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Bone Joint J ; 102-B(7): 807-810, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-265908


The transition from shutdown of elective orthopaedic services to the resumption of pre-COVID-19 activity presents many challenges. These include concerns about patient safety, staff safety, and the viability of health economies. Careful planning is necessary to allow patients to benefit from orthopaedic care in a safe and sustainable manner. Cite this article: Bone Joint J 2020;102-B(7):807-810.

Coronavirus Infections , Elective Surgical Procedures/standards , Orthopedic Procedures/standards , Pandemics , Pneumonia, Viral , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross Infection/etiology , Cross Infection/prevention & control , Hospital Units/organization & administration , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Postoperative Complications/etiology , Postoperative Complications/prevention & control
Surg Infect (Larchmt) ; 21(4): 301-308, 2020 May.
Article in English | MEDLINE | ID: covidwho-88662


Background: 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. Methods: Review and synthesis of pertinent English-language literature pertaining to COVID-19 infection among adult patients. Results: 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. Conclusions: 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.

Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Elective Surgical Procedures/standards , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Perioperative Care/standards , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Adult , Aerosols/adverse effects , Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Cross Infection/etiology , Cross Infection/prevention & control , Cross Infection/virology , Elective Surgical Procedures/adverse effects , Elective Surgical Procedures/methods , Health Facilities/standards , Humans , Infection Control/methods , Intraoperative Care/methods , Intraoperative Care/standards , Intubation, Intratracheal/adverse effects , Patient Safety/standards , Perioperative Care/methods , Pneumonia, Viral/complications
J Dig Dis ; 21(4): 199-204, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-42091


An epidemic of an acute respiratory syndrome caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, now known as coronavirus disease 2019 (COVID-19), beginning in December 2019, has attracted an intense amount of attention worldwide. As the natural history and variety of clinical presentations of this disease unfolds, extrapulmonary symptoms of COVID-19 have emerged, especially in the digestive system. While the respiratory mode of transmission is well known and is probably the principal mode of transmission of this disease, a possibility of the fecal-oral route of transmission has also emerged in various case series and clinical scenarios. In this review article, we summarize four different aspects in published studies to date: (a) gastrointestinal manifestations of COVID-19; (b) microbiological and virological investigations; (c) the role of fecal-oral transmission; and (d) prevention and control of SARS-CoV-2 infection in the digestive endoscopy room. A timely understanding of the relationship between the disease and the digestive system and implementing effective preventive measures are of great importance for a favorable outcome of the disease and can help climnicians to mitigate further transmission by taking appropriate measures.

Coronavirus Infections/transmission , Cross Infection/prevention & control , Digestive System Diseases , Endoscopy, Digestive System/standards , Gastroenterology/standards , Infection Control/standards , Pneumonia, Viral/transmission , Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Coronavirus Infections/virology , Cross Infection/etiology , Cross Infection/virology , Digestive System Diseases/diagnosis , Digestive System Diseases/etiology , Digestive System Diseases/microbiology , Digestive System Diseases/virology , Hospital Units/standards , Humans , Pandemics , Personal Protective Equipment/standards , Pneumonia, Viral/complications , Pneumonia, Viral/virology