COVID-19 Outbreak and Surgical Practice: Unexpected Fatality in Perioperative Period

Abstract

: Little is known about surgical practice in the initial phase of coronavirus disease 2019 (COVID-19) global crisis. This is a retrospective case series of 4 surgical patients (cholecystectomy, hernia repair, gastric bypass, and hysterectomy) who developed perioperative complications in the first few weeks of COVID-19 outbreak in Tehran, Iran in the month of February 2020. COVID-19 can complicate the perioperative course with diagnostic challenge and a high potential fatality rate. In locations with widespread infections and limited resources, the risk of elective surgical procedures for index patient and community may outweigh the benefit.

Conflict of interest statement

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. None was directly related to the study.

The authors report no conflicts of interest.

Figures

FIGURE 1

Chest CT scan of COVID-19 pneumonia. A, Case 1: Bilateral large areas of ground-glass opacities and consolidations, giving a white lung appearance, 19 d after an elective incisional hernia repair. B, Case 2: Unilateral peripheral ground-glass opacities 16 d after laparoscopic cholecystectomy. C, Case 3: Bilateral dependent consolidations in lung bases with minimal pleural effusion 3 d after hysterectomy and cholecystectomy.

FIGURE 1 (Continued)

Chest CT scan of COVID-19 pneumonia. A, Case 1: Bilateral large areas of ground-glass opacities and consolidations, giving a white lung appearance, 19 d after an elective incisional hernia repair. B, Case 2: Unilateral peripheral ground-glass opacities 16 d after laparoscopic cholecystectomy. C, Case 3: Bilateral dependent consolidations in lung bases with minimal pleural effusion 3 d after hysterectomy and cholecystectomy.