tetano
Editor, Senior Moderator
Am Surg
. 2022 Feb 11;31348211067707.
doi: 10.1177/00031348211067707. Online ahead of print.
SARS-CoV-2 Testing of Aerosols Emitted During Pediatric Minimally Invasive Surgery: A Prospective, Case-Controlled Study
Zaid Haddadin[SUP] 1 [/SUP], Natasha Halasa[SUP] 2 [/SUP], Rendie McHenry[SUP] 2 [/SUP], Rebekkah Varjabedian[SUP] 2 [/SUP], Tricia L Lynch[SUP] 2 [/SUP], Heidi Chen[SUP] 3 [/SUP], Muhammad Owais Abdul Ghani[SUP] 4 [/SUP], Jonathan E Schmitz[SUP] 5 [/SUP], Jennifer Sucre[SUP] 6 [/SUP], Kimberly Isenberg[SUP] 4 [/SUP], Irving Zamora[SUP] 4 [/SUP], Melissa Danko[SUP] 4 [/SUP], Martin Blakely[SUP] 4 [/SUP], Jacob Olson[SUP] 4 [/SUP], Gretchen P Jackson[SUP] 4 [/SUP], Harold N Lovvorn 3rd[SUP] 4 [/SUP]
Affiliations
Abstract
Background: The COVID-19 pandemic has presented significant safety concerns for healthcare providers, especially those performing aerosol-generating procedures. Several surgical societies issued early warnings that aerosols generated during minimally invasive surgery (MIS) could harbor infectious quantities of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study tested the hypothesis that MIS-aerosols contain SARS-CoV-2.
Methods: To evaluate SARS-CoV-2 presence in aerosols emitted during intracavitary MIS, children <18 years who required emergent MIS and were discovered to be SARS-CoV-2-positive were enrolled. Swabs were obtained from the port in-line with a filtered smoke evacuation system, the tubing adjacent to this port, the fluid collection chamber and filter, and the distal endotracheal tube (ETT). All swabs were analyzed for SARS-CoV-2 using quantitative reverse-transcription polymerase chain reaction. To evaluate viral distribution in tissues, fluorescence in situ hybridization for SARS-CoV-2 was performed on resected specimens. Outcomes were recorded, and participating healthcare workers were tracked for SARS-CoV-2 conversion.
Results: From July 1, 2020, to June 30, 2021, 11 children requiring emergent MIS were discovered preoperatively to be SARS-CoV-2 positive (median age: 14 years [5-17]). SARS-CoV-2 was detected only in ETT swabs and not in surgical aerosols or specimens. Median operative time was 56.5 minutes (IQR: 46-66), and postoperative stay was 21.2 hours (IQR: 1.97-57.57). No complications or viral eruption were recorded, and none of 63 healthcare workers tested positive for SARS-CoV-2 within 6 weeks.
Discussion: SARS-CoV-2 was detected only in ETT secretions and not in surgical aerosols or specimens among a pediatric cohort of asymptomatic patients having emergent MIS.
. 2022 Feb 11;31348211067707.
doi: 10.1177/00031348211067707. Online ahead of print.
SARS-CoV-2 Testing of Aerosols Emitted During Pediatric Minimally Invasive Surgery: A Prospective, Case-Controlled Study
Zaid Haddadin[SUP] 1 [/SUP], Natasha Halasa[SUP] 2 [/SUP], Rendie McHenry[SUP] 2 [/SUP], Rebekkah Varjabedian[SUP] 2 [/SUP], Tricia L Lynch[SUP] 2 [/SUP], Heidi Chen[SUP] 3 [/SUP], Muhammad Owais Abdul Ghani[SUP] 4 [/SUP], Jonathan E Schmitz[SUP] 5 [/SUP], Jennifer Sucre[SUP] 6 [/SUP], Kimberly Isenberg[SUP] 4 [/SUP], Irving Zamora[SUP] 4 [/SUP], Melissa Danko[SUP] 4 [/SUP], Martin Blakely[SUP] 4 [/SUP], Jacob Olson[SUP] 4 [/SUP], Gretchen P Jackson[SUP] 4 [/SUP], Harold N Lovvorn 3rd[SUP] 4 [/SUP]
Affiliations
- PMID: 35148619
- DOI: 10.1177/00031348211067707
Abstract
Background: The COVID-19 pandemic has presented significant safety concerns for healthcare providers, especially those performing aerosol-generating procedures. Several surgical societies issued early warnings that aerosols generated during minimally invasive surgery (MIS) could harbor infectious quantities of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study tested the hypothesis that MIS-aerosols contain SARS-CoV-2.
Methods: To evaluate SARS-CoV-2 presence in aerosols emitted during intracavitary MIS, children <18 years who required emergent MIS and were discovered to be SARS-CoV-2-positive were enrolled. Swabs were obtained from the port in-line with a filtered smoke evacuation system, the tubing adjacent to this port, the fluid collection chamber and filter, and the distal endotracheal tube (ETT). All swabs were analyzed for SARS-CoV-2 using quantitative reverse-transcription polymerase chain reaction. To evaluate viral distribution in tissues, fluorescence in situ hybridization for SARS-CoV-2 was performed on resected specimens. Outcomes were recorded, and participating healthcare workers were tracked for SARS-CoV-2 conversion.
Results: From July 1, 2020, to June 30, 2021, 11 children requiring emergent MIS were discovered preoperatively to be SARS-CoV-2 positive (median age: 14 years [5-17]). SARS-CoV-2 was detected only in ETT swabs and not in surgical aerosols or specimens. Median operative time was 56.5 minutes (IQR: 46-66), and postoperative stay was 21.2 hours (IQR: 1.97-57.57). No complications or viral eruption were recorded, and none of 63 healthcare workers tested positive for SARS-CoV-2 within 6 weeks.
Discussion: SARS-CoV-2 was detected only in ETT secretions and not in surgical aerosols or specimens among a pediatric cohort of asymptomatic patients having emergent MIS.