Rapidly fatal outcome of Covid-19 after successful emergency surgery during pandemic outbreak in Northern Italy
| Autor: | Renato Costi, Filippo Montali, Lorenzo Pagliai, Lorenzo Casali, Gerardo Palmieri |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Fatal outcome Coronavirus disease 2019 (COVID-19) Isolation (health care) SARS CoV-2 Pandemic outbreak Article 03 medical and health sciences 0302 clinical medicine Emergency surgery Pandemic medicine Intensive care medicine business.industry fungi Outbreak food and beverages COVID-19 Northern italy Respiratory failure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2020.06.073 |
| Popis: | Highlights • The first focus outside Asia of Coronavirus disease is Northern Italy. • Patients undergoing emergency surgery can develop SARS-CoV-2 more easily. • The outcome of these patients can be very poor despite a uneventful POD. • Early diagnosis of Covid-19 infection is essential to improve the prognosis and reduce the risk of contagion among hospital staff. Introduction A pandemic outbreak of novel coronavirus, named SARS-CoV-2 and responsible of Coronavirus Disease 2019 (COVID-19), has rapidly spread from China to Europe, being Northern Italy the first focus outside Asia. Little is known about the evolution of SARS-CoV-2 infection in patients undergoing surgery. Presentation of case Here we report the first confirmed case of early postoperative SARS-CoV-2 infection in a patient recovering after Hartmann’s procedure for acute diverticulitis. After an otherwise unevenful postoperative course, on post-operative day 8, the patient suddenly presented hyperpyrexia and cough, rapidly evolving to respiratory failure and death 36 h after symptoms onset. CT-scan identified bilateral, diffuse, interstitial pneumonitis and oropharyngeal swab test confirmed the presence of SARS-CoV-2. A previous contact with the partner, developing the same symptoms, remained unrecognized until ICU admission. Discussion During a pandemic outbreak, the early identification of SARS-CoV-2 infection of an inside patient initially considered to be infection-free has a pivotal importance not only for the prompt patient’s management, but also to avoid infection spreading to other patients and hospital personnel.In the reported case, a more precise information to the patient regarding the imperative necessity to inform the medical personnel of any person of his entourage presenting, at any time, any tell-tale sign, symptom or examination which may be attributed to COVID-19, may have had allowed to anticipate patient’s isolation and examinations and procedures aimed at identifying such an infection. Conclusion Persistent hyperleucocytosis and increased CRP serum level in spite of uneventful postoperative course were the only, aspecific markers of an ongoing SARS-CoV-2 infection before symptoms’ onset, and should be considered in future clinical practice in order to adopt the prompt and appropriate patient management and limit COVID-19 contagion in surgical units. |
| Databáze: | OpenAIRE |
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