Adv Pediatr Surg.  2021 Jun;27(1):1-7. 10.13029/aps.2021.27.1.1.

Experiences of Preoperative COVID-19 Screening in Pediatric Patients in a Secondary Care Center

Affiliations
  • 1Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea

Abstract

Purpose
In the time of the global coronavirus disease 2019 (COVID-19) pandemic, preoperative confirmation of COVID-19 infection in patients in need of surgery is critical for the safety of medical staff and patients. Our purpose in this study was to analyze the experience with preoperative COVID-19 screening tests on naso-pharyngeal swabs in pediatric patients requiring surgery.
Methods
From May 1st to December 31st, 2020, we retrospectively reviewed the medical records of patients under 18 who had undergone elective and emergency pediatric surgery in Kangwon National University Hospital. During this period, all patients were tested for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) preoperatively on their nasopharyngeal smears (Allplex™ 2019-nCoV Assay, Xpert® Xpress SARS-CoV-2). Patients were divided into 2 groups before (group A) and after (group B) the introduction of Xpert® Xpress SARS-CoV-2, and the COVID-19 positive rate was confirmed by classifying the patients into 4 groups according to the risk of COVID-19 infection as assessed by clinical judgment.
Results
We screened 45 patients, of whom 35 (77.8%) were asymptomatic patients, and 10 (22.2%) had a fever. Elective surgery was done after checking the screening results in all cases. For emergency surgery patients (n=25), before the introduction of Xpert® , only 3 out of 13 (23%) patients had emergency surgery after the screening results were confirmed. However, after the introduction of Xpert® , all patients had emergency surgery after the screening results were confirmed. All patients were confirmed negative.
Conclusion
Clinical judgment on the risk of COVID-19 infection and the introduction of the Xpert® test for emergency surgery patients resulted in safe surgery for all patients without COVID-19 exposure.

Keyword

COVID-19; SARS-CoV-2; Pediatrics; General surgery; Screening; Secondary care center
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