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重复检测在冠状动脉搭桥手术患者中检测2019冠状病毒病(COVID-19)的重要性。

The importance of repeat testing in detecting coronavirus disease 2019 (COVID-19) in a coronary artery bypass grafting patient.

作者信息

Fisher Bryant, Seese Laura, Sultan Ibrahim, Kilic Arman

机构信息

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

出版信息

J Card Surg. 2020 Jun;35(6):1342-1344. doi: 10.1111/jocs.14604. Epub 2020 May 12.

Abstract

While elective cardiac surgeries have been postponed to prevent coronavirus disease 2019 (COVID-19) transmission and to reduce resource utilization, patients with urgent indications necessitating surgery may still be at risk of contracting the disease throughout their postoperative recovery. We present a case of an 81-year-old female who underwent urgent coronary artery bypass grafting and was readmitted following discharge to a nursing facility with a cluster of COVID-19 cases. Despite symptomatology and imaging concerning for COVID-19, two initial reverse transcription polymerase chain reaction (RT-PCR) tests were negative but a third test was positive. This case emphasizes the risks of discharge location in the COVID-19 era as well as the importance of clinical suspicion, early isolation practices for those presumed positive, and repeat testing, given the marginal sensitivity of available COVID-19 RT-PCR.

摘要

为防止2019冠状病毒病(COVID-19)传播并减少资源利用,择期心脏手术已被推迟,但有紧急手术指征的患者在术后恢复过程中仍可能有感染该疾病的风险。我们报告一例81岁女性患者,她接受了紧急冠状动脉旁路移植术,出院后入住一家出现COVID-19病例聚集的护理机构。尽管有COVID-19相关的症状和影像学表现,但最初的两次逆转录聚合酶链反应(RT-PCR)检测均为阴性,而第三次检测呈阳性。该病例强调了COVID-19时代出院地点的风险,以及临床怀疑、对疑似阳性患者早期隔离措施和重复检测的重要性,因为现有的COVID-19 RT-PCR检测灵敏度有限。

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