Understanding Surgical Risk During COVID-19 Pandemic: The Rationale Behind the Decisions

摘要

On January 2020, the World Health Organization (WHO) issued a global health alert for a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused an acute respiratory infection disease (COVID-19) which originated in Wuhan, Hubei Province, China. The COVID-19 pandemic, as declared by the WHO on March 2020, has led to over 770,000 cases worldwide reported at the end of March 2020, spreading on a logarithmic scale in Europe and the USA. As the need for hospitalization among symptomatic cases is ～10% globally, with an increased need for intensive care unit admission and 3% mortality, hospitals have started to intensively reduce elective activities including surgery to prepare for the high numbers of admissions (1). During SARS outbreaks, health care workers (HCWs) have a significantly increased risk of contracting the SARS-CoV. The risk of acute respiratory infection (ARI) transmission through surgical care services is not fully delineated. This is the reason why WHO guidelines recommend additional infection control measures for surgeons providing services on SARS-CoV-2 suspected patients. Furthermore, the effects of submitting a COVID-19 patient to surgery or general anesthesia on pulmonary functions and postoperative courses are unknown (2). The present article aims to delineate why the surgical patient constitutes a risk factor for SARS-CoV-2 transmission to HCWs while at the same time surgery itself constitutes a risk factor for patient’s safety during the COVID-19 pandemia.