Abstract
In order to prevent in-hospital transmission and potential complications related to SARS-CoV-2 in the perioperative patient, most healthcare institutions require preoperative testing for SARS-CoV-2 prior to proceeding with elective surgery. The Centers for Disease Control and Prevention (CDC) recommends a time and symptom-based duration of isolation for the presumed infectious period. The guidance to avoid retesting of asymptomatic patients in the 90 days following a positive reverse transcription polymerase chain reaction (RT-PCR) test is because of the possibility of detection of non-infectious viral shedding. When to reschedule asymptomatic patients who test RT-PCR positive for SARS-CoV-2 preoperatively is of considerable debate, both from the perspective of ensuring a patient’s full preoperative fitness, as well as reducing the risk of viral transmission within the hospital. We describe the novel perioperative use of a strand-specific assay to detect minus strand ribonucleic acid (RNA) in a clinical decision-making algorithm to determine optimal timing of elective surgery after a patient tests RT-PCR positive for SARS-CoV-2. This is the first description in the literature of an attempt to further stratify patients who repeatedly test positive for SARS-CoV-2 into infectious versus non-infectious for perioperative planning.
【초록키워드】 SARS-CoV-2, hospital, viral shedding, risk, Transmission, prevention, RT-PCR, RNA, polymerase chain reaction, CDC, healthcare, disease control, Algorithm, Patient, Isolation, Control, Complication, Viral transmission, reverse transcription, asymptomatic patients, Guidance, asymptomatic patient, Elective surgery, Ribonucleic acid, Chain Reaction, In-hospital, Perspective, center, positive, non-infectious, Prevent, strand, polymerase chain, detect, determine, reducing, 【제목키워드】 SARS-CoV-2, reverse transcription, novel, clinical decision, polymerase chain, positive patient,