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Positive peritoneal swab in SARS-CoV-2 patients undergoing abdominal emergency surgery: effect or cause?
Tartaglia, Dario; Barberis, Andrea; Coccolini, Federico; Pistello, Mauro; Rutigliani, Mariangela; Chiarugi, Massimo.
  • Tartaglia D; General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy. dario.tartaglia@unipi.it.
  • Barberis A; Department of Abdominal Surgery, General and Hepatopancreatobiliary Surgery Unit, Galliera Hospital, Genoa, Italy.
  • Coccolini F; General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
  • Pistello M; Virology Unit, Pisa University Hospital, Pisa, Italy.
  • Rutigliani M; Department of Laboratory and Service, Histological and Anatomical Pathology, E.O. Galliera Hospital, Genoa, Italy.
  • Chiarugi M; General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
Infection ; 50(4): 989-993, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1943467
ABSTRACT

PURPOSE:

The presence of the SARS-CoV-2 in the peritoneal fluid is a matter of debate in the COVID-19 literature. The study aimed to report the prevalence of SARS-CoV-2 in the peritoneal fluid of patients with nasopharyngeal swab tested positive for SARS-CoV-2 undergoing emergency surgery and review the literature.

METHODS:

The present study was conducted between March 2020 and June 2021. Diagnosis of SARS-CoV-2 positivity was confirmed by preoperative real-time reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTS:

Eighteen patients with positive nasopharyngeal swabs were operated in emergency in two third-level Italian hospitals. In 13 of these patients (72%), a peritoneal swab was analyzed SARS-CoV-2 RNA was found in the abdominal fluid of two patients (15%). Neither of them had visceral perforation and one patient died. In ten patients with negative peritoneal swabs, visceral perforation and mortality rates were 30% and 20%, respectively.

CONCLUSION:

SARS-CoV-2 peritoneal positivity is rare. Abdominal surgery can, therefore, be safely performed in patients with COVID-19 using standard precautions. The correlation with a visceral perforation is not evaluable. The clinical outcomes seem uninfluenced by the viral colonization of the peritoneum. Assessment in large series to provide definitive answers about the involvement of the SARS-CoV-2 in the peritoneum will be challenging to coordinate.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Infection Year: 2022 Document Type: Article Affiliation country: S15010-022-01785-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Infection Year: 2022 Document Type: Article Affiliation country: S15010-022-01785-z