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Should Elective Surgical Procedures Be Delayed in Pediatric Cases in Covid-19 Pandemic? Until When? Is Pcr Required in The Preoperative Period?

Year 2022, Volume: 16 Issue: 3, 215 - 219, 30.05.2022
https://doi.org/10.12956/tchd.908015

Abstract

Objective: The COVID-19 pandemic has led to major changes in healthcare around the world, including postponing elective surgery. The aim of this study is to examine the COVID-19 test results in pediatric patients who are asymptomatic and have no history of contact with a COVID-19 case prior to their scheduled elective surgery.


Material and Methods:
This prospective study has evaluated pediatric patients who were asymptomatic and had no contact history with a COVID-19 case and who were scheduled for elective surgery between 01.05.2020-31.10.2020 in one of the world’s largest pediatric hospitals. Nasopharyngeal swab (PCR) samples were obtained from all patients one day before the scheduled elective surgery.


Results:
Eight hundred twelve patients in this study had a mean age of 6.98 ± 4.37 years. The PCR test was positive in 4 patients (0.49%), and one patient had diarrhea during the quarantine period of 15 days.

Conclusion: The low PCR positivity rate in patients scheduled for elective surgery after a detailed history and physical examination raises the question whether elective surgery can be planned without testing. Pediatric surgeons can continue elective surgical procedures by taking precautions, but without requesting PCR, in patients who are asymptomatic and have no suspicious contact history.

References

  • Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382:727-33.
  • Organization WH. Novel Coronavirus (2019-nCoV) situation reports. 2020 (situation report-51). 2020.
  • Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020;109:1088-95.
  • Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. Lancet 2020;395:945-7.
  • Kennedy DM, Zambrano GJ, Wang Y, Neto OP. Modeling the effects of intervention strategies on COVID-19 transmission dynamics. J Clin Virol 2020;128:104440.
  • Surgeons ACo. COVID-19 guidelines for triage of emergency general surgery patients 2020.
  • Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323:1406-7.
  • Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020;69:377-81.
  • Şenel E. Child Trauma and Burn Follow up During the SARS-CoV-2 (COVID-19) Pandemic. In: Bostancı İ, ed. SARS-CoV-2 in child health (COVID-19). 1. Turkey: Turkey Clinics 2020:58-61.
  • Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020;323:1843-4.
  • Lopez AS, Hill M, Antezano J, Vilven D, Rutner T, Bogdanow L, et al. Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities - Salt Lake City, Utah, April-July 2020. MMWR Morb Mortal Wkly Rep 2020;69:1319-23.
  • Zhu Y, Bloxham CJ, Hulme KD, Sinclair JE, Tong ZWM, Steele LE, et al. Children are unlikely to have been the primary source of household SARS-CoV-2 infections. medRxiv 2020:2020.03.26.20044826.
  • Rajmil L. Role of children in the transmission of the COVID-19 pandemic: a rapid scoping review. BMJ Paediatr Open 2020;4:e000722.
  • Geng-Ramos G, Cronin JA, Heitmiller E, Delaney M, Sandler A, Kelly SM, et al. Implementation and expansion of a preoperative COVID-19 testing process for pediatric surgical patients. Paediatr Anaesth 2020;30:952-3.
  • Sii CKS, Lee JA, Nah SA. Early experience with universal preoperative and pre-procedural screening for COVID-19 in low-risk pediatric surgical patients requiring general anesthesia. Pediatr Surg Int 2020;36:1407-11.
  • Li Y, Zeng L, Li Z, Mao Q, Liu D, Zhang L, et al. Emergency trauma care during the outbreak of corona virus disease 2019 (COVID-19) in China. World J Emerg Surg 2020;15:33.

Covid-19 Pandemisinde Çocuklarda Elektif Cerrahi İşlemler Ertelenmeli mi? Ne zamana kadar? Preoperatif Dönemde Pcr Gerekli midir?

Year 2022, Volume: 16 Issue: 3, 215 - 219, 30.05.2022
https://doi.org/10.12956/tchd.908015

Abstract

Amaç: COVID-19 salgını, elektif cerrahiyi ertelemek de dahil olmak üzere dünya çapında sağlık hizmetlerinde büyük değişikliklere yol açtı. Bu çalışmanın amacı, planlanmış elektif cerrahi öncesinde bir COVID-19 vakasıyla temas öyküsü olmayan asemptomatik pediatrik hastalarda COVID-19 test sonuçlarını incelemektir.


Gereç ve Yöntemler:
Bu prospektif çalışma, dünyanın en büyük pediatrik hastanelerinden birinde, 01.05.2020-31.10.2020 tarihleri arasında, asemptomatik olan, COVID-19 vakasıyla temas öyküsü olmayan ve elektif cerrahi planlanan pediatrik hastaları değerlendirdi. Tüm hastalardan planlanan elektif cerrahiden bir gün önce nazofaringeal sürüntü (PCR) örnekleri alındı.

Bulgular: Bu çalışmada 847 hastanın ortalama yaşı 6.98±4.37 yıldı. PCR testi 4 hastada (% 0.49) pozitifti ve 15 günlük karantina döneminde bir hastada ishal görüldü.

Sonuç: Ayrıntılı bir öykü ve fizik muayene sonrasında elektif cerrahi planlanan hastalarda düşük PCR pozitiflik oranı, elektif cerrahinin testsiz planlanıp planlanamayacağı sorusunu gündeme getirmektedir. Pediatrik cerrahlar asemptomatik ve temas öyküsü olmayan hastalarda önlem alarak, ancak PCR istemeden elektif cerrahi işlemlere devam edebilirler.

References

  • Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382:727-33.
  • Organization WH. Novel Coronavirus (2019-nCoV) situation reports. 2020 (situation report-51). 2020.
  • Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020;109:1088-95.
  • Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. Lancet 2020;395:945-7.
  • Kennedy DM, Zambrano GJ, Wang Y, Neto OP. Modeling the effects of intervention strategies on COVID-19 transmission dynamics. J Clin Virol 2020;128:104440.
  • Surgeons ACo. COVID-19 guidelines for triage of emergency general surgery patients 2020.
  • Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323:1406-7.
  • Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020;69:377-81.
  • Şenel E. Child Trauma and Burn Follow up During the SARS-CoV-2 (COVID-19) Pandemic. In: Bostancı İ, ed. SARS-CoV-2 in child health (COVID-19). 1. Turkey: Turkey Clinics 2020:58-61.
  • Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020;323:1843-4.
  • Lopez AS, Hill M, Antezano J, Vilven D, Rutner T, Bogdanow L, et al. Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities - Salt Lake City, Utah, April-July 2020. MMWR Morb Mortal Wkly Rep 2020;69:1319-23.
  • Zhu Y, Bloxham CJ, Hulme KD, Sinclair JE, Tong ZWM, Steele LE, et al. Children are unlikely to have been the primary source of household SARS-CoV-2 infections. medRxiv 2020:2020.03.26.20044826.
  • Rajmil L. Role of children in the transmission of the COVID-19 pandemic: a rapid scoping review. BMJ Paediatr Open 2020;4:e000722.
  • Geng-Ramos G, Cronin JA, Heitmiller E, Delaney M, Sandler A, Kelly SM, et al. Implementation and expansion of a preoperative COVID-19 testing process for pediatric surgical patients. Paediatr Anaesth 2020;30:952-3.
  • Sii CKS, Lee JA, Nah SA. Early experience with universal preoperative and pre-procedural screening for COVID-19 in low-risk pediatric surgical patients requiring general anesthesia. Pediatr Surg Int 2020;36:1407-11.
  • Li Y, Zeng L, Li Z, Mao Q, Liu D, Zhang L, et al. Emergency trauma care during the outbreak of corona virus disease 2019 (COVID-19) in China. World J Emerg Surg 2020;15:33.
There are 16 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section ORIGINAL ARTICLES
Authors

Elif Emel Erten 0000-0002-3666-295X

Can Öztorun 0000-0002-5408-2772

Ahmet Ertürk 0000-0002-8156-5665

Sabri Demir 0000-0003-4720-912X

Doğuş Güney 0000-0001-7168-2123

Gülsüm İclal Bayhan 0000-0002-1423-4348

Süleyman Arif Bostancı 0000-0002-7512-3895

Hayal Doruk This is me 0000-0001-9711-137X

Gülsen Keskin 0000-0002-9990-5533

Sarper Müftüoğulları This is me 0000-0002-9295-2396

Müjdem Azılı 0000-0002-5137-7209

Emrah Şenel 0000-0002-0383-4559

Publication Date May 30, 2022
Submission Date April 5, 2021
Published in Issue Year 2022 Volume: 16 Issue: 3

Cite

Vancouver Erten EE, Öztorun C, Ertürk A, Demir S, Güney D, Bayhan Gİ, Bostancı SA, Doruk H, Keskin G, Müftüoğulları S, Azılı M, Şenel E. Should Elective Surgical Procedures Be Delayed in Pediatric Cases in Covid-19 Pandemic? Until When? Is Pcr Required in The Preoperative Period?. Türkiye Çocuk Hast Derg. 2022;16(3):215-9.


The publication language of Turkish Journal of Pediatric Disease is English.


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