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Cizmic A, Eichel VM, Weidner NM, Wise PA, Müller F, Rompen IF, Bartenschlager R, Schnitzler P, Nickel F, Müller-Stich BP. Viral load of SARS-CoV-2 in surgical smoke in minimally invasive and open surgery: a single-center prospective clinical trial. Sci Rep 2023; 13:20299. [PMID: 37985848 PMCID: PMC10662446 DOI: 10.1038/s41598-023-47058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
At the beginning of the COVID-19 pandemic, it was assumed that SARS-CoV-2 could be transmitted through surgical smoke generated by electrocauterization. Minimally invasive surgery (MIS) was targeted due to potentially higher concentrations of the SARS-CoV-2 particles in the pneumoperitoneum. Some surgical societies even recommended open surgery instead of MIS to prevent the potential spread of SARS-CoV-2 from the pneumoperitoneum. This study aimed to detect SARS-CoV-2 in surgical smoke during open and MIS. Patients with SARS-CoV-2 infection who underwent open surgery or MIS at Heidelberg University Hospital were included in the study. A control group of patients without SARS-CoV-2 infection undergoing MIS or open surgery was included for comparison. The trial was approved by the Ethics Committee of Heidelberg University Medical School (S-098/2021). The following samples were collected: nasopharyngeal and intraabdominal swabs, blood, urine, surgical smoke, and air samples from the operating room. An SKC BioSampler was used to sample the surgical smoke from the pneumoperitoneum during MIS and the approximate surgical field during open surgery in 15 ml of sterilized phosphate-buffered saline. An RT-PCR test was performed on all collected samples to detect SARS-CoV-2 viral particles. Twelve patients with proven SARS-CoV-2 infection underwent open abdominal surgery. Two SARS-CoV-2-positive patients underwent an MIS procedure. The control group included 24 patients: 12 underwent open surgery and 12 MIS. One intraabdominal swab in a patient with SARS-CoV-2 infection was positive for SARS-CoV-2. However, during both open surgery and MIS, none of the surgical smoke samples showed any detectable viral particles of SARS-CoV-2. The air samples collected at the end of the surgical procedure showed no viral particles of SARS-CoV-2. Major complications (CD ≥ IIIa) were more often observed in SARS-CoV-2 positive patients (10 vs. 4, p = 0.001). This study showed no detectable viral particles of SARS-CoV-2 in surgical smoke sampled during MIS and open surgery. Thus, the discussed risk of transmission of SARS-CoV-2 via surgical smoke could not be confirmed in the present study.
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Affiliation(s)
- Amila Cizmic
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vanessa M Eichel
- Department of Infectious Diseases, Section Infection Control University Hospital Heidelberg, Heidelberg, Germany
| | - Niklas M Weidner
- Department of Infectious Diseases, Virology, Heidelberg University, Heidelberg, Germany
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp A Wise
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Müller
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Ingmar F Rompen
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Ralf Bartenschlager
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Paul Schnitzler
- Department of Infectious Diseases, Virology, Heidelberg University, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Beat P Müller-Stich
- Department of Digestive Surgery, University Digestive Healthcare Center Basel, Kleinriehenstrasse 30, 4058, Basel, Switzerland.
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Wang QX, Wang J, Wu RK, Li YL, Yao CJ, Xie FJ, Xiong Q, Feng PM. The safety of digestive tract cancer surgery during COVID-19: A living systematic review and meta-analysis. Asian J Surg 2023; 46:4138-4151. [PMID: 36967345 PMCID: PMC10027963 DOI: 10.1016/j.asjsur.2023.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/23/2022] [Accepted: 03/08/2023] [Indexed: 03/24/2023] Open
Abstract
Surgery is the primary curative treatment of solid cancers. However, its safety has been compromised by the outbreak of COVID-19. Therefore, it is necessary to evaluate the safety of digestive tract cancer surgery in the context of COVID-19. We used the Review Manager software (v.5.4) and Stata software (version 16.0) for meta-analysis and statistical analysis. Sixteen retrospective studies involving 17,077 patients met the inclusion criteria. The data indicates that performing digestive tract cancer surgery during the COVID-19 pandemic led to increased blood loss(MD = -11.31, 95%CI:-21.43 to -1.20, P = 0.03), but did not increase postoperative complications(OR = 1.03, 95%CI:0.78 to1.35, P = 0 0.86), anastomotic leakage (OR = 0.96, 95%CI:0.52 to1.77, P = 0 0.89), postoperative mortality (OR = 0.65, 95%CI:0.40 to1.07, P = 0 0.09), number of transfusions (OR = 0.74, 95%CI:0.30 to 1.80, P = 0.51), number of patients requiring ICU care(OR = 1.37, 95%CI:0.90 to 2.07, P = 0.14), postoperative 30-d readmission (OR = 0.94, 95%CI:0.82 to 1.07, P = 0 0.33), total hospital stay (MD = 0.11, 95%CI:-2.37 to 2.59, P = 0.93), preoperative waiting time(MD = - 0.78, 95%CI:-2.34 to 0.79, P = 0.33), postoperative hospital stay(MD = - 0.44, 95%CI:-1.61 to 0.74, P = 0.47), total operation time(MD = -12.99, 95%CI:-28.00 to 2.02, P = 0.09) and postoperative ICU stay (MD = - 0.02, 95%CI:-0.62 to 0.57, P = 0.94). Digestive tract cancer surgery can be safely performed during the COVID-19.
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Affiliation(s)
- Qiu-Xiang Wang
- Department of Traditional Chinese Medicine, The Central Hospital of Guangyuan City, Sichuan Province, China; Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Juan Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Rui-Ke Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Yi-Lin Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Cheng-Jiao Yao
- Department of Geriatrics of the Affiliated Hospital, North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Feng-Jiao Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Qin Xiong
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Pei-Min Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
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Erdem D, Kayaaslan B, Cakir EY, Dinc B, Asilturk D, Kirca F, Segmen F, Turan IO, Guner R. Investigation of SARS-CoV-2 using RT-PCR in vaginal swab samples of female patients with a diagnosis of severe COVID-19. Taiwan J Obstet Gynecol 2023; 62:270-274. [PMID: 36965894 PMCID: PMC9729648 DOI: 10.1016/j.tjog.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE It is important to determine the presence of SARS-CoV-2 in the vaginal fluid samples of reproductive-aged women with severe disease during the acute stage of the disease and to determine the risks of transmission by sexual or vertical transmission. MATERIAL AND METHODS Adult women with confirmed severe COVID-19 who were admitted to Ankara City Hospital intensive care unit (ICU) between December 1st, 2020, and January 1st, 2021, were enrolled in the study. Vaginal swab samples were collected within 48 h in the ICU using Dacron or rayon swabs and tested for SARS-CoV-2 using reverse transcription real-time polymerase chain reaction (RT PCR). RESULTS Thirty women of reproductive age were included in the study, five (16.7%) of whom were pregnant. The mean age was 44.9 (±10.5) years. The most common symptoms were headache (100%), muscle soreness (86.7%), cough (76.7%), fever (60%), and nausea and vomiting (20%). Nineteen (63.3%) patients had underlying medical conditions. The time interval from obtaining vaginal swab samples to admission to the ICU was 48 h. The time between vaginal sampling and PCR positivity ranged from 2 to 18 days. SARS-CoV-2 was not detected in any vaginal samples. CONCLUSION Our study showed that women with severe COVID-19 did not have SARS-CoV-2 in their vaginal fluids. Investigation of the presence of SARS-CoV-2 in vaginal secretions may help in determining the risks of sexual transmission and vertical transmission from mother to baby. Information on this subject is still limited. Larger studies on comprehensive biological samples are needed.
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Affiliation(s)
- Deniz Erdem
- Department of Intensive Care Unıt, Univeristy of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Infectious Disease and Clinical Microbiology, Ankara Yildırım Beyazit University, Ankara City Hospital, Ankara, Turkey
| | | | - Bedia Dinc
- Department of Medical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Asilturk
- Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Fisun Kirca
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Fatih Segmen
- Department of Intensive Care Unıt, Ankara City Hospital, Ankara, Turkey
| | - Isil Ozkocak Turan
- Department of Intensive Care Unıt, Univeristy of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Infectious Disease and Clinical Microbiology, Ankara Yildırım Beyazit University, Ankara City Hospital, Ankara, Turkey
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Wang Q, Ma J, Zhang L, Xie L. Diagnostic performance of corona virus disease 2019 chest computer tomography image recognition based on deep learning: Systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31346. [PMID: 36281129 PMCID: PMC9592148 DOI: 10.1097/md.0000000000031346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To analyze the diagnosis performance of deep learning model used in corona virus disease 2019 (COVID-19) computer tomography(CT) chest scans. The included sample contains healthy people, confirmed COVID-19 patients and unconfirmed suspected patients with corresponding symptoms. METHODS PubMed, Web of Science, Wiley, China National Knowledge Infrastructure, WAN FANG DATA, and Cochrane Library were searched for articles. Three researchers independently screened the literature, extracted the data. Any differences will be resolved by consulting the third author to ensure that a highly reliable and useful research paper is produced. Data were extracted from the final articles, including: authors, country of study, study type, sample size, participant demographics, type and name of AI software, results (accuracy, sensitivity, specificity, ROC, and predictive values), other outcome(s) if applicable. RESULTS Among the 3891 searched results, 32 articles describing 51,392 confirmed patients and 7686 non-infected individuals met the inclusion criteria. The pooled sensitivity, the pooled specificity, positive likelihood ratio, negative likelihood ratio and the pooled diagnostic odds ratio (OR) is 0.87(95%CI [confidence interval]: 0.85, 0.89), 0.85(95%CI: 0.82, 0.87), 6.7(95%CI: 5.7, 7.8), 0.14(95%CI: 0.12, 0.16), and 49(95%CI: 38, 65). Further, the AUROC (area under the receiver operating characteristic curve) is 0.94(95%CI: 0.91, 0.96). Secondary outcomes are specific sensitivity and specificity within subgroups defined by different models. Resnet has the best diagnostic performance, which has the highest sensitivity (0.91[95%CI: 0.87, 0.94]), specificity (0.90[95%CI: 0.86, 0.93]) and AUROC (0.96[95%CI: 0.94, 0.97]), according to the AUROC, we can get the rank Resnet > Densenet > VGG > Mobilenet > Inception > Effficient > Alexnet. CONCLUSIONS Our study findings show that deep learning models have immense potential in accurately stratifying COVID-19 patients and in correctly differentiating them from patients with other types of pneumonia and normal patients. Implementation of deep learning-based tools can assist radiologists in correctly and quickly detecting COVID-19 and, consequently, in combating the COVID-19 pandemic.
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Affiliation(s)
- Qiaolan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Jingxuan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Luoning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Linshen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
- *Correspondence: Linshen Xie, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China (e-mail: )
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Brandão P, Pellicer A, Meseguer M, Remohí J, Garrido N, García-Velasco JA. COVID-19 mRNA vaccines have no effect on endometrial receptivity after euploid embryo transfer. Reprod Biomed Online 2022; 45:688-695. [PMID: 35803877 PMCID: PMC9148433 DOI: 10.1016/j.rbmo.2022.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTION Does the COVID-19 vaccination affect endometrial receptivity after single euploid embryo transfer, measured by sustained implantation rate? DESIGN A retrospective cohort study analysing two groups of single euploid embryo transfers using own oocytes: one historical cohort of 3272 transfers 1 year before the pandemic; and one comprising 890 transfers in women previously vaccinated with mRNA vaccines against severe acute respiratory syndrome coronavirus 2. The main outcomes were clinical pregnancy rate (CPR) and sustained implantation rate (SIR) per embryo transfer. These outcomes were compared between non-vaccinated and vaccinated women, and women who had received one and two doses. Lastly, vaccinated women were divided into quartiles according to the time from last dose to embryo transfer. RESULTS Similar CPR and SIR were found between non-vaccinated and vaccinated women, and the odds ratio for both outcomes was not statistically significant after being controlled for potential confounders (OR 0.937, 95% CI 0.695 to 1.265 and OR 0.910, 95% CI 0.648 to 1.227 respectively). Within the vaccinated group, women who had received one or two doses also had similar outcomes. In addition, no differences were found according to the time interval from vaccination to embryo transfer. CONCLUSION The administration of mRNA vaccines against COVID-19 had no effect on endometrial receptivity and embryo implantation, regardless of the number of doses and time interval from vaccination to embryo transfer. The potential negative effect of the vaccine on endometrial receptivity and reproductive outcomes is reassuring for patients in the process of undergoing assisted reproductive treatment.
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Affiliation(s)
- Pedro Brandão
- Department of Reproductive Medicine, IVIRMA Lisboa, H 1- 9ª, Avenida Infante Dom Henrique 333, Lisbon 1800-282, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal.
| | - Antonio Pellicer
- Department of Reproductive Medicine, IVIRMA Roma, Largo Ildebrando Pizzetti, 1/Piano 1 Interno 2, Rome 00197, Italy; IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain, Avenida Fernando Abril Martorell, 106 - Biopolo, Torre A, Planta 1ª, Valencia 46026, Spain
| | - Marcos Meseguer
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain, Avenida Fernando Abril Martorell, 106 - Biopolo, Torre A, Planta 1ª, Valencia 46026, Spain; Department of Reproductive Medicine, IVIRMA Valencia, Plaza de la Policia Local 3, Valencia 46015, Spain
| | - José Remohí
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain, Avenida Fernando Abril Martorell, 106 - Biopolo, Torre A, Planta 1ª, Valencia 46026, Spain; Department of Reproductive Medicine, IVIRMA Valencia, Plaza de la Policia Local 3, Valencia 46015, Spain
| | - Nicolás Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain, Avenida Fernando Abril Martorell, 106 - Biopolo, Torre A, Planta 1ª, Valencia 46026, Spain
| | - Juan Antonio García-Velasco
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain, Avenida Fernando Abril Martorell, 106 - Biopolo, Torre A, Planta 1ª, Valencia 46026, Spain; Department of Reproductive Medicine, IVIRMA Madrid, Av. del Talgo, 68, Madrid 28023, Spain; University Rey Juan Carlos, C. Tulipán, Móstoles Madrid 28933, Spain
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Singhal R, Dickerson L, Sakran N, Pouwels S, Chiappetta S, Weiner S, Purkayastha S, Madhok B, Mahawar K. Safe Surgery During the COVID-19 Pandemic. Curr Obes Rep 2022; 11:203-214. [PMID: 34709586 PMCID: PMC8552630 DOI: 10.1007/s13679-021-00458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW Coronavirus Disease-2019 (COVID-19) has had an enormous impact on all aspects of healthcare, but its effect on patients needing surgery and surgeons has been disproportionate. In this review, we aim to understand the impact of the pandemic on surgical patients and teams. We compiled the emerging data on pre-operative screening methods, vaccinations, safe-surgery pathways and surgical techniques and make recommendations for evidence-based safe-surgical pathways. We also present surgical outcomes for emergency, oncological and benign surgery in the context of the pandemic. Finally, we attempt to address the impact of the pandemic on patients, staff and surgical training and provide perspectives for the future. RECENT FINDINGS Surgical teams have developed consensus guidelines and established research priorities and safety precautions for surgery during the COVID-19 pandemic. Evidence supports that surgery in patients with a peri-operative SARS-CoV-2 infection carries substantial risks, but risk mitigation strategies are effective at reducing harm to staff and patients. Surgery has increased risk for patients and staff, but this can be mitigated effectively, especially for elective surgery. Elective surgery can be safely performed during the COVID-19 pandemic employing the strategies discussed in this review.
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Affiliation(s)
- Rishi Singhal
- Upper GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK.
| | - Luke Dickerson
- Department of General Surgery, Leighton Hospital, Crewe, UK
| | - Nasser Sakran
- Director Bariatric Centre, Department of Surgery, Emek Medical Centre, Afula, Israel
- The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Sonja Chiappetta
- Head Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy
| | - Sylvia Weiner
- Department of Obesity and Metabolic Surgery, Krankenhaus Nordwest, Frankfurt am Main, Germany
| | | | | | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
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Kukull B, Shakir SM, Hanson KE. Performance of Non-Nasopharyngeal Sample Types for Molecular Detection of SARS-CoV-2. Clin Lab Med 2022; 42:249-259. [PMID: 35636825 PMCID: PMC8860668 DOI: 10.1016/j.cll.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Silva-Ayarza I, Bachelet VC. What we know and dont know on SARS-CoV-2 and COVID-19. Medwave 2021; 21:e8198. [PMID: 34213514 DOI: 10.5867/medwave.2021.04.8198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus discovered in December 2019 in Wuhan, China, has had an enormous impact on public health worldwide due to its rapid spread and pandemic behavior, challenges in its control and mitigation, and few therapeutic alternatives. In this review, we summarize the pathophysiological mechanisms, clinical presentation, and diagnostic techniques. In addition, the main lineages and the different strategies for disease prevention are reviewed, with emphasis on the development of vaccines and their different platforms. Finally, some of the currently available therapeutic strategies are summarized. Throughout the article, we point out the current knowns and unknowns at the time of writing this article.
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Affiliation(s)
- Ignacio Silva-Ayarza
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile; Departamento de Infectología, Hospital Barros Luco, Santiago, Chile. Adress: Escuela de Medicina, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins 3363, Estación Central, Santiago, Chile. . ORCID: 0000-0002-6996-3695
| | - Vivienne C Bachelet
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile. ORCID: 0000-0002-5715-9755
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