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Pathologica ; 112(4): 174-177, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1022379


Up to now, Italy is one of the European centers with the most active Coronavirus cases with 233,836 positive cases and 33,601 total deaths as of June 3rd. During this pandemic and dramatic emergency, Italian hospitals had also to face neoplastic pathologies, that still afflict the Italian population, requiring urgent surgical and oncological treatment. In our Cancer Center Hospital, the high volume of surgical procedures have demanded an equally high volume of intraoperative pathological examinations, but also posed an additional major challenge for the safety of the staff involved. The current commentary reports our experience in the past two months (since March 9th) for a total of 1271 frozen exams from 893 suspect COVID-19 patients (31 confirmed).

Containment of Biohazards/standards , Intraoperative Care/standards , Pandemics , Pathology/standards , /epidemiology , Humans , Intraoperative Care/statistics & numerical data , Italy/epidemiology , Middle Aged , Pathology/statistics & numerical data
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