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2020, Number 1

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Cir Plast 2020; 30 (1)

How do I rule out the diagnosis of COVID-19 in a patient undergoing elective surgery? Safety recommendations for surgeries performed during the COVID-19 pandemic. Evidence Based Medicine

Morales-Olivera M

Language: Spanish
References: 35
Page: 22-32
PDF size: 268.18 Kb.


ABSTRACT

The diagnosis of the disease by the new coronavirus (SARSCov-2) represents a real challenge in those asymptomatic patients; since, none of the available diagnostic tests reaches has a sensitivity of 100%. As part of the returning to surgical activities, it is essential to perform a preoperative assessment that includes the detection of a probable inadvertent infection with SARS-CoV-2. Therefore, the objective of this work is to identify which the most useful and sensitive diagnostic methods are in our setting based on the best available medical evidence prior to any elective surgery. A systematic review was carried out on the main information sites (PubMed, Medline, Cochrane, and Ovid) in Spanish and English, with the keywords: diagnosis, diagnostic tests, SARS-CoV-2, COVID-19, and coronavirus. Subsequently, the basic questions were written and answered based on the best available medical evidence. According to the information, that polymerase chain reaction was find to be the gold standard for the detection of SARS-CoV-2; however, its sensitivity ranges from 60 to 89% with a high possibility of both false positive and negative. Simple chest tomography has reported a sensitivity of up to 98% in some studies and rapid tests for IgG and IgM, as well as the search for antibodies with a sensitivity as low as 34%. In the preoperative protocol, the best way to identify an asymptomatic patient with COVID-19 is performing the polymerase chain reaction together with simple chest tomography.


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