ABSTRACT
CASE: We report the case of a 64-year-old man who presented with a late onset of acute periprosthetic joint infection after total knee arthroplasty and a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. We describe our perioperative protocol and challenges for ensuring the safety of healthcare providers while operating on a coronavirus disease 2019 (COVID-19)-positive patient. CONCLUSIONS: Given the incredible spread of COVID-19 globally, hospitals should anticipate perioperative protocols for the surgical management of COVID-19-positive patients with concurrent pathology to ensure safety to healthcare providers.
Subject(s)
Arthritis, Infectious/surgery , Betacoronavirus , Coronavirus Infections , Infection Control/methods , Pandemics , Pneumonia, Viral , Prosthesis-Related Infections/surgery , Arthritis, Infectious/complications , COVID-19 , Humans , Knee Prosthesis/adverse effects , Male , Middle Aged , Prosthesis-Related Infections/complications , SARS-CoV-2ABSTRACT
BACKGROUND: With the novel coronavirus-induced disease (COVID-19), there is the fear of nosocomial infections and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions to healthcare workers (HCW). We report the case of a 64-year-old male patient who underwent explantation of a shoulder prosthesis due to a periprosthetic infection. He was tested SARS-CoV-2 positive 7 days after admission to the orthopaedic department following strict infection control measures, routinely including screening all patients for multi-drug-resistant organism (MDRO) colonization upon admission. Aim of our study is to report on the spreading potential of SARS-CoV-2 in a healthcare setting if standard contact precautions and infection control measures have been established. METHODS: All HCW with exposure to the patient from day of admission until confirmed diagnosis of COVID-19 were identified and underwent oropharyngeal swab testing for SARS-CoV-2 by real-time RT-PCR. RESULTS: Sixty-six HCW were identified: nine orthopaedic surgeons, four anaesthesiologists, 25 orthopaedic nurses, five nurse anesthetists, eight scrub nurses, five nursing students, two medical assistants and seven service employees. Fourteen HCW (21%) showed clinical symptoms compatible with a SARS-CoV-2 infection: cough (n = 4), sore throat (n = 3), nasal congestion (n = 3), dyspnea (n = 2), fever (n = 1), headache and myalgia (n = 1). SARS-CoV-2 was not detected in any of the 66 HCW. CONCLUSION: Hygienic measures and contact precautions, aimed at preventing the spread of MRDO, may have helped to prevent a SARS-CoV-2 transmission to HCW-despite high-risk exposure during intubation, surgical treatment and general care. LEVEL OF EVIDENCE: IV, case series.
Subject(s)
COVID-19 , Health Personnel , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Exposure , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Nucleic Acid Testing/methods , Contact Tracing/methods , Device Removal/methods , Health Personnel/classification , Health Personnel/statistics & numerical data , Humans , Infection Control/methods , Infection Control/organization & administration , Male , Middle Aged , Occupational Exposure/analysis , Occupational Exposure/prevention & control , Orthopedic Procedures/methods , Prosthesis-Related Infections/surgery , Risk Management , SARS-CoV-2 , Shoulder/surgeryABSTRACT
The COVID-19 pandemic has greatly impacted the daily clinical practice of cardiologists and cardiovascular surgeons. Preparedness of health workers and health services is crucial to tackle the enormous challenge posed by SARS-CoV-2 in wards, operating theatres, intensive care units, and interventionist laboratories. This Clinical Review provides an overview of COVID-19 and focuses on relevant aspects on prevention and management for specialists within the cardiovascular field.
Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Betacoronavirus/pathogenicity , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Endocarditis/surgery , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Prosthesis-Related Infections/surgery , SARS-CoV-2ABSTRACT
The novel coronavirus, now termed SARS-CoV-2, has caused a significant global impact in the space of 4 months. Almost all elective cardiac surgical operations have been postponed with only urgent and emergency operations being considered in order to maximise resource utilisation. We present a case of a 69-year old lady with an infected prosthetic aortic valve for consideration of urgent inpatient surgery. Despite being asymptomatic and testing negative initially for COVID-19 RT-PCR swab, further investigations with CT revealed suspicious findings. She subsequently tested positive on a repeat swab and unfortunately deteriorated rapidly with complications including gastro-intestinal and intracerebral haemorrhage.