 25% of the time and requires mechanical ventilation with positive airway pressure. Acute kidney injury, a marked hypercoagulable state, and sometimes myocarditis can be features of COVID-19 in addition to the characteristic severe acute lung injury. Even if not among the most seriously afflicted, older patients with medical comorbidities are both predisposed to infection and risk increased morbidity and mortality, however, all persons presenting for surgical intervention should be suspected of infection (and thus transmissibility) even if asymptomatic. Although most elective surgery has been curtailed by administrative or governmental fiat, patients will still need urgent or emergency operative intervention for time-sensitive disease processes such as malignant neoplasia or for true emergencies such as perforated viscus or traumatic injury. It is possible to provide safe surgical care for SARS-CoV-2-positive patients and minimize nosocomial transmission to healthcare workers. This guidance will facilitate appropriate protection of patients and staff, and maintenance of infection control measures to assist surgical personnel and facilities to prepare for COVID-19-infected adult patients requiring urgent or emergent operative intervention and to provide optimal patient care.
ISSN:	1557-8674
DOI:	10.1089/sur.2020.101