Chest CT Scan or RT-PCR: Which One is Appropriate for Screening of COVID-۱۹ among the Surgical Patients in the Preoperative Period? A Case Report

Coronavirus disease ۲۰۱۹ (COVID-۱۹) is associated with high morbidity and mortality. It has been a significant impact on the surgical care of the patients. There is still no consensus on elective surgeries under time epochs with national partial control of the disease. The objective is to report the clinical course of the surgical patient who was eventually diagnosed with COVID-۱۹ despite preoperative screening. A ۶۹ years old woman was referred to the surgical ward for elective low anterior resection (LAR). The complete preoperative workup was performed with acceptable results. Reverse transcriptase-polymerase chain reaction (RT-PCR) of SARS-COV-۲ was not performed because the patient was asymptomatic and the surgical procedure was scheduled during the time of the country's partial pandemic control; the nadir of the curve in daily reported COVID-۱۹ patients. Following the surgery, the patient’s clinical status was stable for about ۸ hours; however, the patient became anuric and hypotensive, receiving a variety of treatments for a list of differential diagnoses, including fresh lung CT scan and RT-PCR test; both of the latter were positive for COVID-۱۹. Despite COVID-۱۹ management and respiratory support, the patient died on day ۱۵ of hospitalization. It seems that postponing elective surgeries if possible and general screening with RT-PCR in situations where delay in surgeries is not possible, are rationale strategies for surgical management of the patients during the COVID-۱۹ pandemic, even when the daily situation of the pandemic seems.

Keywords:

COVID-۱۹ , SARS-CoV-۲ , Screening , Elective Surgery