Radiology Department, Hopital de Hautepierre, Strasbourg, France.
Surg Infect (Larchmt). 2020 Jun;21(5):416-421. doi: 10.1089/sur.2020.169. Epub 2020 May 13.
Coronavirus 2019 (COVID-19) in the post-operative period is challenging. Its clinical manifestations may have similarities to other septic, thoracic, or gastrointestinal post-surgical complications. Additionally, the post-operative period may be a time of increased risk for severe manifestations of COVID-19. We sought to evaluate the frequency of COVID-19 in a cohort of patients who had recently had operations who were undergoing imaging for acute symptoms and the role of chest computed tomography (CT) in this setting. We included all patients who had chest CT for acute symptoms in the 15 days after a surgical procedure between March 1 and 31, 2020. Of 46 patients with acute post-operative symptoms requiring chest imaging, eight (17%) were ultimately diagnosed with COVID-19. Among them, five (62%) required mechanical ventilation and two (25%) died. All had abnormal chest CT with typical findings of COVID-19 in 87%. Computed tomography provided an alternate diagnosis in 53% of patients who did not have COVID-19. The average time between a COVID-19-positive chest CT and the polymerase chain reaction (PCR) confirmation was 1.2 days (range, 0-4 days). COVID-19 is a serious post-operative condition associated with significant morbidity and mortality. Chest CT provides prompt diagnosis of COVID-19. In centers with a high prevalence of COVID-19, chest acquisition should be included in CT scans done for acute post-operative symptoms.
新冠肺炎(COVID-19)在术后期间是具有挑战性的。其临床表现可能与其他脓毒症、胸部或胃肠道术后并发症相似。此外,术后期间可能是 COVID-19 严重表现风险增加的时期。我们旨在评估在一组近期接受手术且正在接受急性症状影像学检查的患者中 COVID-19 的发生频率,以及胸部计算机断层扫描(CT)在这种情况下的作用。我们纳入了 2020 年 3 月 1 日至 31 日期间,在手术后 15 天内因急性术后症状而接受胸部 CT 的所有患者。在 46 名因急性术后症状而需要进行胸部影像学检查的患者中,最终有 8 例(17%)被诊断为 COVID-19。其中,5 例(62%)需要机械通气,2 例(25%)死亡。所有患者的胸部 CT 均异常,87%的患者有 COVID-19 的典型表现。在没有 COVID-19 的患者中,53%的患者通过 CT 提供了其他诊断。COVID-19 阳性胸部 CT 和聚合酶链反应(PCR)确认之间的平均时间为 1.2 天(范围,0-4 天)。COVID-19 是一种严重的术后疾病,与显著的发病率和死亡率相关。胸部 CT 可快速诊断 COVID-19。在 COVID-19 高发地区,应在为急性术后症状进行的 CT 扫描中包括胸部采集。