Department of Orthopaedic Surgery, Brown University Warren Alpert Medical School, Providence, RI, USA.
Spinal Cord Ser Cases. 2021 Nov 19;7(1):100. doi: 10.1038/s41394-021-00465-8.
We present the unique case of a nosocomial COVID infection acquired after urgent surgical intervention for cervical myelopathy, as well as the sequelae that followed in the postoperative period.
An initially COVID-negative patient underwent urgent surgical intervention for cervical myelopathy with significant neurological deterioration. She underwent an uncomplicated staged anterior cervical discectomy and fusion with corpectomy, as well as a subsequent posterior cervical instrumented fusion within the same hospitalization. The patient would refuse to adhere to standard COVID precautions during her admission and demonstrated rapid decompensation following her particularly uneventful surgeries, ultimately leading to her expiration. A laboratory test confirmed that she had contracted COVID at the time of the patient's death.
This report highlights the repercussions of COVID-19 infection during the perioperative period and its implications on surgical outcomes. The stresses of surgery and the body's immunosuppressive responses during this time place patients at particular risk for the contraction of this virus. The standard precautions should be followed and vaccination should be considered for surgical candidates prior to their operations, as they become more readily accessible.
我们报告了一例独特的院内 COVID 感染病例，该病例发生在因颈椎脊髓病进行紧急手术干预之后，以及随后在术后期间出现的后遗症。
最初 COVID 检测阴性的患者因颈椎脊髓病出现严重神经功能恶化而接受紧急手术干预。她在同一住院期间接受了无并发症的分期前路颈椎间盘切除术和椎体切除术融合术，以及随后的后路颈椎器械融合术。该患者在住院期间拒绝遵守标准 COVID 预防措施，并在手术后特别顺利的情况下迅速恶化，最终导致她死亡。实验室检测证实，在患者死亡时她感染了 COVID。
本报告强调了围手术期 COVID-19 感染的影响及其对手术结果的影响。手术期间的压力和身体的免疫抑制反应使患者特别容易感染这种病毒。应遵循标准预防措施，并应考虑在手术前为手术候选人接种疫苗，因为疫苗更容易获得。
