Abstract
Multiple tissue samples were obtained during emergent abdominal surgery in 4 patients with coronavirus disease 2019 (COVID-19) to examine for tissue involvement by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first patient underwent a laparoscopic cholecystectomy for gallbladder empyema and died from severe respiratory failure. The second patient with Crohn disease underwent emergent laparotomy for a perforation in the terminal ileum and recovered. The third patient underwent an open appendectomy and recovered. The fourth patient underwent emergent laparotomy for a perforated peptic ulcer and died from sepsis. Although the SARS-CoV-2 RNA was found in the feces of 3 patients and in the duodenal wall of the patient with perforated peptic ulcer, real time reverse transcriptase polymerase chain reaction (RT-PCR) examination of abdominal fluid was negative for the virus. The RT-PCR did not detect viral RNA in the wall of small intestine, appendix, gallbladder, bile, liver, and urine. Visceral fat (omentum) and abdominal subcutaneous fat of 4 patients were also not infected with the SARS-CoV-2. Although this limited experience did not show direct involvement of abdominal fluid and omentum, assessment in large series is suggested to provide answers about the safety of abdominal surgery in patients with COVID-19.
【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Respiratory failure, severe respiratory failure, Sepsis, severe acute respiratory syndrome Coronavirus, RT-PCR, virus, RNA, Crohn disease, polymerase chain reaction, Viral, feces, Patient, Urine, SARS-CoV-2 RNA, Viral RNA, respiratory, liver, real time, reverse transcriptase, Chain Reaction, abdominal surgery, subcutaneous fat, Perforation, acute respiratory syndrome, laparoscopic cholecystectomy, open appendectomy, peptic ulcer, duodenal wall, acute respiratory syndrome coronavirus, tissue, acute respiratory syndrome coronavirus 2, small intestine, bile, Multiple, transcriptase, Appendix, wall, ulcer, Empyema, Gallbladder, fat, polymerase chain, omentum, terminal ileum, detect, died, the patient, tissue sample, suggested, patients with COVID-19, the SARS-CoV-2, 【제목키워드】 SARS-CoV-2, surgery, detection,