No SARS-CoV-2 detected in the vermiform appendix of a COVID-19 patient with appendicitis: a case report (preprint)

Background:SARS-CoV-2, the virus causing corona virus disease 2019 (COVID-19), has been demonstrated to infect the gastrointestinal tract and might therefore be a source of infection for the surgical team during abdominal operations. One of the most common surgical procedures performed is appendectomy. However, reports of virologic testing of appendiceal tissue specimens in COVID-19 patients are lacking. We sought to determine whether SARS-CoV-2 is present in the appendectomy specimen of a patient with COVID-19. Case presentation:A female patient presented to the emergency department of our tertiary care academic hospital with lower abdominal pain, fever, nausea, and vomiting. She was admitted to the gynecological floor because of suspected pelvic inflammatory disease. Due to worsening symptoms, a laparoscopy was performed the next day and a severely inflamed appendix was detected. Laparoscopic appendectomy was performed without complications. A few hours postoperatively, the patient was tested positive for corona virus disease 2019 (COVID 19). Real-time reverse transcription polymerase chain reaction analysis targeting the SARS-CoV-2 E-gene was performed on the appendectomy specimen. SARS-CoV-2 could not be detected. During her hospital stay, the patient developed mild respiratory symptoms while the postoperative course was otherwise uncomplicated. Conclusions:The absence of SARS-CoV-2 in the appendectomy specimen of our case adds to the preliminary available evidence indicating that appendectomy in COVID-19 patients with mild disease carries probably a low risk of infection by aerosols generated during the procedure. 

Ad hoc laboratory-based surveillance of SARS-CoV-2 by real-time RT-PCR using minipools of RNA prepared from routine respiratory samples (preprint)

We report a laboratory-based surveillance for SARS-CoV-2 using minipools of respiratory samples submitted for routine diagnostics. We tested a total of 70 minipools resembling 700 samples shortly before the upsurge of cases in Germany. We identified one SARS-CoV-2 positive patient. Our approach proved its concept, is easily adaptable and resource-saving.